I’m new here and I’m reluctant to start the treatment prescribed by my doctor for psoriatic arthritis (methotrexate).

[L8bloomer]

Hello. This is my first post about this anywhere.

I am in my 50’s and have recently been diagnosed with psoriatic arthritis. My Rheumatologist has prescribed 17.5 mg weekly dose of Methotrexate, but I have not yet started taking it because I am afraid of the possibility that I might experience any of the horrible side effects that have been reported. Can anyone offer some perspective on the likelihood and severity of side effects at this dosage level? It doesn’t have to be scientific. Personal anecdotal information would also be much appreciated. TIA! 🥲

[Krazykat26]

Hi L8bloomer 🤗I don't have psoriatic arthritis..but I do have Subacute Cutaneous Lupus Erythematosus (SCLE) with secondary Sjogrens.

I am taking Methotrexate in oral form. I started it Dec 2019..alongside my other meds.. hydroxychloraquine and prednisolone. It has been a real game changer for me!! My rashes are more controlled and although I still flare it's not as prolonged as before...not as extensive either. I generally have a bit more energy too..it has given me some quality of life back!!

In 2019 I was started on 12.5mgs n that has increased to 15mgs which is my current dose with a view to increasing it so that I can reduce the pred further.

U don't say whether it's tablets that you'll be taking...sometimes they can cause gastric problems but I've been fine on the tablets. First dose I was a bit nauseous..I had a bit of distorted vision in one eye..like it was pixilated..and some numbness in my left hand which passed after a short while. That first dose though did make me feel quite drained.

However after about the third dose I was absolutely fine!!

I take it on a Sunday so I know that I've got the day to relax. My advice would be to do the same..pick a day that is relatively quiet so u can rest when/if needed.

You'll be having regular blood tests too..I have mine done every month currently..but when I was first prescribed it I had two weekly blood tests.

Folic acid is prescribed alongside MTX too..I take 5mgs every day EXCEPT the day I take the MTX.

If you do have any problems with the oral dose it can be injected too..so if you don't tolerate the tablets there's still an alternative!!

I hope that helps and most of all I hope that you get along with it..I really love the fact that I only take it once a week. 😹Good luck 🍀🍀🌈😽😽xx

[mary203]

Hi L8bloomer,I started methotrexate in Feb 2018. Presently I am on 20 mg weekly. I know that psoriatic arthritis can be difficult to deal with. When I first started methotrexate, I did experience nausea. But, I did learn that if I had something in my stomach, the nausea was much less.

I see my rheumatologist in January. I'm going to ask her if I could change to a different medication. My major problem has been hair loss. In early spring of this year, she suggested to take leucovorin 24 hours after the methotrexate. I had less hair loss for a short time, but now it's starting again.

I hope it does help you. Remember, since I have been on it for quite some time, the medication may not be as helpful for me now as it was years ago. Give it a try and then decide.

I wish you all the best. It's a difficult disease to deal with. But, stay positive.

Also, be sure you like and trust your rheumatologist. Watch your diet too.

I know if I have too much sugar, the pain does increase.

I hope this helps you. Good luck

[Surami2020]

Hi L8bloomer. I had the same worries when I started methotrexate last year. I started on 10mg and if you check with your rheumatologist this may be an option for you to reduce any side effects. I was only on it for 8 weeks as my rheumatologist thinks I am allergic to it. If you do start to get side effects that are interfering with your everyday life check in with your family doctor as they can help adding medications to reduce nausea etc. I am now on leflunomide for my psoriatic arthritis which has been working well and most of those side effects have disappeared. Good luck.

[Hidden]

Hello L8bloomer

I'm 51 and have had psoriasis most of my adult life and developed psoriatic arthritis around 6 years ago. I was prescribed methotrexate tablets for psoriasis in 2016.

My throat felt strange, it was closing up, I developed a cough and was very pale. I came off if after a few weeks. I was then given apremilast (otezla) instead.

This worked very well for a three years for my skin. Around this time, I developed joint pain and psoriatic arthritis was diagnosed due to long term psoriasis.

I am now on an Imraldi Biologic (also called Adalimumab). It is a copy of Humira and cheaper to prescribe now.

I inject it every fortnight. My skin is clear and joint pain much more manageable. It is an amazing treatment though it started waning a little for my joints 6 mnths ago (I needed steroid injections recently for joint pain) it is still working generally well for my skin so my consultant recommends I stay on it a bit longer.

Overall, biologics have given me two pain-free years!

Sorry I really don't have any positives from my methotrexate experience - I must've had an adverse reaction - but obviously others have found it helpful. As they say, you take folic acid and have regular blood checks. I agree with Mary about your diet and I've cut processed foods as much as possible.

...Just posting to let you know there are lots of treatment path options. I have had roughly 2/3 years success from various treatments but did not last at all on methotrexate...If MTX is not for you then I recommend you try a Biologic.

Good luck

[Hidden]

I have had PsA for over thirty years, my immune system was questionable and they tried me on this drug with associated medications. I was on injections and was very ill. There are various other Biologics they can also try, without success in my caseIt is quite important you are able to stand this drug as they will be checking your bloods very regular, includes White Blood Cells.

If you can manage for a period of time, they will try you on N-TNF medications they are quite expensive so they used to only give TNFs if you could get away with Biologics in the UK. In my case I was taken of Biologics and discharged from the Clinic/hospital, just a warning especially I would imagine at this time and COVID

You will most probably ok

Have your tried either Goat Milk Soap with Honey and Oats that seems to help you can also get Goat Milk Soap as well that seems to help me. Parmolive does a bath, Shower and hand clean that contains same type of contents, it seems to increase the moisture in the skin as well. I use it frequently although I have had to stop a while with the honey, I will be restarting soon

BOB

[alicesi]

Sulfasalazine is another option re Methotrexate

[Centerfield_34]

The benefits are worth it. I was scared at the start as well when taking methotrexate, I learned not to self diagnose myself and stop reading Dr. Google 😄the side effects are very rare and it is a life changer when it starts to work for you. Getting your life back and being able to do everyday things is all anyone can ask for. Feel free to ask anything else. Enjoy the day.