My rheumatologist is a bit of a flake and can't keep track of my medications. She called me last night to tell me that my blood work is showing my liver is starting to be affected, so she wants me to reduce my MTX to "9". She then hung up the phone. I'm taking MTX by injection, so I can't reduce it to "9". I called her office back but it's closed until Jan 5 and doesn't accept messages. Do I ask my GP to prescribe me 2 weeks worth of MTX at a lower injection volume (currently it's 25 mg or the equivalent of 10 pills)? Or do I go back to pills for 2 weeks? I see my rheumy next on Jan 9.

6 Replies

  • Crikey, that's a bit of a weird one! Do you have a rheumy helpline you can phone? If that's not possible then go ahead and get in touch with your GP to see what he/she has to say. Maybe they can contact her or someone else in your rheumy team.

  • Thanks. No helpline here (Canada) that I'm aware of. My GP has suggested I take the oral MTX until my rheumy is back from holidays.

  • It sounds like she expected you to take the equivalent of 9 MTX pills for while to see if your liver function improves. I would do as your GP suggests.

  • Do you think she meant 9 tablets Karen? That's how I read it, that would be 22.5mg. Are they prefilled injections or do you have syringe & separate mtx in a bottle? The safest way would be to go to tablets for the fortnight but, again your GP should hopefully advise if that's the safer option. How odd!

    Just as an example, my MTX was increased from 15mg to 20mg once when I had a new Consultant & my liver objected so it was reduced back down to 15mg with no further issues, my next liver readings were back to normal after reducing the dose. x

    Just read your reply to wishbone, tablets it is then!

  • Thanks Heels. Merry Christmas!!

  • That's not good service is it ! If you can get to see or talk to the gp I'd suggest doing that. If not, how about the pharmacist where you'd normally get your prescription ? Another suggestion would be to call 111. They have Dr's available for instances like this. I think you'd be best with some medical advice before you reduce the Mtx yourself. When you next see the Rhuematologist who let you down tell her what you had to do because she didn't do her job properly !! Good luck.

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