I took My first dose of methotrexate 10mg tablets on Thursday morning by the afternoon I felt nauseous and starting getting palpitations, anxiety and first and second night I only slept 2 hours each night.
I felt bit better today but still have anxious feeling so going to call nurse tomorrow for advise. Too scared to take next dose on thurs again!
Hi I had very similar reactions when I first started - nausea is, I guess natural reaction to new drug - mine eventually settled down with some tweaking from my team.
I however also did experience palpitations and dizziness and hot flushes/ I got checked out with GP who assured me it was anxiety and also a natural reaction and it settled down
I don’t sleep well but it is now more down to discomfort but also sometimes anxiety
Good idea to speak to your nurse - we are all different
I also use a good App called Headspace which helps with anxiety- other apps are available 🤣🤣good luck hope everything settles down
Rheumy Nurse advises daily Folic Acid (but not on MTX day) helps with the sickness feelings etc.
So pleased that you seem to be getting are getting sorted I take folic acid too and it does help - I now inject methotrexate as nausea did continue quite badly for me on daily basis and I lost quite a lot of weight. I have no problems at all now and though I was nervous about injecting really pleased I made the decision
I think there is always a solution for us one way or another - good luck
It's normal to feel anxious when starting a new medication that you are already anxious about taking! Some of your symptoms may be due to this and will settle with anxiety calming techniques like slow breathing in and out and distraction. Take the time to do this so that you can feel better. But some people do feel nausea and that can either wear off, or persist according to the individual.
Sorry to hear of the nausea, but it is fairly common to feel quite sick and yuck when starting a new drug, the nausea often settles after a week or two.
I sometimes also get a bit flushing and raised heart rate too, but again this settles quickly.
But best if you are worried to contact your rheumatology nurse.
It is probably anxiety...try to find something to take your mind off dwelling on Mtx.
You say you feel better today....think about it....if it was the Mtx you would probably be vomiting by now.
Mtx is is indeed one of the best drugs available for RA & if you don’t Overthink it too much you may just have found “your“ drug that will keep you well for the next many years.
Which is a lot better than chopping and changing and trying lots of other drugs ....which if you’re going to be anxious about Them......will just give you the same nauseous feeling.
Everybody is over cautious starting on R.A. meds...but if we want the relief....we have to take them.
Try to dig deep & take your next dose after dinner with plenty of water......with a bit of luck you will sleep right through and wake up feeling much better.
I used to get nausea when I started taking the tablets, I now inject my methotrexate and have very little side effects. Do you normally feel anxious? Perhaps the palpitations are connected to the anxiety as opposed to the methotrexate?
Hope you get a helpful response from the nurse. I didn't have any problems with nausia or palpitations but I did find that my mood was lower and I got a bit teary for the first couple of days. They increased my folic acid from 1 to 6 days a week and that really helped. The foggy head/tiredness the first day gradually decreased as the weeks went by.
Hiya Muds 68, welcome. It does sound as though it's the taking of the MTX that is causing anxiety, it's not unknown. Quite why taking it causes more problems than other DMARDs I’m not sure other than it's often the first med given on diagnosis & sometimes the first prescription med ever needed. There is also the fact they are such small dose tablets so you're taking multiple tablets not just taking one tablet. Sometimes it can be bothersome that it was first a chemotherapy med, although it's not when we take it for RD & other inflammatory conditions, as you know it's a DMARD & why we're only prescribed low dose tablets, so they're distinguished from the 10mgs. When used for treating cancer it is at far higher doses & daily not once weekly. Some people fixate on side effects also, & can actually have some, but more often than not they are only really bothersome when you start taking them, like any med the body does get used to it & they ease or even go the longer you take it. Nausea is one of the most common just so you're aware but this is why folic acid is taken.
Do you think anything makes sense to you? When I first started MTX I was nauseous but wasn’t actually sick & as it was my second DMARD it didn’t faze me. That sounds a bit big headed, what I mean is I wanted it to work because my first did to begin with & I wanted to get to feeling less pain & having less inflammation so I could walk normally again. I had hair thinning too so my folic acid was increased to once a week the day after to the twice a week the day before as well. This solved both issues, though to be honest the nausea wasn’t bothering me so much but the hair thinning did a little.
I always took my MTX tablets with meals. My first dose was 15mg so I took 2 tablets with breakfast, lunch & evening meal, as my Consultant recommended. Spreading them out & taken with food I’m sure helped the nausea. I take it you have been coprescribed folic acid? It could be you need an increase in days you take it. I'm prescribed it 6 days, just not MTX day, my Rheumy's preference. This year I've been on MTX 11 years (injections 10 years), diagnosed 12.
