Methotrexate while on Methadone treatment. I need adv... - NRAS

NRAS
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Methotrexate while on Methadone treatment. I need advice.

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Has anyone ever taken Methotrexate while on methadone treatment I currently take 75 mg of methadone liquid oral once-daily I was prescribed methotrexate 2.5 mg six tablets once per week for sarcoidosis my question is has anyone else taken Methotrexate while on methadone treatment because I am concerned about being thrown into a full-blown methadone withdrawal the reason is before Methotrexate I was prescribed Medrol 6 day dose pack the pharmacist and my Dr said they seem no interactions between Medrol and methadone however on the sixth day of taking Medrol I was thrown into a full-blown methadone withdrawal my doctors and pharmacists once again say there are no interactions between Methotrexate and methadone however I am so afraid I'm being thrown into a withdrawal again as I am unhealthy and my organs cannot handle that has anyone else taken these two drugs together with no complications I do need to take Methotrexate as my sarcoidosis is quite severe but have been taking methadone for 4 years so it's not so easy to just discontinue taking that thank you so much for any advice anyone has to offer

27 Replies
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No but I find the methotrexate injection much kinder then the tablets

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in reply to Tinkerbell5

Thank you. I haven't even tried the tabs yet but really need to just get the courage to do it. I have Sarcoidosis really bad in my thoracic area, chest, heart lungs, lymph nodes. Which makes me feel like I'm having a heart attack sometimes. Yesterday it was the worst ever. It dropped me to my knees. And i havent felt good at all since that. Which is awgul because i would hate to think it was just sarcoid and it really be a heart attack and i ignore it. This disease is awful. But i will ask my Rheumatologist about injections vs tabs. Would a Rheumy Dr do injections or do you do them yourself?

lilyak
lilyak
in reply to Hidden

Hi Purplewings, please don't be so frightened about methotrexate. It is the most maligned medication and it has the worst reputation, when in fact it helps so many people. Most people have few side effects. Sarcoidosis is far scarier and can do far more damage to you than mtx ever could (unless you are literally one in a million). As for methodone and mtx, I was prescribed methadone while on mtx. I didn't actually take it, but I would be confident there are no problems with that, as my pain management doctor prescribed it, and it was reviewed by another pain management doctor. I know its hard, but trust your doctors. Of course always ask questions and if they don't answer them satisfactorily, then find a new doctor, but be informed and aware, but not alarmed. Take care xx

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in reply to lilyak

Thank you so much. Yes there is alot of concern with mtx even my Rheumy dr gave me the talk of its only a 50/50 chance it will help me and because of its toxic side effects i have to get bloodwork every 6 weeks on my liver. So that alone scares me. But i do have to just go for it because i am getting sicker from the sarcoid. Thank you again

Hidden
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in reply to Hidden

Hello there. You do injections yourself. They are fine. I didn't find the painful at all. The needle is very fine.

Sorry don't know about that combo.

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in reply to Hidden

Thank you so much. How often are the injections? The tabs I'm prescribed are once per week. 6 pills.

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in reply to Hidden

Once a week usually 🙂

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in reply to Hidden

Thanks

Hi purplewings I would keep asking gps and rumatology etc untill you are 100% specially with methadone I'm not sure if anyone has been on methadone on hear .i would like to think they checked the 2 go together .have you asked chemist as well .you really cannot give up methadone as well .hope you get the answers and sorted out

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in reply to Ajay575

Thank you. Yes my pharmacist has checked for interaction as well as my Dr. They both could not find any but once again they couldnt find any with Medrol dose pack and it caused me a severe withdrawal that lasted 4 days. My body cannot handle that.

Ajay575
Ajay575
in reply to Hidden

I no good hope you can get to bottom of it soon I know a lot of chemists are changing makes of meds to cheap ones

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in reply to Ajay575

Yessss. Thank you

Yes, for years I was on 70mg methadone plus 15-20mg MTX. The nice thing that the nausea associated with MTX meant I also got 56 cyclizine a month, which is very nice with methadone 😊. No problems whatsoever, the methadone was the best painkiller I’ve had. Sadly, the association with abuse of and addiction to heroin and other drugs - particularly across the medical professional sector - meant that the discrimination, incorrect assumptions and taboo forced me to swap it for morphine. I’m on a huge amount of that, having had a very bad year, but nobody ever views me with anything other than sympathy and respect. GPS are reluctant to prescribe methadone, yet give out large doses of other strong opiates like morphine without batting an eyelid.

