When to take methotrexate

How and when do you take your MTX. I start finally on Monday, not sure weather to take it before or after lunch or leave it until tea time. I don't eat big meals in the evening, unless my husband is days as he doesn't get home until 6.30pm so we usually have an evening meal about 7pm. What is the norm for taking MTX or should I just take it when I want?


21 Replies

  • My doc recommended taking it at bedtime, that way, you will sleep thru any efects. For the first few weeks I would feel a bit yuck, but not any more :)

  • Thank you lab-lover for your reply, will try that and hope for the best, I do suffer with a very weak stomach so not looking forward to the nausea or sickness should I get it.

    Thanks again


  • Hi I agree with lab I took it at night just in case I felt yucky and just slept through it, good luck!!

  • Hi I took my first dose last evening xx I am off sick but work rotating shifts so thought long and hard about it . I took it after food then had early night felt sick but wasn't and still feel bit yuck but I slept well x im on 7.5 mg cos I have ultra sensitive stomach and had ti drop to 2 sulfas as four made me really ill .. I fully understand next week might be worse and ive got to double the dose but first hurdle is over x good luck

  • Gosh that sounds awfully quick, first week at 7.5 then 15 the next week??

    I started at 10, then after 6 weeks, as no improvement, increased to 15. Then advised about another 8 weeks later increased to 20.

    I wish you luck with that as I really did think they increased a little more gently than that but perhaps I'm wrong?? Don't know if anyone else has increased this quickly??

    I hope it goes well and starts to work quickly for you Rx.

  • Hello

    Decisions, decisions, I take mine on Tuesday morning when the wife takes Pax out for His walk, she does not like me injecting myself.

    Do not think there is a time it depends when we feel a little bit more happy about taking it.

    Happy jabbing or swallowing, I hate these meds with a passion


  • Hi Jan, I take mine with my evening meal on a Monday evening. Im not sure if it makes a difference as I find nausea can come and go a little thru the week, I just think it's better taken with a reasonable sized meal. Good luck and hope it goes well for you. If you do have nausea problems, I was advised to adjust my folic acid dose and this really helped, so something to consider asking about. Hope it goes well, Rx

  • Thank you all for your replies, I start off on 7.5mg pills for 2 weeks then take Folic Acid the next day 5mg, the nurse said I could take for a few days if I felt nauseous, then have blood tested, if all ok I increase to 10mg for 2 weeks then another blood test, if this is ok I up it to 15mg and this will be my maintenance dose, if everything goes ok and have blood tested once a month thereafter.

    Will try the evening time and hope I sleep through the side effects.

    Thank you all


  • I took my first dose of mtx in the morning while someone was home just in case I had any bad reaction. I figured it would be easier to speak to a Dr if something really worried me. After trying out different times I settled on mornings after breakfast on a Monday as I'm off work Monday and Tuesday. I found the tiredness would really kick in about 6hrs after taking so struggled to get up if I took it before bed. My dose was stepped up from 7.5 for 2 weeks to 15mg maintenance dose in week 3. I took 5mg folic acid 48hrs after my mtx but this was increased to daily apart from mtx day because of side effects. Good luck and hope the mtx works well for you. x

  • I don't take mtx any more but took it for ten years. I found the best time after tea, it's not good on an empty stomach. I used to feel sickly a few hours after so as the effects were kicking in I was going to bed and could sleep them off.

  • Thanks for your replies, will have to experiment with this I think and see which suits me best.

    All very good info thanks again.


  • I take mine at teat time but my side effects last for a few days, I'm about to go on to MTX by injection so will see if that helps. I also increased my Folic acid to 4 days following taking MTX - that has helped.

  • I took my oral mtx at night before bed. I found that i slept through the side effects.

  • My first dose was on a Thursday night week before last. I've started on 15 mg and on hydroxy 200mg twice a day. I take my folic acid tab 5mg two days later. Didn't think it was supposed to help with nausea / sickness thought it was to help avoid anaemia problems. Not the full shilling for past two weeks and had the odd day which was not good flare wise. Trying to figger out the triggers as lost a day sleeping and holding my shoulders on Sat. Have my first blood check on Tuesday.

  • And I take mine at a lunchtime as I find any nausea starts after about 9 hours and so I then (hopefully) sleep through the worst of it! Doesn't always work but mostly helps. I agree - you just have to find a time that works for you and it may be a bit of trial and error. Best wishes.

  • I took mine first thing am and then with evening meals.

  • Hi

    I have picked this thread up...I was looking for answers as to what time of day is best to take my 10mg of methotrexate. I am on wk5. I have been moving it forward a day at a time to taking it on a Wednesday, in a couple of weeks. I would like to enjoy my weekend! Also hoping to go back to work when my body starts behaving itself! My theory is that I'll work through feeling lousy? I have taken it after an evening meal but don't always eat much every evening and would rather eat my big meal lunchtime . I've just taken it after soup and bread at 2.30....

  • I'm not sure if I've mentioned this before but as another experience it may help. I took my 15g tablets dose as 2 tablets with each meal, breakfast, lunch & dinner, as suggested by my consultant. He told me not take them as one dose at bedtime because of possible sickness, the thought of being sick in my sleep bothered me anyway so no biggie! You could try dividing your 4 tablet dose with the larger of the 2 meals you have each day?

  • Hmm. ..that sounds like a plan- especially if/when they decide to up my dose. 10mg seems a lot less than others'. Maybe they're seeing how I react to everything. Had a blood test this morning 😕

  • I was started on 15mg but that wasn't in the UK. Here it does seem that lower doses initially are favoured, as you say probably to see how you react & increase incrementally but also sometimes symptoms don't warrant a higher dose. It was also my second DMARD, about a year after diagnosis, so it had been established that a lower dose wasn't appropriate at that time.

    I hope your bloods show some improvement. Were you given your last blood test results?

  • Yes- I make a point of asking for them to be printed out ☺I had them done prior to diagnosis (in Dec) and again in Jan- 2 weeks into treatment. This one is 4 wks. Going to be done at 8wks then around 12wks before my next consultant appointment 22nd March. I asked for my cholesterol and for them to check my b12 etc this time.

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