Side effects of increased dosage

[candyangel]

After a phone appointment last week with my consultant, he has decided to up me from 15 to 20mg of MTX a week. I first started on MTX around 13 weeks ago, the first few days I was quite ill, sickness and dihorea, but that cleared up after a few days. So Monday I started my new dosage and since then I have felt quesy, though not been sick, and have had dihorea a few times, and I have also completely lost my appetite, is that normal after such a small increase??

[springcross]

I started on on 15 mg MTX (Metoject) and had nausea for which I was prescribed an anti-emetic tablet but did not need them as the nausea passed off. The MTX was eventually increased to 20 mg and the nausea started again but after a while, it passed off again - I still get it occasionally but not so bad and not for long. I did not have diarrhoea but with you (correct me if I'm wrong), it may be that you have the tablets?

[Boxerlady in reply to springcross]

The side effect I experienced (fatigue) settled after a few weeks but with each dose increase it came back temporarily. I started on 15mg tablets, went up to 20mg, then onto 20mg injections and recently have gone up to 25mg. The fatigue (only for a day) is back but I'm assuming that it will pass as before.

Hopefully things will settle down soon but if they don't, I suggest that you ring your rheumy nurse as they may suggest that you change over to the injections.

[springcross in reply to Boxerlady]

Hi Bl. Did you mean to reply to me or candyangel? I already have the pen.

As a matter of interest though, have you ever had any hair loss with it?

[Boxerlady in reply to springcross]

Sorry - not used to the "reply" system here! No hair loss...

[helixhelix]

Yup, each time I increased dosage it was like starting again. But the good news is that each time it took a shorter time to wear off....

[candyangel in reply to helixhelix]

Thanks at least I know it is a normal reaction

[candyangel]

Yes I am on tablets, I also suffer from fatigue quite a bit, especially the day after taking MTX, the consultant also upped my folic acid, I originally only took it once a week but now take it 6 days. Hoping my appetite returns before Tuesday as it is our wedding anniversary and planning on treating ourselves to a takeaway, plus I have ordered some sweet treats to share with the kids!!

[springcross in reply to candyangel]

Yes, I hope it does for you too. Congratulations for Tuesday and I hope you enjoy your takeaway and sweet treats. xx

[AgedCrone]

Make sure you drink plenty & take the Folic Acid ....if you are not on 6 per week...do ask your rheumy nurse if can up the dose.

It can take a while to settle on Mtx...but if you persevere it is really worth it.

[candyangel in reply to AgedCrone]

When my consultant upped my MTX, he also upped me to 6 folic acid a week, as I was taking one a week

[AgedCrone in reply to candyangel]

That’s good...give it a week or two & it should make a difference.

[crashdoll]

You poor thing. It sounds like you’re going through the mill. Unfortunately, this can be normal in the early data and you’ve had quite a big jump in dose. Have you tried any anti sickness medications? Your GP can prescribe. You really don’t have to suffer, if feeling unwell, do don’t let it linger. I didn’t cope very well with the tablets and found the injections much better. I don’t get sickness anymore at all.

With any luck the increased dose of folic acid will kick in and help the side effects.

I hope you’re feeling better to enjoy your anniversary. Sounds like you’ve got some nice treats planned.

[candyangel in reply to crashdoll]

Thanks, how do you go about going on to the injections? Do you just ask your consultant if you can change over?

[summer32A]

I got to that dose but then my body rejected methotrexate and then I could no longer take it, but I do have bad reac reactions to some drugs sulphasazailne put me in hospital

[candyangel in reply to summer32A]

Oh blimey, that sound horrible, hope you are on something now you can tolerate!

[sylvi]

I would contact your rheumy team to be on the safe side.xxx

[Rashford20]

Out of curiosity, people on folic acid 6 time’s a week take 5mg per day? I’m guessing this is just on non MTX days?

[Dspooky01 in reply to Rashford20]

Yes, 5mg every day except MTX day.

[nomoreheels]

Can be. I first started on 15mg tablets & when I went up to 20mg I was getting nausea so instead of increasing my folic acid my Consultant prescribed injections, same dose then after 3 months brought it back down to 15mg. I've been on MTX 11 years & still have less appetite the day after I inject, I just accept it as parts & parcel & graze really as one day isn’t too bad.

[silentpool]

I am on weekly injections of 25mg mtx. I get nausea and fatigue for several days following the injection, but I can just about cope with it. I have asked about reducing the dose but am not pushing it as now probably isn't a good time to experiment. I was on just one day of folic acid 3 days after the injection, but after a telephone consultation with a specialist nurse I have been increased to 3 days. It is hard to tell if it has made a difference but husband says I am complaining less about feeling sick. I will phone my GP to ask about my next blood test results. I am worried that my alcohol intake is creeping up and I have been in trouble before about my liver reading. The GP has never contacted me direct but it might be easier now to secure a telephone appointment. It's powerful stuff to quite likely that 5mg increase will have a big impact to start with. Good luck!

[Smithycat]

I had a lot of nausea and also headaches when I was on 15mg and this increased when my dose was increased to 20mg ( I had anti nausea tablets which helped) I have also had other side effects such as changes to taste and appetite. I was told that if this continued I could switch to having Methotrexate by injection as this can be better tolerated. However, although I still have the changes to taste and appetite the other issues have resolved, admittedly after more than a year. I hope that this is helpful. I hope that you feel better soon.

[Smithycat in reply to Smithycat]

Ps my Folic Acid was increased to every day apart from the day that I take Methotrexate. I think that this has helped too.