Does Intake Of Folitrax And Folivit Help In Treating Sarcoidosis?

Posted on Sat, 6 Aug 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 6 Aug 2016 Answered on

Mon, 29 Aug 2016 Last reviewed on

Question : Hi, My wife of age 60 is sufferering from sarcoidoisis and having nodules formation in chest area. Doctor has prescribed Folitrax 15 mg followed by Folivit 5 mg weekly. Please advise if it is the right medicine and safe. Also if there can be any adverse side effects.What other precautions should be taken?
Thanks
XXXX

Answered by Dr. Drkaushal85 (26 minutes later)

Brief Answer:
Better to first try methylprednisolone.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the reports you have attached.
Yes, possibility of sarcoidosis is more with these reports.
And best treatment for sarcoidosis is methylprednisolone (corticosteroids).
Methyprednisolone is more safe add effective as compare to methotrexate (folitrex).
So please let me know
1. Has she ever taken methylprednisolone?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wishing good health to your wife. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (12 minutes later)

Sir,
She was initially diagnosed with sarco in April 2011 and was put on Omnacortil
( Steroid) 20 mg gradually reduced to 5 mg and was responding well. In April 2013 she had relapse and doctor changed medicine to Folitrax 15 mg gradally reduced to 5 mg. By Dec 2015 she was perfectly well and medine was stopped. But in July 2016 a relapse was noted as per the uploaded reports. now she has again been put on Folitrax 15 mg. I find it strange because on the net everywhwere Folitrax is mentioned for cancer and arthiritis only. Please advise.

Answered by Dr. Drkaushal85 (11 minutes later)

Brief Answer:
What are her symptoms in present relapse?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I don't think she should take folitrex.
Better to start methyprednisolone.
Please let me know
1. What are her symptoms during this latest relapse?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wishing good health to your wife. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (26 minutes later)

Sir,
In fact there were no symptoms of any disease. It was routine quarterly check of blood sample for SACE which was found at raised level of 190.( Earlier it was well within the prescribed limits). this was followed by HRCT Chest of which report has been uploaded and which shows formation of nodules. However for last one month she is having fever and cough which the family doctor says is due to normal viral infection prevalent at this time and it is now mostly under control. She has also lost weight by about 4 Kg during this spell of fever , and is at 46 Kg. She is 5 Ft. 1 inch tall.
Please let me know likely adverse effects of Folitrax if taken for long time.

Answered by Dr. Drkaushal85 (8 hours later)

Brief Answer:
Has she ever undergone PFT?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Methotrexate is having many side effects.
Most common ones are gastritis, nausea, vomiting, bone marrow suppression, immunosuppression etc.
Immunosuppression makes patient vulnerable for infection with atypical organisms.
So I usually don't prefer Methotrexate. Instead, I prefer methylprednisolone as it is more potent, effective and less harmful.
Please let me know
1. Has she ever undergone PFT report?
2. If yes then what was her last PFT?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your wife. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (11 hours later)

Sir,
Lastly PFT was done in April 2011, when her Sarco problem was at it's peak. PFT was found normal. USG guided FNAC and Biopsy of Nodes in lungs was also done and was found benign. At that time her main symptoms were loss of appetite, weight loss, joint pains, blurred vision etc. and doctors started treatment with Omnicortil 20 mg as already mentioned above.
If we have to start again on Methylprednisolone, what should be the dosage and other accompanying medicine if any.

Answered by Dr. Drkaushal85 (23 minutes later)

Brief Answer:
What is her weight?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I would love to guide you the dosage of methylprednisolone.
But it's dose is directed on weight of patient. So please let me know your wife's current weight so that I can guide you dosage.
I will be happy to help you further. Wishing good health to your wife. Thanks.

Above answer was peer-reviewed by : Dr. Prasad