20mg mtx

[essexgirl]

Feel sickly & so tired the day after mtx is that what other people experience

[Hidden]

I have . I had to have my dose reduced after a 6 week break. I found I was sleeping 6 out of 7 days after my dose. When I slept 36 hours solid I was told to take a break then reintroduced on a low dose and slowly increased to 15mg still tired the next day x

[essexgirl in reply to Hidden]

Ok thankyou ... how did you feel on your 6 week break

[Hidden in reply to essexgirl]

Started off good there was enough left in my system to keep me going in fact I felt brilliant then by week 4 started to stiffen up and slow down and my friend fatigue was back x

[essexgirl in reply to Hidden]

What a bummer x

[Hidden in reply to essexgirl]

I don’t think MTX likes me. I’ve just started baricitnib as well with the hope a lower dose MTX can be introduced eventually x

[essexgirl in reply to Hidden]

Good luck 🤞 hope that happens x

[springcross]

I feel very tired and headachy for two or three days after and I don't sleep very well, also my joints start playing up the next day too then they ease off just when it's time for the next injection. 😖

[essexgirl in reply to springcross]

Exactly ☹️

[Brushwork]

Yes, sometimes for a few days. Sometimes, but not always nausea. I’m on Metoject not tablets, tablets were awful for me

[Jad58 in reply to Brushwork]

I was the same, it got to the point where I dreaded taking the pills (8 of them) and it was a struggle to swallow, headaches and nausea. I moved to metoject but had to increase folic as still had issues. Seems to have settled down now

[essexgirl in reply to Jad58]

Yh eight also & 6 days folic acid ... I was thinking maybe it’s because I’ve started straight back onto 20mg as hadn’t taken them for a year , so maybe it’s the reason ... not sure as I used to have the fatigue as everyone but not the nausea

[Moomin8]

Hi, I was diagnosed December 2015 and was started on mtx. I seem to remember feeling the same as you are describing. At first, I took mtx in tablet form but changed to metoject (mtx in a pen/injection.) This was far better but still didn't make me feel brilliant. Upping the folic acid to 4 days out of 7 - mtx on Monday and folic acid Thursday through to Sunday - definitely made a difference to me. It took some months for anything to kick in though for me.

[Rashford20]

Take 25mg in tablets, usually feel alright.

[Ruth12345]

Yes but not as often as I used to. I take it very last thing at night so I sleep through some of it and when I wake during the night I always have some water to drink. This has helped .Good luck.

[bpeal1]

I really didn’t get on with MXT. Felt really nauseous, dizzy and very fatigued and it lasted 5-6 days. I tried both tablets and injections and increasing the folic acid to 6 days but nothing made any difference. My rheumatologist switched me to leflunomide instead and I’ve had no issues with that at all. MXT works amazingly for some but we are all different so if it’s that bad don’t hesitate to contact your rheumatology team there are plenty of other options.

[Angjoplin]

Are you on tablets? Personally, and I'm not saying its doctor sanctioned. But I start with 2 tablets one week then 3 the next week etc. My body seems to handle it better. I told my nurse this last time that that was what I was going to do. She didn't object. However that could have been because she knows there's no point. 🤣

[essexgirl in reply to Angjoplin]

Tablets ... how does that work then ? So you take 5 mg one week

Then the next 15mg ?

[Angjoplin in reply to essexgirl]

Yes that's right. Seems to work for me.

[nomoreheels]

I don't do well on 20mg side effect wise so as I’m taking folic acid 6 days my Rheumy reduced to dose to 17.5mg & added another DMARD, then another when I reacted to the first, then the second was stopped as I responded negatively to that one too. I'm still on 17.5mg monotherapy. My prednisolone was increased & when things were no better I returned to my regular dose. Not doing the best to be honest but following my last tel review I have had xrays of the joints most affected. My tel appointment has been changed to a clinic appointment so we'll see what happens next given I’ve tried all the most prescribed DMARDs.

