I am back! In need of your excellent advice...

[Sarnano]

After successfully reducing to zero pred last autumn, the symptoms began to reappear. After advice about how to deal with a flare I increased the dose (to 15mg), but that didn't seem to help. Then I was given a depo-medrone injection, with the advice that it would last a couple of months and hopefully clear things up. It lasted two weeks. So, back to 15mg, then after two weeks down to 12.5 and finally down to 10. But nothing seemed to work. I have now been back to the rheumatologist who has prescribed methotrexate, to be taken weekly alongside continuing with 10mg pred. So... any experience/advice about methotrexate would be greatly appreciated. Seems a bit of a dangerous drug, doesn't it? And I am worried about the side effect of mouth ulcers, which I have suffered from most of my life, although not for the last ten years or so. I would hate to get them back on top of everything else. Any thoughts, or personal experience would be very welcome.

Thanks

S

[PMRpro Ambassador]

Had you included methotrexate in the title of your post you would have got links to 10 previous posts on methotrexate in the Related Posts. If you look in FAQs under M you will find a lot of info and if you use the search function and limit it to PMRGCAuk rather than all of HU you will also get a long list of relevant posts.

I have no doubt you googled it - and Google gave you all the terror stories for its use in oncology (cancer therapy). Its use in rheumatology is at a much lower dose and as a result the adverse effects are much less. You are given folic acid alongside the MTX and that mitigates the adverse effects, including the mouth ulcers. How much depends on the doctor - some give 1x5mg dose to be taken the day after the MTX, others up to 6 doses to be taken every day you don't take MTX.

It is the first line treatment for inflammatory arthritis and it sometimes has a very good effect in PMR so your doctor is covering all bases - only trialling it will show if it works for you.

[DorsetLady PMRGCAuk volunteer]

Had you inserted Methotrexate in the title of your post it would have brought up related posts - but this is a very recent one on same subject for a start -

healthunlocked.com/pmrgcauk...

..plus whole section from FAQs -

healthunlocked.com/pmrgcauk...