Mtx injections

[Mel_H]

Good morning. I have been taking methotrexate since December 2015. I can always tell when it's time for my next dose. I take it on Thursdays ( injections now). I feel great by Saturday and even better come Sunday. But by the time Tuesday and Wednesday come I start to feel crappy and tired. My hands will start to lock up on me. Does anyone else have the same problems. I feel the best I've felt in 4 yrs with this medication and I am doing things I haven't done in a long time because I have my mobility back. I was just wondering if it was me or if others have had the same experience with mtx.

[thelmar]

You don't say what dose you are on. Maybe you need a higher dose to get you through a week? Do you have an appt with rheumy soon or can you call a helpline at the Rheumatology Dept?

[nomoreheels]

I've been on MTX coming up to 7 years & I only start to notice symptoms creeping back after 2-3 weeks of not taking it not towards the next dose the same week. Have you mentioned this to your Rheumy, I'm wondering if your dose needs adjusting? Maybe because you've not been taking it long you need some extra support, an NSAID or a short course of steroids until you've become established on it.

Is this your first DMARD? I ask because when I first started treatment I was also prescribed a couple of NSAIDs & a short course of steroids to tide me over, they brought down the inflammation & allowed the DMARD to work on the disease 7 in turn I had less pain. You see they can take up to 12 weeks, sometimes longer to work properly. It does seem odd though, what normally happens is you start to notice less pain, inflammation & fatigue the longer you're on the DMARDs, not as you're experiencing towards the time you do your next injection.

[Mel_H in reply to nomoreheels]

I take 25 mg/wk mtx. I also take 8 mg prednisone a day. This is my first DMARD. It could also be that I push myself too hard. I definitely do not take it easy and I am a 911 dispatcher so I am constantly using my hands and my level of stress is always high.

[nomoreheels in reply to Mel_H]

I'm afraid everyone here will tell you that stress & RD don't make good bedfellows! Still, that doesn't explain why you have this weekly pattern with MTX. Is your Rheumy or nurse appointment reasonably soon, I would think it's not too far off being newly diagnosed so do include this on your list, explain as well that your hands are locking up, that could become a problem if it continues.

It's good you have the backup of steroids at the tart of treatment, but please question how long you can expect to be on them. I've been on a maintenance dose far too long because without them I flare & it's not ideal. It's preferable that your DMARD is looked at rather than increasing your steroid if that's what's suggested. Maybe ask if you could try an NSAID instead?

Rest up as often as you can out of work, de stress! At work when you can get up & move about so your joints don't cease up, try & exercise your hands, warmth first (warm water helps), it may help with the locking.

It's a big learning curve in the early days but you'll learn over time just like the rest of us that it pays dividends to listen to your body & react when it's screaming stop.