So, what I’m basically saying is if you don't take max dose folic acid it could be that the MTX dose is just that bit too high for you to cope well with as well. An option if you're still on tablets is switching to injections, though the dose would be best reduced slightly if you do as you may still have side effects on 20mg given there's greater bioavailability in subcut. Talk to your Rheumy, that's the best thing.

[essexgirl in reply to nomoreheels]

Thanks I’ll do that , to be honest I was thinking of just reducing it myself lol

[nomoreheels in reply to essexgirl]

No, please don't even though it's tempting. Your Rheumy &/or GP if you have shared care, check your drug monitoring blood tests & if they notice any changes for the worst, if you start flaring for example, they'll be concerned not being aware you dropped a dose without ok'ing it.

Have you tried dividing the dose & taking them with meals? I had no side effects on tablets (except a little hair loss the first month or so). I started on 15mg & took 2 tablets with each meal. Maybe you could take 3 with breakfast, 3 with lunch & 2 with evening meal, if I’m correct in thinking you're on 25mg?

[rounder]

I don't take my any more because of the side effects, but I found it less unpleasant in injection form, maybe worth asking if you can swap. Mtx absolutely wiped me out for 2 days a week and I wasn't prepared to spend all week dreading Mtx day, so after a very candid discussion with the rheumy team I moved on....Don't despair, there are lots of different meds out there, it's a bit trial and error to find the one that suits us best, I think it's drug number 7 for me and my disease is better controlled than at any point in the last 20years with minimum side effects.

[essexgirl]

Will do thanks

[essexgirl]

I’m on 20mg I tried Monday splitting in two parts but maybe I’ll try the three , actually I’ll try anything, but have to be happy that I wake up now and can walk 😃which is a bonus

[Thingybob]

My advice is to ask to swap to the mtx injections. I swapped from tablets quite quickly due to side effects and increased folic to 6 times a week. It means you can reduce the dose of mtx as its a more efficient way to get the dosage. I still get a bit of nausea and fatigue the day (or two sometimes) after but its not half as bad as the tabs and some weeks I dont get after effects at all. . All the best 🙂

[Feank]

I used to as well, but changed from tablets to injections and it didnt happen so much and i felt so much better. hope this helps you, it really effects everyone differently. worth a try if you are feeling so dreadful though, take care.

[essexgirl in reply to Feank]

Thankyou I can’t have injections as my skin wouldn’t tolerate it 😩

[Nanna71]

I know this sounds weird but I have never felt sick with MTX; I take 25 mgs weekly and for about 2 and a half years. At the beginning I drank lots of water, LOTS. And always had food in my stomach. I also take sulfasalazine at max. dose plus prednisone which is reduced now to 3 mgs daily. Lost some hair, got a few mouth sores but not so much now. Remission is just now appearing but nothing ever went back to normal. Hope this is helpful.

[essexgirl in reply to Nanna71]

That’s so good , I take them on full stomach but I’ll do the lots water

[rounder]

Just a thought but I did find peppermint tea helped a bit with the nausea.

[nomoreheels in reply to rounder]

Yes, peppermint or ginger in various forms.

[Summerrain14]

I struggled with nausea and fatigue badly with the tablets. Been on MTX around 4 months now. I have been changed to the injections. Been on them 7 weeks and six days a week of folic acid. Much less side effects with injections. My MTX has just been on increased to 20mg and did my first injection of this on Monday night. Just a bit of nausea and a bit of a headache with increase but minimal. Shall see what my blood tests come back like next week and see how I get on. I am on Sulphasalzine too 6 tabs a day and currently 8mg of prednisolone daily too. Had a depo injection of steroids last week as well as a bridging treatment and hoping to be able to reduce prednisolone to 5mg daily in the next couple of months. As others have said do get in touch with your rheumy team as they can make lots of tweaks for you.