Taking methotrxate early: I know they say to take mtx... - NRAS

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Taking methotrxate early

Dreamer85 profile image
15 Replies

I know they say to take mtx injection same day and time every week.

Do you think it would make a difference taking it a day early as a one off?

Mtx makes me feel really ill and sick the day after I take it. (Fridays)

It's for purely selfish reasons, it's my birthday Friday and I want to enjoy the day with my family, without feeling terrible.

Thankyou 🙏

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Dreamer85 profile image
Dreamer85
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15 Replies
helixhelix profile image
helixhelix

In theory you are supposed to leave 7 days between doses. So what the official advice would have you do is take it after your birthday on Saturday. Then the following week you take it on the Sunday, and the next week the Monday etc etc until you get to the day you want.

Missing one week shouldn’t make a difference I know some people do for a special occasion. ( I have) I take it you usually have your dose on a Friday to recover over the weekend which if you work is a good idea . Hope you have a lovely birthday 🎁

charisma profile image
charisma

Have a lovely birthday! I use my injections on the same day each week but slowly manipulated it to my preferred day by doing it one day earlier for three weeks. No harm done like that, or by skipping a week once established on it.

dawkin_S profile image
dawkin_S

I take tablets so don't know if it's different, but with them you can take it a day late instead, or even skip a dose - I have done when ill, for example. Of course, I'm not a doctor!

More to the point, Happy Birthday for Friday!

Dreamer85 profile image
Dreamer85

Thankyou! I'll have a think about the best thing to do.

I've been on mtx for 2 years now and I'm quite controlled so if I decide to miss the dose hopefully it won't make a difference 🤞

springcross profile image
springcross

Have a good one. x

Boxerlady profile image
Boxerlady

I think that you're probably right that you won't notice missing one dose - I didn't when I had a nasty cough. If you don't do that, it's probably better to take it a day late rather than a day early. Have a great birthday! 🎂

Brushwork profile image
Brushwork

You really should not take it early. I have often delayed my meds by a day or so, but never, absolutely never earlier. The drugs are too dangerous to risk an overdose, which you wouldn't do by delaying.

Stay safe

Hamby10 profile image
Hamby10

It shouldn't make a difference. I used to do it. Tell doctor it's not suiting you. There are lots of different drugs to try that are better. This is the cheapest first drug that they try. It makes you feel terrible!. Both me and my daughter were given this as first drug. We both felt sick etc. on it. The doctor changed it. Rituxinab and sulfasalazine work for me. My daughter is on tocilizumab and that works for her. Neither of those make us feel ill. Yoy shouldn't have to feel like this. You will have to wait till after covid sorted to start them probably. Sulfasalazine could probably be started now though.

Dreamer85 profile image
Dreamer85 in reply to Hamby10

Thankyou, I'm on leuflunomide too.

I've tried sulfasalazine it worked well for a few years but stopped being effective. I'm going to speak to rhumy after covid when I can see someone and ask to change.

I get sickness and mouth & lip ulcers constantly and it does get me down.xx

MagsLough profile image
MagsLough

I'd go late rather than early, maybe wait until after the weekend as a few days skipped won't matter too much and Monday is probably best day of week to have a "down" day :-)

nomoreheels profile image
nomoreheels

Not a day early as you’ve to leave 7 between doses but a day later could be an option. I have on occasion skipped a week for a special occasion or short break. I’m pretty well controlled & don't miss just the one week.

Just thinking... how often do you take your folic acid? If it's less than 6 days a week you could request it's increased, that may help your day-after feeling. Or do you have the option to decrease your MTX dose slightly & increase your LEF dose? My most recent MTX decrease has eased the symptoms that have been building up over time. That & a change in antiemetic. Ignore this if you’ve explored these options without success.

Dreamer85 profile image
Dreamer85 in reply to nomoreheels

Thankyou! Yes I'm going to speak to rhumy about reducing my mtx dose down to 15 from 20.

They advised that my ulcers that come up on my lip are my body's reaction to a high dose( they take forever to heal) and also the mtx fog feels worse so im hoping a small reduction will help. I'm already taking folic acid 6 days.

Thankyou. Xx

nomoreheels profile image
nomoreheels in reply to Dreamer85

I was fortunate in that I only needed a 2.5mg reduction, went from 20mg to 17.5mg. It sounds reasonable that the dose is relative to your symptoms, so maybe a reduction will seem them improve too, I hope so for you, especially as you're taking as much folic acid as you can.

I was told by the rheumatology pharmacist that varying it by one day is OK, either earlier or later, but not to change it any more than that. Hope this helps.

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