Methotrexate once a fortnight anyone?: Out of interest... - NRAS


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Methotrexate once a fortnight anyone?

Tessthomy profile image

Out of interest does anyone do Methotrexate every fortnight? I'm finding even the injections can make me feel pretty low/nauseous/fatigued/ even anxious.?! ..have decided to do them every 2 weeks..I'm on 12.5 mg injection form...anyone else doing once a fortnight? TT x

11 Replies

Hiya TT. First of all is this your decision to inject every 2 weeks or has your consultant suggested you do so? It's my understanding that it's a weekly regime. I've been on 15mg methotrexate for 5 years, injecting for 4 years and have only ever administered weekly.

As a matter of interest are you supplementing with folic acid? This helps reduce the side effects. I used to only take 5mg the day before & the day after injecting but now take it every day except the day I inject. I've found this helps. Ok I'm still pretty iffy for a couple of days but nothing like I was before taking 6 a week. Some people find if they take it just before going to bed helps as you sleep through the worst of it. Maybe even ask your GP for an anti-emetic to help with the sickness. I inject Wednesday morning so I'm fine for the weekend but that's just what suits me!

Please ask for medical advice if it's as I understand & you've made the decision off your own back, it's not a drug to be messed about with without supervision. Hope you get the help you need & get back on more of an even keel.

Hi, I have been on oral Mtx for about 5 years & suddenly started to feel nauseous & my Rheumy suggested splitting the dose (17.5mg) so I take 4 tablets wait three days then take 3. It's a bit of a nuisance as it falls on different days,but it seems to work & I am back to normal. I take the Folic acid on the days I don,t take the Mtx I think your best bet is to discuss it with your doctor/ nurse.....I don't know if you can split injected Mtx & you don't want to mess up. God Luck

Generally the docs try to give you the lowest effective dose for you. So switching to every other week is halving your dose and could mean it's not going to do you any good at all as 12.5mg is quite a low dose to start with. And what would you do with the ones you don't use? If like me you get 8 weeks supply at a time with a short shelf life it would be a real waste to put half of them straight int he sharps bin. Especially since some people are refused injections because of the extra cost.

I do urge you to talk to your rheumy or specialist nurse effort before you make any changes as there may be other options.

Hi yes thanks for that..I've been on mtx for 3 or 4 years and injectable for about 4 months now. I've been taking it dutifully on a weekly basis but recently been feeling worse for some reason so do very occasionally miss a week if I've got a busy week coming up. I haven't decided to completely go every two weeks but I did see an article where if the RA is in remission (which I've been told it is for now) then a fortnightly dose COULD be considered.

I of course will be consulting my nurse regarding this, but was interested to hear if anyone else either missed the occasional week or took it fortnightly. I've also been on Embrel for nearly 3 years which so far has been a miracle drug ..long May that last! I have been told I have a high Rhuematoid factor but so far doing well with the drugs except hate the mtx after effects.

I take folic acid but only 2 or 3 times a week as the nurse said every day could lower the dosage of mtx. Just wish it didn't have such toxic side effects as I know it works well against the war !


helixhelix profile image
helixhelix in reply to Tessthomy

If you're on Enbrel as well, then maybe also think about asking about dropping to 10mg weekly? I think there are some people on here who just take a small dose to help the Enbrel along. I've found that I'm sensitive to a change of 2.5 mg. So 17.5mg is fine, but everytime I've tried to go up to 20mg it's rubbish.

I was on mtx in pill form and due to a misunderstanding reduced my dose. Quite quickly my condition deteriorated. So I wouldn't reduce it without medical advice. Also, did you know that mtx protects you against oa? I'm off it now and the result is very negative. I also found that the gut upset did improve with careful management. I would trade the odd dash to the loo for being able to dash!

nomoreheels profile image
nomoreheels in reply to cathie

I also had to go without (injections) when I returned to the UK after living abroad, a total of 3 months as my surgery initially wouldn't take responsibility for prescribing. After checking that they had signed up to "shared care" commitment they finally relented. It was like going back to square one with symptoms.

HI I do miss an occasional week, usually when I am not feeling great, and coming down with a cold. 12.5 mg does seem like a small dose to inject once a fortnight. I am on 20mg

Thanks for all your responses everyone, helixhelix I do believe the mtx is there to help the embrel along and I, like you, seem sensitive to even the smallest of increased dose. I think missing an occasional week isn't going to cause too much of a problem because all the medication is on a even keel, but it might do more harm long term, ie doing fortnightly all the time...I will discuss with the nurse next time I go. Thanks again x

My understanding is that mtx is used with Enbrel to stop us rejecting the proteins in it. Mouse I think. Like an person whose had an organ transplant needs an immune suppressant to stop them rejecting their organ. I agree that you shouldn't miss any dose until you have spoken to your rheumy team. Your decision of course to omit a prescribed drug, it's your body, but you may do more harm than good. Also if you are in remission it is because you are taking these meds. If you stop or reduce your remission may end. I've tried to reduce drugs in the past to see if I truly need them. Always ended up very badly. I've learned my lesson and accept I will always need them. Hope it goes well for you for many years to come. Take care and happy Easter.

I was taking MTX 25mg orally once a week; after 10 years, decreased to 10mg weekly. Just stopped taking it last week. I didn't notice any side effects except my white blood count has been very low. Good luck to you finding the right dose.

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