Methotrexate - first week: Hello All, so I started with... - NRAS

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Methotrexate - first week

regina79 profile image
71 Replies

Hello All,

so I started with Methotrexate (7.5 mg) last Friday. The following day I had to stay in bed until very late (12) as the fatigue and hangover feeling were pretty bad..

After that I started having tummy pains and went to the toilet several times until yesterday. Better today! I will perhaps be on a better and lighter diet next time I take it, to make sure my tummy doesn't get too bad.

Oh I also got tongue ulcers straightaway! and still have...

I guess it could be worse...

I wonder if they will increase my dose eventually. xxx

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regina79
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JFlay profile image
JFlay

Hopefully you will adjust to it 👍 sadly I had awful side effects for the 20 weeks I was on it until I couldn't stand it anymore 😟 My NHS rheumy started me on 7.5mg and it was increased to 15mg gradually over the first few weeks. Hope it gets better for you as you go along 🤞

MTX injections may also be a possibility at some point too if you can't get on with the tablets.

regina79 profile image
regina79 in reply toJFlay

Oh no :( what side-effects did you get? I hope the tummy issues don't last....

yes, I will definitely ask for the injections xx

Pasjc profile image
Pasjc in reply toregina79

I was on methotrexate injections for 5 weeks had to come off as the stomach and bowel problems were so severe. I'm now on sulfasalazine first week very low dose tablets built up to full dose over 4 weeks. No problem so far but also no benefit I live in hope

dembonesDAMNBONES profile image
dembonesDAMNBONES in reply toPasjc

This is my third time on Sulf.

Nausea for at least half an hour after each tablet and by the time I was on five a day that was five bouts of nausea, every day, so I checked with my rheumy and gp if it would be a problem taking them all in one go, the idea being I would feel sick just once a day.

They were okay with it.

Two hrs a day for about a week, then it eased back, fairly quickly, once I started taking Omeprazole to to counteract it, along with probs caused by other meds.

What I didn't realise was the Omeprazole is dangerous to the kidneys and can prove fatal, requiring regular blood tests to monitor their condition.

Neither my GP or rheumy had thought to mention this, their concern being how the Sulf might be affecting my liver.

I only found out myself yesterday from a couple of ladies on this platform.

Another side effect of Sulf that some folk experience, myself included, is weird, sometimes very disturbing dreams.

Hope you're one of the lucky ones that has no side effects!

helixhelix profile image
helixhelix

Bad luck about the ulcers! Rinse your mouth regularly with salt water to help with them. I did get them after about 2 years on MTX and swapped to injections, and they went away.

But well done for starting! I know it took me a while to take those little yellow pills, and they sat on the table for quite a while before I managed.

regina79 profile image
regina79 in reply tohelixhelix

Will do, thank you! :)

I was thinking to ask for injections after this prescription ends in 3 months, as I think it's better on the tummy...

Thank YOU :) xxx I just wanted to start treatment quickly as I'm terrified of the progression of the disease.........

Bummer !! It’s a shame you’ve reacted so badly on your first dose. I’m lucky I just got tiredness I still do sometimes. Mouth ulcers are so painful 😖. My husband has suffered all his life. He was swishes his mouth with bicarbonate and water difflam spray from the chemist might help.🤞🏻things will settle down

regina79 profile image
regina79 in reply to

Yeah, fatigue and hangover feeling weren't great, but that was only bad the morning after!

The bad stuff was the tummy issues.. and ulcers I guess. But I can live with those I think?! As long as I don't get severe side-effects it's ok.

I will try that thank you! :) XXX

Georgiab123 profile image
Georgiab123 in reply to

My consultant told me to take folic acid 6 days out of 7don’t take it same day as methotrexate

regina79 profile image
regina79 in reply toGeorgiab123

Yes, I was told to take 5 mg of Folic Acid the day after taking Methotrexate. x

Georgiab123 profile image
Georgiab123

I used to take it one day a week, but mouth ulcers were terrible so consultlent said take 6 out of 7 days

regina79 profile image
regina79 in reply toGeorgiab123

same... :O I will tell my consultant then! x

regina79 profile image
regina79 in reply toGeorgiab123

did they go away when you took more? x

Georgiab123 profile image
Georgiab123 in reply toregina79

Yes have no bother now

Nellp profile image
Nellp

Sorry to hear you are having side effects on 7.5mg

I found it took 12wks to settle side effects but not my tummy. So after 7 mths i started to inject 15mg weekly and wish I had started earlier. I take 5mg of folic acid day after I take methotrexate and if I have mouth ulcers take 1mg of folic acid on other days but never on methotrexate day. I didn't feel well on 5mg daily of folic acid. I do suffer from fatigue and supplement vit d in winter months. Trying to find a balance that suits you is the biggest challenge. All the best and hope you feel a bit better soon

djt101161 profile image
djt101161 in reply toNellp

With the injection do you still get the hangover feeling the next day?

