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Methotrexate/abatacept - best time to take?

I have recently been diagnosed with RA and have qualified to be part of a double-blind trial to compare the effectiveness of giving methotrexate alone or alongside abatacept for early treatment into remission of symptoms. I go in on Monday to start the trial and I assume take the first dose of methotrexate (pills) and abatacept (injection) - that's unless the abatacept is a placebo which it might be. I'm not sure if I'll then always have to take the medication on a Monday or whether I can change the day. I am concerned about possible side effects such as nausea that might affect me doing the school run etc. Can anyone advise me of the best times to take pills and what side effects and for how long do they last? Many thanks.

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When I first started Abatacept (on its own) I injected on a Friday morning and the Saturday afternoon was a right off so started going back 12 hours at a time to inject on a Thursday am so it was a Friday I was not good so I had the weekend with the kids. It does not affect me now almost 2 years later. It took a good 9 months and the addition of 200mg hydroxy at 6 months to really kick in but has now (together with a TKR March 15) turned my life around. I cannot tolerate MTX. I do run low on white blood count and neutrophils but this has not caused any problems. Farm



I have had no side effects at all from abatacept so makes no difference for me when I take it. I did have quite a bit of nausea with methotrexate. I take that on a Wednesday because I have a half day off on Thursday.Now it doesn't make me sick anymore so doesn't really matter when I take it. you could do as farm suggested and go back 12 hours each week till you get to where you want to be. I would just go back with the methotrexate, then if you get side effects you will more likely know which drug it is. Assuming you get abatacept of course!

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I think as it's a trial you're participating in it might be best to ask the team when you start on Monday just in case they're wanting responses on a specific day, thinking when blood test results are required & such. As far as MTX tablets are concerned when I started them it was recommended by my Consultant to split my weekly dose to have with meals.... so I took 15 mg as 2 tablets with breakfast, 2 with lunch & 2 with dinner & that seemed to suit me. I started on just the one folic acid the day after & only needed a one day increase in folic acid to ease nausea, though I now take 6 since increasing my MTX dose. Generally if you have side effects the folic acid dose can be adjusted, that is if you don't start on 6 times weekly which seems to be the maximum dose here in the UK.

Good luck with the trial & I hope you respond well whichever group you're in. It will be interesting to hear how you get on at some stage if you don't mind sharing.

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