Sore Mouth on Methotrexate

Suddenly yesterday I started feeling what feels like burning in my mouth. I can't see any obvious sores or ulcers but the roof of my mouth and tongue are a bit red, 'raw' and sore feeling. My throat is now starting to hurt a bit too.

I was warned to look out for ulcers, but a sore tongue? I've just had my second weekly dose of MTX 20mg orally, just increased from 15mg. Is this a sign that the jump in dose might be too high?

21 Replies

  • I have a sore mouth,but i have been told mine is caused by tramadol which i have just started to ease pain during a flare. I hope yours settle down soon,with mtx side effects mostly settle down after time. Not everyones side effects go away,but often they do after time.xxxx

  • Hi. Try rinsing mouth and throat with cooled boiled water mixed with a dash of salt three or four times a day. My dentist said this was a good treatment for soreness in the mouth. Good luck!

  • I had similar effects ( I take 20mg ) but found that drinking several glasses of water a day ontop of usual intake for a few days after injection eased it. Still get a bit of a dry mouth and croaky voice but generally fine.

    Good luck

  • Have you heard about oil pulling? I Auyerveda pratice you start your day with taking oil and letting it stay in your mouth for 15 min before spitting it out. This has an antibacterial and soothing effect. I have been doing this for a while with coconut oil, and have seen how very good it is, you should give it a try😊

  • Oil pulling rocks!!! I use the coconut oil too. Just one word (or phrase) of caution.. don't spit it in the sink - most EVCO hardens at 75 degrees and that can be in your pipes too. Pick a trash can with a bag in it and warn everyone not to EVER dig in there - ha ha, and spit it there. This also works well for Sjogren's and allergies..

  • I too had soreness of the mouth & throat on Methotrexate. Change toothbrush regularly for new one and drink lots of fluid. Also be very diligent about taking your Folic Acid tablets as prescribed. They help your immune system to fight harder. Take as many toxic unnecessary food products out of your regime and get back to basics. Good luck 😀

  • You can also store your toothbrushes in Hydrogen Peroxide and change that every day or two. It will sterilize the brushes..

  • I get little blister spots inside my top lip from time to time which I thought was due to the methotrexate (I'm also on 20 mg). My dentist told me I have a dry mouth and to drink more water but regular sips.

  • Check with your GP if it's the start of thrush, maybe lack of vitamins. Do not ignore it please see your doctor. Good luck x

  • I had it too, a couple of weeks into starting mtx. My mouth and gums were so sore I thought I had an abscess and saw my dentist. He x-rayed my mouth but didn't find anything.

    My rheumatology nurse suggested taking plenty of fluids and using a soft toothbrush and sensitive teeth toothpaste. I also bought Corsodyl mouthwash and that all helped. It went after a couple of weeks but I still have to be careful around very cold food.

    Ally x

  • Hi Hope, I've been taking Methotrexate 20mg dose for almost four years. I've tried different ways of taking it, and now after a long time found the best way to take my weekly dose. I take them in two quite close batches if you wish. First I take 4 Methotrexate tablets together with an Omeprazole tablet 20mg and Paracetamol tablet. Then about half an HOUR later I take another 4 Methotrexate tablets with Paracetamol and Buscopan tablets 10mg. I swallow both doses of the tablet with a large gulp of milk, full fat type. Hope this is clear and easy for you to understand. Paul.

  • Hi, I have been taking MTX since last Nov. and was advised to leave a 4 hour gap between taking MTX and any antacid relief (I was taking Omeprazole). This is because antacids reduce the absorption of the MTX. Both the Rheumatologist and the Pharmacist told me this independently.

  • I too have been on Methotraxate for over ten years. Do get sores in months that the tissue peals and hurts for several days. I use biotene rinse per Dr orders which hs helped.. Changing tooth brush every three month too. I also boil my brush once a week to make sure no bacteria as form. Dry mouth is no fun so I also chew gum when I feel very dry which helps

  • Hi there been on methotrexate since 2012 I've found using euthymol toothpaste from bootsreally helps ease the discomfort along with corsodyl mouthwash mox

  • For mouth ulcers caused by MTX, I found an excellent answer in Norway of all places (when on a trip from Australia). I didn't have any of my regular ulcer cream left, so went to a pharmacy but they didn't stock it. Instead, the pharmacist suggested propolis ointment (propolis is something produced by bees in their hives), and it was sensational!! The ulcer cleared up in less than half the usual time. A year later,back at home, having used the tiny 'holiday tube', I was able to find propolis cream in a local pharmacy. Not expensive-worth a try.

  • Hi Hope, I joined this site about 2 weeks ago because the roof of my mouth was sore and then I got huge painful mouth ulcers all thanks to the MTX. I was taking 15mg MTX.

    I trawled through all the suggestions and then went to see the Pharmacist. He said don't waste your money on all these mouthwashes etc. The reason you are getting a sore mouth + mouth ulcers is because the MTX is reducing your immunity and one of the lets say 'unclean' places, is your mouth. So he told me to rinse saline (water + salt) around my mouth as many times a day as I liked. Within 3 days the mouth ulcers completely disappeared. So far the saline is working - just hope it continues.

    Whether you use cold or warm water is up to you. Warm water basically allows more salt to dissolve in the water. I just use a couple of twists of the salt mill into 200mls of warm water and leave it on my desk to swirl around every now and then.

    As for the sore throat that could be a cold bug or it could be the MTX. As another side effect of MTX is a sore throat. The Pharmacist told me this is common too.

  • Diflam mouth wash is very good. You can get it from the chemist. It's what they give cancer patients.

    Still got the joys of the mouth ulcers to come as only been on methotrexate 2 weeks

  • They came and went in 3 days - phew!

  • Hi, you should be on 5 mg per day except metho day. Get prescription off go. Should be prescribed as standard but often not. They will go in couple of days.

  • 5mg folic acid (b12).

  • Yes I've been on 5mg x 6 days a week since I started MTX - it was when I went up to 20mg (from 15mg) the mouth problems came. Relieved to say they've gone, hopefully for good!

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