I digress slightly! I didn’t fine methadone had any effect on taking MTX, which I’ve always had in injectable form.

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in reply to Embriony3

Thank you for your reply. That is comforting to hear that you had no interactions with methadone and mtx. I'm sorry but I'm not familiar with cyclizine? All i know is medrol threw me into a full blown withdrawal. There was no easing into it. It was very hard on me and i can't go throught that again. I also suffer from a very weak stomach i stay nauseated on a daily basis and worried mtx will make me vomit. When i vomit i can't stop. It goes on until im dehydrated and having to go to the ER room to get IV fluids. I pray mtx will not cause vomiting. I want to ask my dr if i can do a trial run and maybe just try 3 pills for my first dose. As i have said before i do need to stop whinning and take the mtx as Sarcoidosis has me pretty sick. I need treatment and the treatment options for sarcoidosis are awful so here i am. Thanks for the advice.

Embriony3
Embriony3
in reply to Hidden

Hi there

Cyclizine reacts with methadone and acts as a stimulant. It’s legit purpose is as an anti nausea drug. So you may be lucky and get it prescribed, try not to mention methadone at the hospital as they’re often suspicious - before I even knew about it’s effects, I had one GP who for years gave me Ondansetron which is *very* expensive and usually OTT for MTX nausea. It’s mainly used in chemo treatment and severe morning sickness. But this is what I mean about prejudice where methadone is concerned. Personally I don’t see what’s wrong with something that perks you up while you have to take an unpleasant drug like MTX and cyclizine doesn’t cause dependency or amphetamine like stimulation. (In fact it’s good with any opiate, but especially good with methadone). But that GP only saw me as a drug abuser and elected to prescribe a very expensive drug rather than give me something which in fact you can buy as it’s category P in the UK, not POM. I’ve not heard of Medrol, but whatever it is it must be a full on opiate antagonist, which wouldn’t affect someone with no opiate dependency, but would hurl anyone like us into full withdrawal. It’s happened to me before 😬

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in reply to Embriony3

Medrol is a steriod. I currently have a script for ondansetron. They write that for me with no problem but my pharmacist told me to becareful taking it with methadone because they both can cause the QT Prolongation heart problem. Thats my whole problem i panic over medications and fear taking anything. I honestly wish i didnt take methadone it interacts with too much stuff and scares me. But I've taken it for so many years i can't seem to get off it and my pain is so intense i couldn't imagine not having it. I'm in pain with it. I'm no spring chicken maybe a chicken lol. But i have alot of health probs. Alot. And now that im older i suffer panic and anxiety over every thing. When i was younger nope. Not to pry and this maybe to personal you don't have to answer but i was wondering how you switched from methadone 70mg per day to morphine without suffering a methadone withdrawal. I thought about switching but fear the change sending me into withdrawals.

Embriony3
Embriony3
in reply to Hidden

Hi there 😊 I am no spring chicken either, I have 5 grandchildren! As to your question re switching to morphine, it was not without withdrawal, you’re right 😖. Morphine doesn’t reach nearly as many opiate receptors as methadone so no matter how much I took, it never quite got rid of them for the first week or so. However, I first reduced my dose to 30mg, but it still needed 60mg morphine sulphate SR to make me feel comfortable. I struggled with the lack of longevity too. Although you’re not aware of it, methadone stays in your system so much longer - the half life for morphine is 4 hours, for methadone it’s more like 4 days! Since that changeover I’m now on huge doses of morphine as I’ve had such an awful year pain wise, but that’s another story. However, I wouldn’t go back to methadone however good a painkiller it is vs morphine, because of the way I was treated and the ignorance even among medical professionals and the taboo that shows no sign of changing yet. It’s on our regional formulary for pain, but *everybody* used to assume the reason for taking it was previous opiate drug abuse 😡