Nellp profile image
Nellp in reply todjt101161

I still feel under par and tired but because I can enjoy my meals without stomach problems it is a lot better with injection.

regina79 profile image
regina79 in reply toNellp

Good about the tummy but not about the fatigue. I started taking a Vitamin B12 spray thing daily to fight fatigue, but it doesn't work when it's too bad...

Nellp profile image
Nellp in reply toregina79

I do think vitamin supplements can help and as individuals we need different strengths to make a difference. It is trial and error I am afraid to find out what will help you but your rheumy nurse should be able to help too. Re fatigue I am not really making much progress but but natural vit d in summer does help. However I haven't been able to get the same boost using vit d supplements. Same with vit b12 as I don't seem to be able to get the level right. We are all on a journey and the aim is just to feel well!!

regina79 profile image
regina79 in reply toNellp

You are very right there Nellp! It's not an easy ride and it's definitely trial and error.

We need to keep trying. What sort of 'natural' vitamin D are you taking?

xx

Nellp profile image
Nellp in reply toregina79

What I meant was getting out in natural sunlight.

regina79 profile image
regina79 in reply toNellp

Oh yes of course..! 🤠

singlecrochet profile image
singlecrochet in reply todjt101161

I do--for 24-48 hours post inject.

regina79 profile image
regina79 in reply toNellp

That's great about the injections! So are you getting NO side-effects on these? I will definitely consider injections in future if tummy doesn't settle.

Do you still feel fatigued?

Yeah, the specialist said that she might increase the Folic Acid, depending on my blood work too.

THANK YOU! xx

TheBoys profile image
TheBoys

I had terrible fatigue on my first week or two and had a terrible diarrhoea incident in public. Now i set aside my Methotrexate day, Monday, as a day at home. Sometimes i get tired on the Tues but it s easing . Its settling down quickly to be fair so do stick with it. Apart from some blotches.on my sides and tummy am pretty ok on it. I take my folic acid on Friday which tends to make me feel "content "in myself.

Hope it works out.

regina79 profile image
regina79 in reply toTheBoys

Yeah, fatigue is very bad for me too actually, so far 2 days since I took it. And tummy was pretty bad after 2 days and again after 4 days :o :(

I have chosen to start with it at the weekend cos I can relax and rest at home if needed.. So i'm taking it on Friday night. xx

regina79 profile image
regina79 in reply toTheBoys

I will stick with it, but might consider injections in future if tummy doesn't settle. x

regina79 profile image
regina79 in reply toTheBoys

Is the fatigue better after weeks of getting used to it? x

TheBoys profile image
TheBoys in reply toregina79

I would say yes. I found now that its diminished... i get good days eg this week, whereas last week i seemed to want to lay down alll day

.i take my Methotrexate on a monday, so yesterday felt a bit tired mid afternoon..today, weds i feel fine.

Stick with it, its true what folk say, for most people,it settles down xx

regina79 profile image
regina79 in reply toTheBoys

Thanks! I will do :)

Tinpol profile image
Tinpol

I have been on methotrexate for a year now and experienced those side affects at first.

regina79 profile image
regina79 in reply toTinpol

Thanks for sharing! xx

Asheen profile image
Asheen

Morning Regina .... just give your body time to adjust & take it easy the day after.

I have a pen with 25 mg dose (weekly) following day is much better now but still have an easy day 😊

Good luck x

regina79 profile image
regina79 in reply toAsheen

Thanks!! I will wait and see. As long as my blood work is ok too of course. Will have to go and check next week. May I ask something about the pen? Is this pen a "fast prick" on the skin or is it a long injection as normal ones with no pen?!

Thanks!! xx

Asheen profile image
Asheen in reply toregina79

Hi, sorry for long wait for a reply.

It’s a pre measured dose in a pen, thin needle (you can’t feel it) I find it far better than tablets & kinder on the stomach.

Good luck xx

regina79 profile image
regina79 in reply toAsheen

No worries and thanks for replying!

Sounds good!! I will definitely ask once my month worth of pills is finished..

is it a 'quick' prick with the pen?

thank you!! xx

Asheen profile image
Asheen in reply toregina79

Yes it is a quick painless prick ... 😉 xx

regina79 profile image
regina79 in reply toAsheen

Amazing.. just what I wanted to hear.. scared of injections and needles. But if it’s like a pen and hidden and fast I can do it!

