Mtx and nausea???

Hi everyone, well this is my 3rd week taking mtx now and feeling a bit fed up.

The first week I experienced quite bad nausea 2 days after taking it. I then anticipated feeling unwell the next week and was pleased that I only had a little nausea. This week, 2 days after taking it, was at work today and bam hit by really bad nausea again. It actually makes me feel wobbly and exhausted. At times I can barely talk as it makes me feel like I'm gonna be sick.

Now I know that the nausea is to be expected but what's really getting to me is the unpredictability of it. I plan for possibly feeling unwell and I'm fine, which is ok but I expect to be well and get caught out at work cos I'm not. I'm meant to be running a big conference tomorrow and I feel like pants ... totally washed out and fit for nothing. The cleaners are coming tomorrow and the house is a tip from getting back from camping and I need to try and clear up so the cleaners can actually clean!! Don't know where to start or what to do.

A grumpy Rosie Rabbit!! Xx

13 Replies

I've just realised I didn't actually ask what I wanted to as I was so busy ranting, sorry .. Is there any pattern to the nausea. I take it in the evening with my main meal and plenty of water and can't think that I'm doing anything different each week??

Oh and I've got 5 packed lunches to make too ... sorry still ranting



Hi Rosie,

I have been MTX a few years now. But consultant also told me to take folic acid a few days later to keep side effects at bay.

I take mine with breakfast on a Saturday but thankfully don't get any side effects.

As for the pack lunches-do then sitting down at the dining table, I have been known to do that on bad days! :-)

Hope you start feeling better soon.


I've been on MTX for a few weeks now - I was told to increase the Folic Acid 5mgs to 3 days after taking MTX, this does seem to help but it does seem unpredictable as to how I feel. Last week I felt really rough however the previous week I'd been fine! I dread Wednesday's when I take my MTX, it seems to come round so quickly!

Hope you get it sorted. x


Thanks yes I was given folic acid 5mg to take on Fridays and the first week it did seem to get rid of any remaining sickness.

I've had a bit of a rest, done a bit of a clear up with helpish from the children. Husband tidying kitchen ehilst im putting kids to bed, just packed lunches to do and will definitely be fitting at the table, good idea Jazie ... god I'm exhausted :(((


No wonder you're exhausted!

I am off MTX because of possible rare side effects but took it by pill and then injection for 19 months. I found it terribly unpredictable and sometimes would dread important meetings that landed on a Wednesday or trips away and then all would be fine. I had a whole summer of constant nausea last year so switched to injections - but still just as variable in side effects for me. However I did at least find injections made a big difference to my RA.

I think the best thing you can probably do is just to plan for a rubbish day afterwards always and then if its not its a welcome reprieve? Planning for it could involve a ready supply of ginger tea or ginger biscuits and take an anti emetic the night of the MTX. That's the best I can advise - sorry! X


Thanks Tilda, yes I've ginger ale, peppermints, anti sickness stuff from my GP too. I'm due to see him at the end of next week after my first blood test, so I'll have chat with him. The anti sickness pills help the nausea but are an antihistamine and make me even more tired.

I feel a bit better after my earlier rant. I've done what I need, although still haven't done packed lunches and off to bed shortly. Thanks Tilda and all xxx


Hi, switching to injections really helped me stomach/nausea wise. Have had problems with headaches with injection but now taking folic acid everyday apart from injection day and that seems to be helping. My symptoms were very unpredictable too ,making it hard to plan everything. Xx


Hi, def switching to injections was the best thing that I did - also taking it on a Friday night gives you the whole weekend to recover. Although admittedly I wasn't dealing with the demands of small children, mine were ten, fourteen and seventeen when I started MTX.

Cece x


I agree, despite having taken MTX for years and years I still get the nausea and the wiped-out ness. Just not every week. I don't really know what to suggest. I have folic acid 5mg every day apart from the MTX day - there is a big variation in what clinics seem to prescribe. Maybe more days of folic acid would help you?

I also hate the making of children's food when I feel like that - this week I had to take my 8yr old twins to town for some school things and all I wanted to do was to lie down quietly and not speak to anyone. Instead I had to walk gingerly around, chat, sort out squabbles and buy cake for them at the promised coffee shop (which really turned my stomach at that moment in time). Best wishes.


Hi I'm 2 doses in and feel exactly the same.

First week couldn't even keep water down, doctors gave me omeprazole and this week metoclopramide which is making me feel slightly better but stomach is so swollen and cramping.

I have folic acid 2 days after my code which I take late on Friday evening, just feels like there's always something at the no x


Sorry for not responding to all your kind replies I was sooo exhausted. Conference was tiring as expected but worse was the motorway was shut when I left and instead of a 40 min round run to collect kids and get home it took me 3 hours. Then worse still having busted a gut to tidy the night before the cleaners didn't come aarrgh!!!

Anyway slightly better day today, was my day off, took folic acid so nausea calmed down. Brought a new baby bunny for my daughter who is so happy ad one of our 4 had to be put to sleep last week, cleaners came so all a bit more in control , just my daughters birthday to cope with this weekend ... Still totally wiped tho.

Anyway, back to the mtx, yes I really would rather have injections but they are reluctant to give them to me probably due to cost. Like you say, I think I'll plan for feeling ill and be thankful if I'm not. I prefer to take them Mondays so that I can enjoy my weekend and now the children are back at school I can work from home if I feel bad.

I will chat to my GP again next week about injections, also perhaps increasing my folic acid and changing the sickness pills to something that doesn't make me more tired.

Thank you all for listening to my rants it helps to know you're being listened to. Rx


Hi, I take 25mg a week every Thursday night after diner. I plan that Fridays I will feel v. tired and sometimes nauseous but not always, so very lucky there. I was told to take 2.5mg folic acid every day except mtx day - weird how we are all told differently. But for years I was taking just one folic tab. 3 days after mtx and not any more until my cons. and GP noticed and said oh, you should be taking it every day except mtx day! I do have ginger tea on hand for nausea, but I dont suffer as much as you obviously do and others do.

We are here to listen to rants so don't worry about that and as busy as you've been no wonder you're exhausted!

Maybe increase of folic acid will do the trick.

Take it easy when you can and break all your chores down into small parts, do one at a time and rest in between. I have heard that drinking coke helps nausea, but you have to let it go flat first!!! Worth a try maybe?

Have a good weekend.

Lynn x


Hi Rosie sorry to hear you are having problems with the nausea, I have been on it for 3 months now and started at 10 mg and have increased to 20 mg now ( for last 7 weeks now) did have some problems when I first started with nausea and feeling generally c**p. however I now take it on a sat night before bed with a drink of milk and have not had any problems for last 3 weeks. Did feel bad on Wednesdays and sundays for a bit but am keeping fingers crossed as it now seems to be working well and am having no morning stiffness and my feet do not feel as inflamed. I take the folic acid 6 days a week. Hope things settle down for you



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