Methotrexate dose ?

[Kathyem]

? If put on mtx injection, does anyone kniw why you go thru the 3 different doses, when they say it could take up to 3 months to work. Where as you are on each dose for only 2 wks at a time? I know about getting the right dose, but to go through maybe bad side effects or liver damage before you get to the right dose. Just curious, tks

[AgedCrone]

You should be having regular blood tests to monitor your liver function,& your rheumatologist will build up your dose slowly to prevent any serious damage.

[Kathyem in reply to AgedCrone]

Yes, my first test was fine, i am now with my 2nd dose. Thanks gor thr reply.

[helixhelix]

It's to help your body adjust to it as easily as possible and avoid side effects. If you start with the maximum dose - which some doctors do - it can be more a shock for your system.

[Kathyem]

I agree about the higher dose. I guess its, i would prefer staying at the lower dose to see if that would work, longer than the 2 weeks, if they say it could take up to 3 months. If that makes sense!

[Hidden in reply to Kathyem]

Makes total sense to me.

[Pamelah5]

Everyone's different mine took 6 months to take kick in it varies person to person some can take tablet form others injection, I went straight on to injections. They test bloods regularly

Pamela

[nomoreheels]

It could be just his way. My Consultant didn't do that he just started me on the same dose as the tablets to try & bring down my disease activity but the dose was too high so reduced it by a dose. If you're titrating the dose up maybe he thinks it's not such a shock to the system increasing the dose each fortnight, or you've expressed concern about side effects. If you're titrating the dose down maybe he wants to attempt to bring better control sooner & reduce/retain the dose according to your response. The person to ask for a definitive answer is him, or your Rheumy nurse, maybe call the helpline?

You should be having fortnightly new med drug monitoring bloods so any changes in your liver values should be picked up before there's any risk of it being seriously affected, if it is to be at all. My results are usually available the following day, certainly no more than 2 days, so if there's reason to my GP calls me. Side effects, well historically they're usually fewer or less of an impact when injecting but also the folic acid you should have been prescribed are intended to help ease them. Drinking plenty of water on MTX day also helps.

[Kathyem in reply to nomoreheels]

Tks, i totally get the theory of it! Blood work has bèen fine. No side effects, maybe a little on 2nd dose. I guess im just concerned of the increase.

[Pulfs]

I've been on methotrexate over 20yrs started on tablets 20mg was changed to injections 5yrs ago which was dropped to 15mg. Last 6mths liver function results keep being raised when I stop inject for 2wks it comes back down. Going to try dropping to 10mg but if it's still raised seriously thinking of coming off it and seeing if there's an alternative out there. I also have 6monthly retuximab infusion was wondering if the 2 are overloading the liver .

[Kathyem]

Yes, that seems something to look at, about the liver levels , with the 2 drugs. Good luck!

[Kariss]

Hi Kathyem,

I was told that mtx injections have a stronger effect than tablet form because less is wasted by not going through the digestive system and possibly being excreted. That may be why they try different strengths as the results could therefore come up different. In my cause I was given a lower dose when I switched to metoject pen because of side effects, and these have reduced considerably. It takes a while to find what is most suitable for you.

[Kathyem]

So, i just have to be patient and go through the process!