Do you find that injections work faster and better compared to the pills? Xx

Asheen profile image
Asheen in reply toregina79

Oh yes definitely, injections are tummy or top front thigh area.

The needle is hidden away which will be great for you, I don’t even bleed.

Unlike a small bleed when you have a blood test xx

regina79 profile image
regina79 in reply toAsheen

Sounds great. I’ll definitely ask for that instead after a month on methotrexate. That is if my blood work etc is ok on it for a month.. xx

Asheen profile image
Asheen in reply toregina79

Great....good luck 🍀 xx

djt101161 profile image
djt101161

I have been on this medication for over a year now, the only side effects that I get now is the fatigue the following day, I find it unbearable, my dose is 15mg, I also take folic acid 6 day's out of 7.

regina79 profile image
regina79 in reply todjt101161

Same, but I also got fatigue on some other days (yesterday for instance was super bad!) afterwards. xx

Arthurthecat profile image
Arthurthecat

Hi there! Everyone on here has a very individual and personal response to the meds we are given.

I have been taking MTX 20mg morning once a week with folic acid on the other 6 days, since November 2015. I initially was on less folic acid and had a few mouth ulcers. Increasing folic acid helped and not had any since. Always took just before bed and sat upright for 30 minutes and then slept through any nausea. MTX wasn’t sufficient on its own to control RA so also take 2g sulphasalazine ( split into two doses a day. And Enbrel ( now Benepali ) was added in March 2017. This combined approach has controlled my RA which has stayed controlled over this period. If I miss the MTX I know about it but I can live a relatively active life even including a dance aerobics class, yoga and Pilates - though within my comfort zone. I am now 5.

Please persevere. You may be one of the lucky ones like me that the medical regime works for and keeps the RA at bay.

regina79 profile image
regina79 in reply toArthurthecat

THANK YOU! I will persevere, despite the lethargy and fatigue and bad tummy... To me these are not severe side-effects tbh. I experienced worse with other meds. :O xx

Arthurthecat profile image
Arthurthecat

Btw 56 not 5! Typing variable!!

precious123 profile image
precious123 in reply toArthurthecat

Wow I am 60 and have been on the methotrexate for about 3 months now. I do take the injections. I am much better than I was but still not good enough to hold out to do anything much. My dosage has been increased twice. I cannot take the sulfasalazine due to stomach issues. I have been on everything under the sun for this mess and nothing helps me over 6 months. Some things have lasted a year but that is rare. The meds just stop working and the sed rate and pain to through the roof. This is the second time around on the methotrexate the first time it caused my liver enzymes to go crazy. Hopefully I can get through this time without that. So adding the extra meds have helped you? My Rheumy told me that he would do that if the methotrexate alone didn’t do it. Just wondering when he will add something else. I’m so miserable feeling like this for so many years. He has been trying to get things under control for me for about 12 years now. He is a great doctor and folks come from way off to see him. I’m fortunate to have him as my doctor. Anyway have a great day, Peggy

RAlife2018 profile image
RAlife2018

Hi, same happened to me. I’ve been on/off since March. They started me on 10mg and within thirty minutes I had a mouth sore and by morning I had four, plus my lymph nodes went crazy. Doc stopped MTX until lymph nodes calmed down because I coincidentally also ended up with an upper respiratory infections. Three weeks later after lots of steroids and 6 pound weight gain; they restarted me at 5mg for two weeks, then 7.5 for two weeks and now finally back on 10mg. Hope this helps!

regina79 profile image
regina79 in reply toRAlife2018

Thanks for sharing your experience with me. Yes, I feel you about the mouth ulcers :( it's very uncomfortable but I guess I can live with them. What Im struggling with is the LETHARGY and fatigue. :(( not great at all xx

precious123 profile image
precious123

Hey Regina79. I still feel bad the day after I take my injection. They have increased my dosage twice now. I had the mouth ulcers bad when I first started but now not so much. The medication is helping me I am hoping after this last increase it will help even more but right now I’m having a lot of weakness all over and especially in my hips which was not unusual anyway. But having mri of hips and echo on heart done to make sure nothing else is gong on. I was put on medicine for diabetes on Friday of last week as the steroids I am on and have been on for many years is causing a problem with that now. Can’t seem to get off of those without bad flares. Hang in there those ulcers will get better and hopefully so will the day after effects for you. But I know when I take mine I will be feeling bad the next day. I just go with it. Lol. Hugs to ya

regina79 profile image
regina79 in reply toprecious123

How long have you taken it for? I felt hangover and very fatigued the day after and also yesterday felt very lethargic at work... not great! But better today. Yeah, tongue ulcers still there.... hopefully they will clear up in time.

