Flare Up after taking Methotrexate

[Dingaan]

I'm on 25mg injectable Methotrexate. I take it on a Monday night and Tuesday I start having a flare. Tuesday evenings is the worst. Usually by Wednesday evening I start to feel better. I have been on this for months now and the same thing happens everytime. I would be interested if the same happens for anybody else.

[Downtime]

I noticed the same thing when I first started on Mxt but after a few months it did improve.

[Simba1992]

Have you tried lower doses?

[Dingaan in reply to Simba1992]

I have been on lower doses 15mg but can't remember. I have a few 15mg injections that are still in date so might experiment.

[Simba1992 in reply to Dingaan]

The lowere doses were probably increased because not enough effect?

Looked at your history. Understand you are no longer on any biologics and probably had to go back to mtx that hadn't been effective before?

[Mmrr]

Yes, I had the same thing happen with MTX , I mentioned it to my rheumatologist who said she thought the hot sleep was not related to MTX and tried to pass it off as menopausal symptoms, which I finished 12 years ago.

The hot sleeps did settle after a few months of being on treatment.

The literature providing side effects if MTX does not mention it either.

If you search past posts on this site, you will find a number of people have experienced the same issues. I keep a daily detailed journal and remain convinced MTX caused the hot sleeps.

[Simba1992 in reply to Mmrr]

Hello Mmrr,

You have often mentioned your hot hands at night. I have had the same and always at bedtime. I have thought it had to do with the inflammation in wrists, which I have heard gives this feeling.

[Mmrr in reply to Simba1992]

No not related to hot hands, which come and go, but 24 hrs after injecting MTX. The same happened last week 24 hrs after injecting benepali

[Dobcross1 in reply to Simba1992]

I don't have hot hands but the night I take MXT my sleep is broken by hot sweats all night and I sleep really badly. It's not menopausal but feels the same.

[janmary in reply to Dobcross1]

Same for me - usually 1 or 2 nights after MT X day I wake up in a hot sweat. Even with window open in freezing weather.

[Dobcross1]

I am so glad you have said this! The same thing happens to me and has done since I started taking methotrexate. I mentioned it to my GP and he looked at me as though I was mad and there was no way MXT should cause a flare so I put up with it. It only lasts a day or so but as I'm still waiting for mxt to work properly anyway it's hard to tell what's what. But pain is definitely worse the day after mxt. Sorry I know this isn't much comfort to you.

[Janakkumar]

If you are suffering from RA than Paddison programme for reversal of RA is the best.

Slowly you dosage of methotrexate will be raduced & not require to be taken.

[Simba1992 in reply to Janakkumar]

Are you on Padison? Has this happened to you?

[Dingaan in reply to Janakkumar]

It would be nice to hear your experience with the Paddison diet.

[Shelley1701]

I ache a lot the day after I inject my methotrexate. I'm on 15mg. A also ache after my Humira injection.

[Thingybob]

Yep. I get hot flashes after, but I can't work out if its the MTX, pred, blood pressure, RA, hypothyroid, post menopause flushing or any number of other possibilities. My rheumy says its the pred but who knows.

[anastasia43 in reply to Thingybob]

I get the same thing and I don't take pred. I do have hypthoroidism though. I've changed a number of meds and the only thing that I have consistently taken for the past year was MTX, and I always sweat the next couple of nights after it. I don't notice it as much as my husband does though, I seem to sleep through the worst bits, but he says the sheets around me are drenched after MTX.

[anastasia43]

I've always had night sweats after MTX but never paid attention to an increase in joint pain, maybe because there wasn't too much of a change compared to regular everyday pain. However I was off MTX for about a month now, and I went back on it after reading this post, and decided to pay attention more closely to those symptoms. Well, that wasn't hard - compared to the almost zero pain I've had for a month, yesterday and today I am barely able to type I 'm sure it will pass soon enough but now I'm curious to see whether this persists in the future or if it was just a coincidence.

[Millysmum]

I was only thinking this last night, I take 20mg on a Friday, and ache like hell on Saturday, I can't wait to take my 4 folic acid, sat eve, and then Sunday I'm getting back to normal again. I guess it's only one day, and I just fill Saturday with plenty to do, so I don't think about it.

[nomoreheels in reply to Millysmum]

Hiya Millysmum. Is this something your Rheumy recommended, taking 4 folic acid the day after your MTX? It's just I've not heard of this before & wonder if it's new thinking.

[Millysmum in reply to nomoreheels]

Hiya, ever since been on methotrexate 24hrs later its counterbalanced with prescribed folic acid. I have 8 metho on Friday, 4 folic on Saturday. I belive most people take folic acid, but sometimes it's prescribed each day instead of once a week. Mine seems to do the job. X

[nomoreheels in reply to Millysmum]

That's interesting. I'm wondering if those who have less tolerable side effects could ask their Rheumy if it's something they could try. Makes sense the higher dose will help ease the worst of them, knock them on the head or stop them developing totally. Not so much for me, 5mg every day except the day I inject works but so many have to give up on MTX because of side effects, it may be an option for them though. Thanks.

[Millysmum in reply to nomoreheels]

Been on this way, since May last year

[nomoreheels]

I've not had this recently (been on MTX a long while now) but I used to feel fluey the day after taking MTX when I was on tablets, don't know if this sounds familiar. I can't say it was as if in flare but definitely really groggy. Nowadays (on injections 9 years, currently 20mg) I've just less energy & no real appetite but it's only the one day so just don't arrange anything important if I can avoid it.

Have you mentioned this to your Rheumy? Might be interesting to see if any of his/her other patients have reported similar.