Methotrexate and Ulcers

[MrsC2403]

Hello.

I have recently started taking methotrexate injections and since I started I have the most horrific mouth ulcers. Wondered if anyone else had the same and if it got better?

Thank you. X

[allanah]

Yes, it's one of the more common side effects i believe. It did pass for me and I just used mouth gel etc initially. If it gets worse of course do give the doc a call xx if you look on the NRAS.org website theres lots of advice on mtx and other drugs x

[helixhelix]

Salt water gargles, and up the folic acid to the max. Horrible things, but may go away. If not ask to change drugs. I Haven’t had any for about 8 years now.

[Moog73]

Morning mrs C👋

I have the same problem and sore eyes.

Symptoms have eased a little since a started an increased dose of folic acid.

I also was taking amitriptyline which was potentially not helping.

Hope your symptoms improve, it's frustrating continually having a sore mouth, but it's the price of being able to walk.

Have a good day.

[Moomin8]

Hi, sorry to hear that you are struggling atm. Folic acid increase helped me. Check with your gp or clinical nurse.

[charisma]

Yes, MTX gives me them. Not severe but ongoing.

Other RA drugs also induce them for me though.

I take L-Methylfolate instead of Folic Acid; had to get Rheumatologist to write a letter to GP stating I had discussed this option with them and that it was my choice. Then GP could safely write my MTX prescription.

[Mollieharry]

Charisma could you please tell me the difference between l-methylfolate and folic acid if you don’t mind.i just like to know what is best for me to take.thanks.

[dawkin_S]

Yes, I had them terribly when I increased my dose - I had a big one at the back of my throat, really nasty, and some inside my lips. They did clear up though, and the GP recommended a mouth wash called Difflam which you can buy in any chemist - it really helped. I just had to eat soft and non-spicy foods while they cleared up. It felt miserable, but since they cleared up I haven't had the same bad ones again.

I *very occasionally* get 'normal' small ulcers now, but rarely and some Bonjela complete - the stuff that forms a protective skin over the ulcer - clears them up quickly.

[MrsC2403]

Thanks everyone. I’m on one tablet of folic acid 6 days and don’t take it in day I take injection. Will keep plodding on.

Xxx

[oldtimer]

The mouth ulcers were an enormous problem for me. I cleaned my teeth very carefully so that no remnants of food could be turned by the enzymes into more acid based liquid. I used an antiseptic mouth wash. I painted them with Orobase to protect them. I even tried local anaesthetic. Eventually I had to give up methotrexate. But it did help with my weight.

Such a shame as so many people do really well on methotrexate.

[Mmrr]

My GP prescribed Difflam mouth wash which helped. A move from tablets to injections also helped a bit, over time the ulcers did reduce.

[hatshepsut]

Difflam every time.....Hope they clear up

[Vivienham]

I've been on Methotrexate for about 9 months and have had the odd mouth ulcer until a few weeks ago when I had some nasty ones; on my inner lips and under my tongue. They are painful/sore, aren't they? Antibiotics got rid of most of them and the GP also prescribed folic acid 6 days a week (normally I take only once a week) for 2 weeks. I'll definitely try Difflam mouth wash - thank you to others for the recommendation. I hope yours are getting better MrsC2403.