Severe nausea

[AishaSalie33]

Hi there, I have PsA and I take 20mg mtx injection and 10mg folic acid a day 6 days a week. My nausea is off the chart. Ant remedies? Zofran and Clopamon are not working and the dry lemon drink just give some relief but it's short lived. Any help would be appreciated. Thanks

[Titchyj]

Hi there AishaSalie33, I get this from time to time, I asked in Holland & Barrett while away last year and they suggested Ginger Buscuits, Ginger Tea or anything with Ginger basically. I found the tea the best for me as I'm diabetic, but they also do sweets. Worth a try.

Hope you find something that helps, I know how you feel, not very pleasant.

Jan

[nomoreheels]

Hiya AishaSalie33 & welcome. That's not acceptable really, unless you're well controlled & your Rheumy would consider reducing your dose but then taking 20mg 6 times weekly it may be you're not getting the full 20mg anyhow so reducing it may send you into flare, not wanted! Here we're generally only prescribed 5mg up to 6 days weekly. Has folinic acid not been suggested? Some members have tried changing to that from folic acid with some success.

If the two antiemetics didn't work I think it's reasonably safe to say you just don't tolerate MTX too well. As Jan says you could try ginger (oddly just had a yummy Border's dark chocolate ginger biscuit with my tea!) or peppermint (oil or tea, both good), drink plenty of water & eat non spicy foods. I've heard of people using Sea Bands but not sure how successful they are.

It may be that MTX just doesn't suit you, especially as you're injecting, that often eases nausea. What has your Rheumy said?

I hope something helps & ease things, you must feel miserable. I had a little nausea when I first started MTX, it eased with an increase of days I took folic acid & been fine for a long while now since changing to injections.

[earthwitch]

Personally, I wouldn't be putting up with that level of side effects and I'd be requesting an urgent discussion with my rheumatologist about other options. Not being able to tolerate a medication (because of severe nausea) is a valid reason for "failing" that treatment option, so it would be worth asking whether having failed this treatment you might now be eligible for anti-tnfs (which generally have very negligible side effects) - noting that the criteria for PsA are quite different from the criteria of disease activity used for assessing eligibility if you have RA.

[SALI]

I agree you should be sorting this out with your Rheumy.

Everyone reacts differently, so they need to sort out an acceptable plan of action for you. Your tolerance may improve over time. I was assessed over 3 months on different dosages. I was told that MTX was 'The Gold Standard' treatment, but I did not improve on it, so after about 1 year I was assessed for anti TNF treatment - so it is a long road.

Please seek help and impress how bad things are for you. I know it is tough as I have been there, but got lots of support from contributors on this site.

Hope things improve for you soon.

[oldtimer]

That is the main reason that I came off methotrexate (and feeling dreadful, the mouth ulcers and the brain fog that made my relatives think I was getting early dementia). There are other medications or a combination of a lower dose of MTX and something else? Seek help.