Methotrexate and fast pulse

[Frankiefarr]

I've been having problems with a fast pulse and palpitations. My US friend has sent me lots of data on the relationship between methotrexate and abnormal heart rhythm and heart attack even at low dose (7.5mg). Really wish I hadn't read it. Has any other research been done that people have seen.

[oldtimer]

Here are two reputable websites with details of side effects of methotrexate.

drugs.com/sfx/methotrexate-...

arthritisresearchuk.org/art...

Methotrexate has been around for a long time now, so is well documented.

Your palpitations and fast pulse need investigating - atrial fibrillation is common, so is thyroid disease. Seek a proper diagnosis.

[helixhelix]

I agree with oldtimer, especially sticking to reputable websites. When you are sent links do consider the source of the information. Question whether it is a reputable organisation or research institute, staffed with real doctors and with no relationship to any drug products. There are a lot (especially from the US I'm afraid) that are not that robust. The doctors may list qualifications that are not relevant,such as saying a PhD or doctorate and then you dig deeper and find it's in philosophy.

Look at the research study that the information is based on. Is it a significant sample over a long timescale, using double blind techniques and with a control group. Or is it just a report of a small group of people with particular problems.

It is true that we have a higher cardiovascular risk than those without RA. However a lot of research has said that the real cardiovascular risks are from uncontrolled inflammation, and if that controlled for example with methotrexate, then the risks drop close to those of a disease free person.

So yes, get your palpitations checked out but don't alarm yourself too much.

[Frankiefarr in reply to helixhelix]

Thanks I agree with this thing about them looking like doctors at first glance. Have been checked out no obvious cause for them but I'm better when on no medication sadly no medication means uncontrolled inflammation not that the drugs have controlled it either ,(

[Hidden in reply to helixhelix]

Helix said everything I would. I just wanted to add that the newer RA drugs mean on the whole (although obviously not everyone) we are not experiencing as many non-organ complications as people did some years ago. Obviously, there will always be some who have very aggressive disease but the newer treatments mean that it no longer has to be inevitable.

I know you've had lots of issues with various RA meds and I have lots of sympathy. Have you had an ECG?

[Frankiefarr]

Hi crash doll yes had an ECG normal but fast pulse rate. Although there are many new drugs out there it seems access to them is patchy. I've failed on three dmards and have active disease but am being made to challenge and rechallenge the same three drugs.This is the third time I will have tried methotrexate and the consultant admits she thinks the dose will be too low to make any difference

[AgedCrone in reply to Frankiefarr]

If you have failed on three Dmards Frankie you should be eligible to try a Biologic drug. In my opinion it is cruel to ask you to rechallenge drugs that have caused you problems in the past.

Askyour rheumy to assess your DAS score & if it's +51.2 ask her if she will apply for funding for Biologics ( unless of course they are clinically contra indicated).

They are expensive drugs & I'm sure rheumies are unofficially encouraged not to prescribe them as they do take up a disproportionate amount of cash from the practice prescribing them!

However...if you need them...you should get them.

When you see the waste on spending on things like employment agency fees in the NHS I have no sympathy as the govt encourage chaos by throwing money at a problem that needs long term all round planning in every aspect..not just financial!

[Frankiefarr in reply to AgedCrone]

Indeed there is son much waste in the NHS. They do prescribe biologics in my area but it seems only when people are in the later stages like 15 years down the line. I have had no respite from the disease since diagnosis as the dmards don't work because I can't tolerate them or the dose is so low it's pointless. My employer is now getting very impatient. I have an appointment in April with the rheumy but they seem to keep hoping somehow something will change and they don't need to do anything. My DAS score is an issue as although I score highly on the joint swelling (though why feet aren't included is beyond me) no matter how swollen and how active the disease is visually my inflammatory markers are always normal. My rheumy acknowledges for people like me the DAS score is not an accurate reflection of the severity of what's going on but is key in the NICE guidelines

[AgedCrone]

If you can't change your Rheumy...throw a real wobbly...I'm sure some rheumies "adjust" DAS scores!