No marked improvement after 7weeks: Just enquiringly... - NRAS


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No marked improvement after 7weeks

Mollieharry profile image

Just enquiringly how long oral methotrexate should take to on my 8th wk of taking it.starting at 7.5mg and now up to12.5mg.will be at 15mg come Monday.i also take 3mg(6tabs) of sulfasalazine daily too.this initially worked on its own but methotrexate was added when it stopped working.knees still very sore stiff and swollen.ankles and feet just really sore.

16 Replies

I think most doctors say give it at least three months. I know that's hard when you are in pain and tired. Maybe call your rheumy helpline and ask if it's possible to have a steroid to tide you over, my rheumy did. The higher dose should also help.

Good luck x

Mollieharry profile image
Mollieharry in reply to allanah

Hi Allanah,rhuemo gave me oral steroids the beginning of December so I could go on holiday without being miserable and to give meds time to kick in.unfortunately she tapered them down and stopped after 4wks.when cutting down pain increased.dont think they would put me back on them as soon.

allanah profile image
allanah in reply to Mollieharry

Might be worth ringing them still. I got injections xxx

Fingers crossed kitty.thanks for replying.out of curiosity,do you know if the injection methotrexate works better or has less side affects?

allanah profile image
allanah in reply to Mollieharry

The oral can make some people nausea. The injection bypasses the tummy so tends not to cause nausea. But then you have to inject x

Hang in there Mollie and you should notice improvement soon. I did after ten weeks. x

Unfortunately, finding what works can be quite brutal. Mtx may not work in the end by itself. I was told that each DMARD is tested for a minimum of 3 months before adding something else if it doesn’t work. I took oral steroids for over 2 years to support 20mg mtx, sulfasalazine. Already given up on hydroxy as was pointless. At 2 and a half years and finally off steroids, was almost immobile still, so approved for Benepali. I’m now in a very different place.

That’s probably not what you really want to hear, and I hate that due to funding mainly, all the cheaper stuff is tried first when biologics appear to help immensely. Steroids will mask the disease to some extent which is not always a good thing.

I hope you find what works for you very soon. It’s horrid feeling so rubbish all of the time.

Hi. Stick with it, the impact from the MTX takes about 3 months to kick in. My rheumatologist gave me a steroid injection to ease the pain in the meantime. Maybe worth ringing your rheumatoid helpline in the hospital and explain your pain and hopefully they too will offer you a steroid injection 🤞🏻.

It’s the other way round I think. Because the injection bypasses the stomach and you don’t lose some of it it to your digestive system etc

in reply to MagsLough

I was put onto injections because I couldn’t tolerate the higher dose in tablet form though. Perhaps my post should have said tolerate instead of have. 😊

It took around 3 months for me and during that period I was also on a lot of naproxen to help get the inflammation under control. Your mtx dose is being stepped up quite slowly I think so hang in there

I was told it takes about 12 weeks. And for me yes it was about 12 weeks.

Started almost a year ago. Building the dose each time I visited the doc three months apart and new bloods drawn. I’m at 25 MG. splitting the dose 5 tabs one day and 5 tabs the next. I’m ok most of the time but pain can hit me anywhere making me either miserable or just uncomfortable. Right now my jaw is bothering me and may go to dentist to check it out. Last week it was my chest. Prednisone when there’s a flare. Hate it. Good luck with yours.


Hi, Methotrexate is a long term med and doesn't always show you any benefit immediately, try to stick with it.


I've been on 10mg, then 15mg MTX total of 8 weeks. However, weaning off Prednisone too. It is hard to tell if the MTX is working because the Pred. works very well for me for pain. I'm going from 15mg Pred. to 10mg. tomorrow. Then after a month, nothing I think. The MTX is supposed to have taken over the job. My Internist is working my meds. and I think it takes a LONG time to get it right. Pain is surely the hallmark of RA. Hope my limited info is helpful.

Mollieharry profile image
Mollieharry in reply to Nanna71

I would have thought it would have been better for me to stay on the prednisalone for more than 4wks,at least enough time for slight improvement,but this wasn’t to sure my rhuemo nurse had a reason for from all the comments i’m just going to have to put up with the pain and wiped out feeling a bit longer to see if adding the max is going to make a difference.thanks everyone for replying.

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