Methotrexate day

Hi. Does anyone know if it's ok to change the day if the week that I take my 17.5mg of methotrexate- just for one week? I usually take it on a Monday but it makes me feel a bit grotty on Tuesday particularly and next Tuesday I'm organising a family party.

I was thinking I'd delay taking next Monday's until Wednesday , then move it to Tues the week after and then back to Monday week after that?

Has anyone done this sort of thing and had any problems please?

22 Replies

  • Can't give medical advice, but I do that every now and then for holidays and special occasions and I'm still standing.... doesn't seem to make any difference to me at all. Except having to remember to change folic acid days too.....

  • I've gone one day when I've forgotten it's MTX day & taken my folic acid so injected on Thursday then back to Wednesday the following week, which is basically what you're intending to do in two stages. You can do this for up to 48 hours but no more, if it's longer then move the one day forward the following week & so on to work back to your usual day. I've even gone up to three weeks if I've had an infection treated with antibiotics. I think your idea's a good one if the day after taking it is disruptive, as long as the next time it's taken isn't too close to the previous week.

    Enjoy your party.

  • My docs tell me you can even miss one week on the odd occasion. :-)

  • not medical advice, but I have done so a few times, mine is this sunday Christmas day so I will take mine on the Monday or Tuesday. Yes I've also been told missing the odd one is ok, though not too often. If like me you also inject a biologic remember to space the days out as well. I was told to leave 48 hours between injecting mtx before Humira.

  • I too am due to take mine on Christmas Day and wondered about leaving it for a day or so - whilst we are advised against drinking alcohol, I have to say I have also wondered, as it is Christmas and family and friends have dinner at mine, whether it would be ok to have 1-2 glasses of wine with dinner. Does anyone have any thoughts on this ? I have to say since beginning methotrexate, I've avoided alcohol altogether; not that I was ever a substantial drinker I might add!

  • This is what the article on methotrexate on the NRAS website says:

    Because of the possibility of an increased risk of liver damage with MTX the safest policy is to avoid alcohol if you are on MTX.

    Many rheumatologists believe however that it is safe to have up to ten units of alcohol per week i.e. a total of ten glasses of wine or five pints of beer or lager.

    People on MTX would be very unwise to exceed the maximum limit recommended for the population at large i.e. 14 units for women and 21 for men per week.

  • The reason for limiting or avoiding alcohol on MTX Eiram is the effect both can have on the liver. If your liver results are ok & your Rheumy says a little alcohol is fine then what better day than Christmas day. Best to keep to a glass of wine or beer though, spirits aren't usually recommended.

  • Thanks once more. Nomoreheels. I do understand the caution in relation to liver and fortunately , I am not a spirit drinker, it a big drinker to be honest. I guess it's more about feeling social and fully participating in the festivities , if that makes sense? If I have a glass, I think I'll dilute with soda water. The last thing I'd want to contend with on top of normal "shitty" feeling would be any hint of a hangover!! Wishing you a great Christmas, when it comes.

  • You're welcome. I'm not a drinker either, it doesn't like me & why I try to be sensitive to those who do like a drink & limited by MTX. I think your idea of diluting it is a good one but another may be to have a look online at recommedations & consider a bottle of low alcohol wine, some are very good I believe nowadays. Wishing you a wonderful Christmas too.

  • Thank you all for your advice - very helpful.

  • I've asked that question of my rheumy: they said it's ok to change it but move forward a day to take it back to where you want it to be and not backwards. Or alternatively, miss a week.

  • Oh that's interesting- So it's not recommended to have less than a week between doses? I can understand that. Thanks.

  • At the very beginning, I missed the day too. I took it immediately on the next day and continue the weekly basis. When I saw my rheumy, I asked her, she said nothing one could do when a day was missed but one should take it the moment remember it and continue weekly but not to took it less than a week.

    To avoid nuisance after mtx, my rheumy advised me to take it at night and sleep over it. I do that and I feel okay with that though I still feel not comfortable immediately after taken mtx. However, one must remember to take mtx only after food.

  • That makes sense amy_lee. I hadn't known that mtx was to be taken with food and this may well be why I always feel so bad when I take it - I take first thing in morning before having eaten anything at all.

    I think it's fantastic all the tips one can pick up re managing things on this site; people are just so helpful.

  • Methotrexate doesn't necessarily have to be taken with or after food Eiram. That said I used to take my MTX tablets with meals but only because I was advised to spread the dose through the day to avoid side effects & taking them with meals was my reminder to take them. There are some meds we take where it's suggested they're taken with food but that doesn't apply to MTX.

  • That's good to know - I didn't relish the thought of breakfast before taking meds! Again, thank you.

  • No probs.

  • My rheumy told me to avoid in contact with the mtx tablet directly when I handle it, this is because it is harmful to our skin. The pharmacist had given me a small container and said that I could press the tablet into the little container, poured some water into my mouth then threw the tablets into my mouth and swallow them immediately. She told me to take the tablets after food.

    Read the link below on how to handle mtx:

    When should I take methotrexate? - It should never be taken every day. The tablets are taken with food and should be swallowed whole, not crushed or chewed.

  • What dose do you take amy Lee?

  • I started with 10 mg to 20 mg and now slowly reduce to 12.5 mg. It doesn't matter how much we take, but the way we take to minimize the side effect.

    I have RA friend here who used to take mtx before food and she used to have severe stomach pain after that. One day she asked me and I told her to take after food. She did that and she came back to thanks me for the piece of information.

    I guess I was lucky to be informed at the very beginning hence I did not have this issue though I still have the very uncomfortable feeling after taken it but I sleep over it and I am fine.

  • Thanks Amy lee

  • I occasionally have wine but always drink a lot of water when I do. I realised that it was the first glass I really enjoyed and after that it was just habit. It works for me. I have also lost 7 stone over the last 18 months so drink very little to protect my weight loss. Still have 2 to 3 stone to go. Will have the odd glass over Christmas. Wishing everyone a happy Christmas.

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