Should I start Methotrexate now or after holidays

[Triple07]

Hi Folks,

Just a bit of “what would you do?” please...

After 18months on Sulfasalazine 3000mg controlling my RA fairly well these last few months have been a struggle, quite a bit of inflammation in my hands (which are always the main issue) feet and now shoulders.

Really struggling with work and just general running a household with children.

(Also building a house so the stress of that and trying to sell our current home REALLY isn’t helping!)

Had my Rheumy appointment on Friday and consultant noted my fingers are tilting (ulnar deviation) so has now introduced Methotrexate 15mg.

I am due to start at 7.5mg tomorrow, working it up to 15mg.....

However...

We are due to go to Ireland for a family wedding leaving next Wednesday (4th) for 5nights.

I really want to get the Methotrexate started as Id rather like to get back to functioning quickly and am feeling rather miserable but we haven’t been away for years and we are going away without the kids so I also don’t want to feel extra miserable!

Is starting the Methotrexate at only 7.5mg going to be that bad? What should I expect?

Is it a prolonged “yucky” or one I can work round days that we are home? Anyone got a Crystal ball?!

Thanks folk if you have read on this far 🙈xx

[Hidden]

Hi. My husband took his first dose of MTX last week. RA not controlled so didn't make him feel any worse than he did already! Whichever way you jump, and whose to say which is best, I hope you have a really good time and soon feel better.

[Triple07 in reply to Hidden]

Thank you for your reply, I hope ur husband starts to feel the benefits soon!

[summer32]

I would wait until after the holidays as it is a new medication, and you don't know how any side effects may affect you

[helixhelix]

7.5mg is a pretty small dose (and it will be 3 pills of 2.5mg so you can start even lower). I have no crystal ball unfortunately, but sometimes just getting on with stuff when you are busy can be a good thing as it takes your mind off worrying about side effects. However a week either way won't make much difference in the long run!

[Fra22-57]

I asked this for myself on a different forum and got good advice. Advice was not to start a new med before a holiday as could spoil it if you get allergic reaction to it.A few days won't matter and you want be adding more worry to yourself.Go and enjoy

[cathie]

A common side effect is diharrea (can’t spell) and fatigue I’d wait til after your trip.

[Triple07]

Thanks folks, great advice as always x

[annie0261]

MTX makes me sickly . Everyone responds differently, and it may not effect you however it might! So if you can it may be better doing after your holiday so that you are guaranteed to enjoy. x

[margeruite]

I would wait till after your holiday just in case it makes you feel rough the next day (as it does for me).

[Joy_1]

Hi

7.5mg is quite a low dose.

I started on 10mg MTX. Side effects only started kicking in when I hit 15mg.

[Nuttyshirlz]

Hiya

I also started on a 10mg MTX my side effects not start until my dose went up but If you want to drink at the wedding then I would enjoy myself then once got home I would start after my holidays.one more week won’t make any difference.I was also going to a wedding before start mine nurse said to enjoy myself first. Have fun x🙂

[nomoreheels]

Has your drug monitoring blood test been booked? Usually they're more frequent when first starting a DMARD (every 2 weeks for the first 6 weeks or so), so if it's been booked & you choose to start your MTX a week late it should be rescheduled for a week later too otherwise your Rheumy will be looking for it, maybe even chasing it up, & it won't have been taken.

If it hasn't then either start it with the thought you'll be occupied enough to not have anything too problematic, only really because 7.5mg is a very low dose & the likelihood is less. Although if you like a drink, & who doesn't at a celebration, particularly an Irish wedding, it's a good idea not to have alcohol for the first weeks on MTX so it's clear if any rogue liver results are due to the MTX not MTX plus alcohol.

Ultimately it's up to you, though I hope you have a lovely time whether you zig or zag. I don't know if you've been advised how to take your MTX but when I first started I took my 15mg as 2 tablets with each meal, for you it would be one tablet per meal of course. Some take the whole dose at night though it was suggested I didn't as they'd sit on my tum.

[Triple07 in reply to nomoreheels]

Thanks, didn’t think of that, it’s a shared protocol with my Gp who when I phoned today was completely unaware and had only just got results of a scan I had early this month so I’m now thinking it’s out of my hands anyway, by time gp gets the letter and acts on it I’m gonna be away... and yes it would be rather nice to have a knees up b4 the methotrexate regime! x

[nomoreheels in reply to Triple07]

It's good you have shared care, I find it more convenient. I hope whenever you do start it it works as well for you as it has for me, 9 years now, that it halts your drifting too & mom ever it's working helps your life generally. Do remember too, if you do start with side effects your folic acid could be increased to help ease them, that is if you've not been started on 6 x 5mg weekly.