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Oh how i understand that. Every single doctor that has treated me this past year trying to get a diagnosis as soon as they seen methadone in my chart it was 50 questions and then the whole demeanor seemed to change. And some of them exspect you to just be able to stop taking it. Haha. Really. I have two grandchildren and the last thing I'm trying to do is abuse drugs. But i also don't want to live the rest of my life in agony which alot of days now I'm in but surely dont want to increase my methadone in fact thats what i assumed i would have to do is taper down to 20 or 30 mg and then try the switch. But where i live its hard to get anything wrote in fact i think getting morphine would be really hard. But on top of all my other health probs to then find out i have a pretty severe bout of Sarcoidosis is no fun. And I'm still trying to work because getting on disability is so hard. And no one but myself to pay the bills. But i am wearing down quick. In fact i wasnt able to work today because i was taking omeprazole for reflux and getd and had to come off that ovet a week ago to start the mtx. Can't take the 2 together. So believe it or not im sick as a dog from not having omeprazole. Its ridiculous. I appreciate you sharing your story with me. Makes me know im not so alone in this battle.

Don’t worry about taking Omeprazole or any other PPI along with your methadone. I successfully took both together for about 10 years! If that’s what you’re being told I would get s second opinion. Go back to your consultant and let him know your GP’s attitude. Does he want you to get a stomach ulcer?! I know you shouldn’t take a PPI like omeprazole at the same time as other antacids but that’s all.

alexask
alexask
in reply to Embriony3

I am trying baking soda for reflux. In part because it might help RA

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in reply to alexask

Yikes I've done baking soda. It does make you burp like crazy but the sodium content is so high and it makes me nauseated. But i have a weak tummy. It may work great for you. 😊

Embriony3
Embriony3
in reply to alexask

That’s interesting, my husband gets bad acid reflux but just treats it with OTC meds, neutralising agents basically. If it works I’ll see if he would try it. He’d be better off with a PPI from his doctor really, but he’s like most men - needs a hard shove to go and consult someone.

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in reply to Embriony3

Its not the methadone they were concerned about with omeprazole. Its methotrexate and omeprazole that have interactions. So my pharmacist and rheumatologist told me to switch to zantac. And zantac isnt working. I actually coughed up blood on Thursday and went to the ER dept they did a ekg ct scan bloodwork and then said it is most likely from the surge of acid because all the test were ok. Geez. I'm so over all this.

Did I say methadone? Sorry - my mistake. I meant methotrexate. I’ve taken MTX with omeprazole for around 10 years and never come across any problems, or warnings of any problems either from prescribers or the patient information leaflet. Do you inject your MTX? Maybe it’s never been a problem for me because it bypasses the stomach.

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in reply to Embriony3

No in fact i am new to this site in fact this was my first post. And i just started my first dose last night. Oral dose. Because they wanted the omeprazole out of my system. These doctors. So many different ways they all practice and prescribe. So i just took my first dose and I'm a nervous wreck my tummy does feel a little weird but i guess it can take up to 24 - 48 hrs for nausea to kick in fully. I hope thats not the case with me. But as i said before i stay nauseated on a daily basis anyway so i fear this will increase it. How do you get prescribed injection form of mtx? I wasn't offered a choice. I feel like i would have much less issues with injections. Anything in my tummy is never good. Like i said before i do have ondansetron because of how bad i deal with nausea and vomiting. But try to take that a little as possible. My anxiety gets the best of me when it comes to taking any meds. Its one of the most awful issues i deal with. My own mind is my worst enemy.

Purplewings, you clearly have a lot going on and are thinking and worrying about the consequences of meds taking together and of course your condition. I have never heard of your illness but read a bit about it. I understand how you feel with the heartburn. That must be so uncomfortable. Glad you have joined this very supportive and caring forum and I hope everything works out for you. I'm sure it will. Stay calm, easier said than done. Need a chat or a bit support someone is here most of the time. Take care Xx

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in reply to Shalf

Thanks. Yes my mind gets the best of me. Its hard to control my anxiety but this forum has already helped so much being able to chat a bit with others that take mtx. I did think there would be others on here that had sarcoidosis. It is kinda rare and most of the time doesnt give much problems im one of the ones that that cant get it under control. Some people have severe cases that would be me. I'm just hoping that mtx with put my sarcoid into remission if this doesn't work i don't know what they will try next. I have 7 very enlarged lymph nodes in my mediastinal thoracic chest area and they are like that due to sarcoidosis and its also in my lungs. They are trying to get it into remission right now its fully active. Its very similar to cancer when in a active state. One other reason my mind is over thinking. But I'm doing my best. Thanks again for the support.

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