Thank YOU and I hope you feel better too. So sorry to hear about your diabetes diagnosis too :( xx

precious123 profile image
precious123 in reply toregina79

Regina79 thanks so much. I have been on methotrexate since April or first of May. Anyway I feel that way the day after every time. Hasn’t changed for me. I’ve heard others say that the day after they always make it an easy day. Hugs my friend.

regina79 profile image
regina79 in reply toprecious123

Oh :/ it’s not great that the fatigue hasn’t settled. I could put up with it if it’s only 1 day but I felt crap most of the week after taking it really.

Has it started working now..? Do you feel relief from pain? I hope you do xx

Maggiemae58 profile image
Maggiemae58

Good morning. I have been on 25mgs of Methotrexate for 2 yrs. with minimal side effects apart from mid afternoon tired spell( not sure if that’s just old age). Lol. It took 3 months on the Methotrexate to notice any improvement in my RA. But I went into remission for almost a year. I’ve now had some milder attacks but nothing that Advil can’t help out. I do wish you well on your RA journey.

regina79 profile image
regina79 in reply toMaggiemae58

Same... yesterday at work everyone mentioned how 'tired' I looked! I hate that... I just felt as I needed to lie down pretty much all day! and I took the drug last Friday.

Not only for old age people then ;)

It's amazing about remission! :O It must have been so good to get some relief from pain etc.. wow. I wish it will happen to me.

What are you taking now then?

THANK YOU! xx

Liggle profile image
Liggle

Very bad luck it is supposed to be wonder drug , I cannot take it terrible tummy trouble, big sore on my body ,keep trying for a bit your body may settle down. Good luck R/Arthritis is so awful, hope they find a cured soon x

regina79 profile image
regina79 in reply toLiggle

Yes, but I'm glad I didn't get sickness and worse side-effects.. I still have bad tongue ulcers! :( hate them. Tummy was quite bad on Sunday and yesterday. I did feel much more lethargic, apathetic and fatigued since Friday :o I definitely don't feel myself.

I wish so TOO xxx

JFlay profile image
JFlay in reply toregina79

I didn't have any problems to speak of the first month when I was on 7.5 and then 10mg, apart from feeling tired. It was when the dose increased to 12.5 and then 15mg that my gut issues and headaches started (I rarely have headaches normally). It takes time for the drug to build up. After trying to plod on with it (5 months) I thought I just can't live like this, it was annoying because it was starting to work for my RA symptoms. I've now changed DMARD. I really hope it settles down for you.

regina79 profile image
regina79 in reply toJFlay

Yes, the fatigue is very unsettling as if you need to be at work you can't feel that way all the time.. It's extremely uncomfortable :( All I want to do is being in bed and REST. Soon it will be my 40s birthday, end of September, and I can think of many ways I would love to celebrate as a huge 90s party in a club and dancing all night, but I don't see myself and my painful joints doing any of it... sadly. x

regina79 profile image
regina79 in reply toJFlay

What is your new DMARD? And how are you getting on with it? xx

JFlay profile image
JFlay in reply toregina79

I started hydroxychloroquine last week, so far so good 👍 but like all the DMARD's they take ages to start working 🤞

regina79 profile image
regina79 in reply toJFlay

I see. I really hope it gives you relief soon enough :) fingers crossed.

So, no side-effects?

xx

JFlay profile image
JFlay in reply toregina79

Early days yet but no seems good! Just hope it kicks in and works 🙄

regina79 profile image
regina79 in reply toJFlay

How long has it been? x

JFlay profile image
JFlay in reply toregina79

Only a week 😂

regina79 profile image
regina79 in reply toJFlay

Like me on Methotrexate. Well let's wait and see then! I have to say though that my hip feels 'different'.. a bit better?! :O but everything else is still bad: shoulder and arm very bad, hands not too bad, toes have started getting bad :o

JFlay profile image
JFlay in reply toregina79

We'll get there! eventually!

regina79 profile image
regina79 in reply toJFlay

YES! we have to! |:O) x

Liggle profile image
Liggle in reply toregina79

Bless you darling,

Kaz13A profile image
Kaz13A

I started methotrexate 2 weeks ago , I found my throat very dry and had couple ulcers on my inside lip also had to run to the loo a couple times but all in all not to bad , very tired for first couple days after I'm hoping this will improve in time .. hope things get easier for you .

Elsabeth profile image
Elsabeth

I just started on Monday, no tummy problems but I've never been more tired in my life! I feel your pain.

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