Are you generally an anxious person do you think? Or is it that it's all too much, diagnosis can be a big thing to come to terms with & maybe this is part of why you're feeling as you are. I think you're right to have a word with your Rheumy Nurse, she may be able to offer other help than us being able to speak with you. We have experience in spades being the ones who take the med but sometimes you need someone to speak to & be reassured for whatever reason bothers us. I hope she can help, but it not keep talking here, something may just complete sense & switch off that very real concern. Also, there is the NRAS helpline, again speaking with someone who who has experienced the same problems may be what's needed. It's free from a UK landline 0800 298 7650
If all else fails there are other DMARDs available for your Rheumy to prescribe but I would say give it your best, nobody can say you didn’t try if you do.
Keep in touch, let us know how you're getting on.
Thank you for your reply, I’m not anxious person and take other medications for asthma and for stomach.
I was nervous starting these tablets but I know it was the medication but have a nurse calling me on weds for advice so will see what she says.
I took folic acid the next day after taking Methotrexate and drank lots of water.
I will update post when I know more
Thanks
You're welcome. Look forward to your update.
Hi, Glad to hear you have been getting on well with MTX for such a long time. Is it true that you should not drink Alcohol whilst on MTX? Or can you drink occasionally? The same goes for Tea or Coffee and Fizzy drinks, or so I have read on leaflet? Any experiences? Thanks
No, you can drink alcohol on MTX, that is as long as your liver results are stable. What I would recommend though is trying not to drink for the first few blood tests when you start MTX, just so you see how your liver responds to the med & of course so you're getting a true representation of MTX potentially affecting your liver. After that it's just a case of being careful, keeping to the recommended units (14 units/week*) so not bingeing really, or drinking your weekly units all at once! Always be guided by your Rheumy's advice though. Obviously if your LFT values rise limit or stop your alcohol intake until they go back to your normal values.
Caffeine is different in that it was considered the good effects of MTX can be reduced if you have high intake. That seems to have been disproved. To be perfectly honest I've never changed mine & still drink caffeinated drinks & coffee. It all depends on your body’s response I suppose. The same may not be the case for some other meds commonly used in rheumatology though, prednisolone for example. So, again, see how it goes & just don't overindulge if you have issues. One example being sleep as pred is known to cause insomnia at certain doses.
*14 single measures of spirits (ABV 37.5%); seven pints of average-strength (4%) lager; nine and one-third 125ml glasses of average-strength (12%) wine; seven 175ml glasses of average-strength (12%) wine; four and two-thirds 250ml glasses of average-strength (12%) wine.
Thanks so much nomoreheels, brilliant advice, will follow. Just one more question, what about eating a curry, which contain coriander and cumin as most do and other ingredients, will the curry ingredients interact with MTX, I have read stuff on internet which state they do, but really do not know what to believe? Any experiences on your part with these types of foods?? Grateful for your reply.
You're welcome. Well all I can say is I've never stopped eating curries regardless! Never noticed any difference. It's different to taking a daily dose as a supplement of course, you only have a curry now & then & the amount of coriander or cumin is small by comparison when you do.
Does methotrexate affects you’re teeth ? I’ve been taking this med for 4 weeks n I’ve noticed my teeth’s are so sensitive now and also the jawline hurts . Anyone experienced that plz help
I haven’t had that. Might be a good idea to talk to your dentist and rheumy?
Yes I will thank you 🙂
Hi been on mtx for years,what I found was just spreading them out during the day. Folic acid also helped.
Are you taking folic acid too. I also got some anti sickness tablets which I took initially until my body got used to them. Ask your GP if you are having to wait
I find that most RA sufferers these days, because there are so many drugs available and so much information - both official and shared with other RA patients- anxiety seems more prevalent. I started on methotrexate tablets in 1998 and had no thoughts about it at all. I just took them as prescribed and expected good results. Forums like this did not exist.
My experience has been positive - never had any trouble; perhaps because I was relaxed from day one! I now have methotrexate by injection - 10mg. When I started the tablets the dose was 7.5mg and I gradually worked up to 10mg.
Perhaps starting at a lower dose avoided any side-effects - but I can't vouch for that.
Anyway, the drug has been well tried and monitored over many years and found to be the best DMARD, so I do hope you have a positive outcome.
bienassis
Methotrexate
Methotrexate
Methotrexate 
Methotrexate
