Mouth ulcers

[jane1976]

Have people on oral methotrexate had problems with mouth ulcers? Have people on methotrexate injection not had mouth ulcers?

[Matilda_1922]

Yes I do with both oral and injections

[Deniseelk]

I took oral Methotrexate for 5 1/2 months ( had to stop as I couldn’t tolerate the side effects and my Rheumy said it wasn’t holding the RA) and I had mouth ulcers. My hygienist suggested using a mouthwash “gengigel” which aids the speedier healing in a more natural way. I found it in Boots for around £6/£7. All the family can use. When I stopped Methotrexate all ulcers stopped! On Benepali now and no side effects! Best of luck.

[helixhelix]

I took MTX in tablet form for about 2 years, and then developed mouth ulcers. Tried everything to get rid of them with no success as I was afraid of needles. Anyway finally gave in to my rheumies suggestion that I try injecting MTX. Within 2 weeks the ulcers were gone, and have never returned...(it's 5 years now that I've been injecting).

[SnooW]

I was on methotrexate for around 18 months, tablets first and then injections. Mouth ulcers were one side effect I DIDN'T get, thankfully.

[Mittagating]

I was on Mtx two years and got mouth ulcers, rheumatologist took me straight off it and said I couldn’t tolerate it, despite being only side effect I had! He had made me raise to top oral dose when I hadn’t wanted to - I’ve changed rheumatologist now and just starting out on hcq.

[nomoreheels]

Hiya Jane. I've been on MTX 8 years but never had mouth ulcers. I take it you've tried taking increasing your folic acid? MTX is a folate antagonist, it inhibits a particular enzyme that we need for DNA cells, ones replenished all the time including those in the mouth so we need to be sure we're taking enough to counteract this loss. If you're not sufficiently then you can get mouth ulcers. I take 6 x 5mg a week, just not on the day I inject, if you are too then let your Rheumy know, if you're not then ask if you can increase the days you can take it.

Rinsing your mouth in warm salt water a few times a day may help too.

[Magymay]

Hi Jane I was on Methotrexate tablets and was plagued with mouth ulcers.It was a pain as I wear dentures so i couldn't go out without teeth .Now on metoject not so many ulcers but skin peels off inside of mouth .Not pleasant but can't find solution.I guess I can live with it 😕

[Hidden]

Yes, i had mouthful amongst other nasty side effects, used adult bonjela, this was on 20 mg. they can alter amounts etc: reduced mine to 12.5 & added hydroxychloroquine in. Also upped folic to 6 days a week, drank loads (water!) i still get nausea from both even tho metoject now. I'd try advice line, good luck x

[Nettac]

I'm on tablets. No mouth ulcers...yet!

[Downtime]

Yes I have a sore mouth a lot of the time with ulcers usually inside my bottom lip. Really hurts when I’m drinking hot drinks. I don’t have them all the time and they’re not always proper ulcers just sore swollen bits. Try to ignore it and sometimes I increase the folic acid but it doesn’t seem to make much difference.

[lornaisobel]

Im on methtrex 25mg injection weekly - I take folic acid every day and have found I dont get mouth ulcers - before I took daily folic acid I use to get them all the time - I also use a mouth wash 3xdaily if I remember it also helps - keeping your mouth and teeth really clean seems to help xx

[Joy_1]

I have had MTX both in tablet form and jab form. Both forms have given me mouth ulcers. A pharmacist told me it's to do with the immune system. So the MTX as we know suppresses the immune system to a degree. The mouth is a haven for 'germs'. So your mouth becomes a place to go on holiday for all the bugs/germs.

I found a solution though.

Rinse your mouth with saline (salty water) around 5 times a day. It was a Pharmacist that told me to do this. He said don't waste your money on rinse aids and who wants to take yet another drug. For me what worked is to use warm water (more salt dissolves in warm water + gentler on mouth), hold water in mouth for 1 min each time rather than rinsing. I found rinsing action to painful.

The pattern was always the same with me. 48 hours after taking my MTX I would feel the first signs of pain. Rinse 5 times a day for 2 days and the mouth ulcers did not appear.

In the beginning I had 4 huge bulbous ulcers and it 2 weeks to get rid of them.

Nowadays I hardly get them at all - perhaps once every 3 months.

[jane1976 in reply to Joy_1]

Hi Joy_1

I’m exactly the same with my sore mouth! I take my methotrexate on Thursdays, by the weekend my mouth is so painful I could cry!!

Nurse advised me to stop methotrexate for 2 weeks then she’ll ring me. I’ve gone a full week & missing out today’s dose, my tongue is totally healed!!

It’s not a one off having a sore tongue, it happens all the time, but it seems to be getting worse.?

[Joy_1 in reply to jane1976]

I totally sympathize Jane. When the mouth ulcers were at there worst it was tougher dealing with the mouth ulcers than the RA!! I could not eat, drink, talk and I had to have paracetamol during the night as the pain woke me up.

I tried reducing my dose of MTX and as you say it works straight away but then they came back so I reduced a wee bit more again (hitting 10mg MTX) the pattern was the same but this time the RA pain kicked in.

Hence I arrived at the saline solution. I can't quite recall but I think I had to religiously take the saline 2 days after MTX day for 2 days for about 4 months. It was at this point that the mouth ulcers gave up their attack.

They now only come back if I am run down eg during a cold virus in Dec.

[va972tdw]

Just increased my MTX injection to 20mg weekly and within a few days my taste buds on front half of tongue all red and sore. Also take 1mg Folic Acid daily. Not sure if it is dose related as I didn’t have this on smaller doses. It’s no fun Reading up I’ve seen warm saline or apple cider mouth rinses can help? I’m going to give it a try and also call Dr.