Any suggestions for a painful mouth on Methotrexate?

[Mazyanna]

After a recent increase in my Mtx, I have developed oral thrush and ulcers to my tongue. I am really struggling with the pain. Has anyone had any experience of this please?

[aligator]

Hi, i had tongue ulcers whilst on MTX, I feel for you. I took folic acid everyday except when i had mtx. All under guidance from consultant. They did improve but for other reasons i came off mtx. Hope you get relief soon. Love Alison

[allanah]

Yes, and still get them occasionally I'm afraid. But mainly when I first start a new treatment. Once I get used to the new drug they seem to improve. My doc increased my folic acid and gave me blister mouth gel until it settled. Xx

[caroline21]

Hi,I was on mix quite successfully a few years back ,but suddenly got very bad mouth ulcers ,massive ones all over.They took me off it ASAP and gave me something to get it out my system .i have never been back on it and take Enbrel on its own and it works ok ..I'd check again if you shouldn't come off mix you sound like you're allergic to it now

[bryner]

Used to get it bad then changed to injections. They stopped. Best thing for it is salt water mouthwash.

[helixhelix]

Yes, like Bryner I changed to injections because of awful mouth ulcers on the MT tablets. And they stopped within days and have never come back. Don't suffer, call your rheumy team. I used Eludril mouthwash and boots dual action throat lozenges to dull the pain. Horrid aren't they!

[Scottishlad]

I started to notice problems once I reached 20mg got worse at 25mg. Was on folic acid every day except MTX day due to previous low floated levels. Things settled down when my dose was reduced to 15mg prior to starting biologics.

I used a good mouthwash daily (make sure you follow the instructions carefully especially about timing after brushing) brushed carefully with an electric toothbrush. Speak to your dentist.

See if you can get your folic acid increased and ask about injecting MTX instead tablets as some people find that helps.

Hope you get relief soon

Cecil

[Pipcat15]

Yes me. Just before xmas I had a sore mouth for 10 weeks. In the end I needed to seek help from the doctors for some antibiotics. If you have gone that far I would suggest the same. You could als ask to up tthe folic acid. And just on a day to day mouth cleaning. I use corsedel mouth wash. Just be careful not to over use it as it can turn your teeth brown. There is also a over the counter green mouth wash from the chemist thats great also. Does not brown teeth but is about 8 pound a bottle. Worth it tho if you're struggling

[moonbutter]

yes, doc upped my folic acid, i only get them occasionally now, mine tend to be on the roof of my mouth ,,,

[Mazyanna]

Thank you so much everyone for you kind responses. I am new to this group and am so pleased that I have joined! I increased my dose of mtx 3 months ago and was troubled by mouth ulcers, so have been taking the folic acid daily ( except for mtx day). I think my steroids have caused the thrush in my mouth but the ulcers are excruciating this time. I will try some of the ideas suggested above and ask to change over to injections on Monday. I am waiting to start humira next month, so hopefully can reduce the mtx too. Sorry to go on... even though I am a nurse and have so many great people supporting me none of them have RA, I feel a bit lost with all of this sometimes and just knowing others understand makes me feel better already. Thank you again.

[Pinkymarie63]

Yes I had the same and they increased my Folic Acid to everyday EXCEPT the day I take my MTX and within a couple of days it went, and has not come back. Hope that is helpful! Linda x

[denvajade]

Hi there, I had bad thrush and splits in the corners of my mouth, doctor prescribed allsorts, then a chemist suggested i buy teatree oil and put a few drops in about a quarter glass of water and rinse mouth a couple of times, you need to do this before bed and anytime you are not going to eat for a couple of hours during the day, it was fabulous. all the best

[Mazyanna in reply to denvajade]

Thank you. Will try this today.

[mistymeana]

A diluted vinegar mouthwash will deal with the thrush (cider vinegar is probably the most palatable) but might make the ulcers sting. It got rid of mine in no time. I use Anbesol liquid on ulcers to help numb them a bit. It seems to speed up the healing time as well.

[Butterfly78]

I am on 20mg. of MTX once a week. I also take folic acid and B12 every day. When I start getting those ulcers or tongue sores I double my intake of Folic acid until they go away. This usually takes 5 to 6 days. It seems to me that I have these ulcers ( 1 or 2 ) every month or so. As soon as they pop out I also start using "Kanka Soft Brush Gel" that numbs them for a little while. Before I had RA I would get ulcers after I ate certain things, not sure what, but really didn't pay any attention to them at that time because I didn't get them often, but once I started MTX it was a different story. Hope this helps.

[Mazyanna in reply to Butterfly78]

Thank you for your post. My mouth is still really sore so I have spoke to the RA nurse today. I'm going to double my folic acid and switch to mtx injection. Has been great for the diet though !

[mamainacrowd]

Ask your practitioner about an increase in folic acid. That did help me. Swish often with warm salt water to soothe the sores. Avoid any rough foods which scrape your irritated mouth if you can.

[Mazyanna]

Thanks again folks. Lots of great advice and support.

[LauraAsheighh]

This i am afraid is a side effect of the methotrexate i can get them quiet severe sometimes, but you just have to deal with them the best you can, sorry hope this helps. feel free to inbox me about anything love laura x

[Mazyanna in reply to LauraAsheighh]

Thank you so much Laura. I am going to try injectable mtx to see if this helps. Fingers crossed

[mamainacrowd]

Mazyanna, did you find that any particular suggestions helped with your mouth sores? Just wondering as mine continue. Thanks. Mamainacrowd

[Mazyanna in reply to mamainacrowd]

Hi there. I'm sorry your suffering too. Ulcers and sore tongue start 2 days after taking my oral methotrexate and lasts for 3-4 days. I have found nothing really helps so far. I have a clinic appointment in 1 week so am hoping a switch to the injectable mtx will help.

[emma6833]

I have been taking MTX for my RA for about a year and have had severe canker sores the whole time. I tried everything from oral numbing gel to salt water to hydrogen peroxide to prescribed "Magic Mouthwash". Absolutely nothing helped to alleviate the pain for more than maybe 30 minutes. Then, I found "Canker Covers", which are made by Dentek. These things are an absolute godsend! They actually stick onto the sore to keep it protected from bacteria and irritation. And they stay on for hours! 12 bucks is sooooo worth the relief! I hope this helps someone else who has been as miserable with mouth sores as I was!

[Chefkeke in reply to emma6833]

Thank you!