Additional advice please in taking MTX

[Moonjean]

I’m still having a little bother with nausea after I take my MTX. Can anyone advise when is the best time to take the medication? Before food or after? And all at once or gradually over the day. I’m on 4 pills a week every Sunday.

[Kate2628]

Hi Moonjean when l was taking MTX l was told by consultant to take it an hour after my evening meal, it worked for me. Hope this might be a help for you. Kate 2628

[Moonjean in reply to Kate2628]

Thank you. Kate2628

[Flipper12345yellow in reply to Kate2628]

Hi,I like many others had bad nausea.

I now have methotrexate by subcut jab weekly and nausea is much better than when taking tablet version.

Take care

[MoniqueB]

Hi Moonjean. I take my weekly dosage of MTX at night after eating. I also have a big glass of water when I take my MTX. (Water is advised when taking MTX; apparently people are to drink two litres on the day of the dose.) Taking the MTX late at night means that I sleep through the side effects. Thankfully, I experience far less nausea than I did when I first started MTX.

I've read that some people, who experience nausea, will split their dose, so that they take two doses in one day (for instance, if you're taking four pills, you would take two pills in the morning and two pills in the evening), but please speak to your doctor before doing so. Also, taking folic acid can help with the side effects of MTX, but people are advised not to take folic acid the same day as taking MTX. Following is a link pertaining to how to manage MTX side effects. I hope this week's dose is easier for you!

arthritis.org/health-wellne...

[Moonjean in reply to MoniqueB]

Thank you so much.

[BigJazza in reply to MoniqueB]

Thanks Monique. That link is the best info that I've seen about MTX.

[vonniesims]

Are you on Folic acid ?

[Moonjean in reply to vonniesims]

Yes. One a week.

[Boxerlady in reply to Moonjean]

You should ask for your Folic Acid to be increased to 6 days a week - every day except your Methotrexate day.

[Moonjean in reply to Boxerlady]

Thank you.

[vonniesims in reply to Boxerlady]

Yes, 5mg , 6 days a week. Not on Methotrexate day. I think this is what the majority of us take. I'm sure it will help

[dawkin_S in reply to vonniesims]

Just wanted to second this - I definitely have less trouble with it when taking folic acid 6 days a week. I also split the dose on nurse's recommendation - half when I wake up and half at lunch in my case.

[happytulip]

How much folic acid are you taking?

[Moonjean in reply to happytulip]

One a week.

[happytulip in reply to Moonjean]

MTX strips your gut of folate which can lead to severe nausea. In my experience I had to take folic acid 6 days a week and that dramatically reduced my nausea. I was also swapped to the metoject injections which helped with nausea.

But in the interim it might be worth discussing an increase in your daily folic acid intake. Or if you can't get help from your GP because of their cvovid workload you can buy it over the counter if you feel confident enough to try it. Obviously, I'm not recommending that you do this because I'm not allowed to give advice, but it's what I chose to do and it worked.

[Ali_H]

Hi,When I started I took mine with porridge and some freshly chopped ginger with a dollop of organic plain yoghurt and that seemed to get me through the first 6 months. I now take my 6 tablets in a split dose of 3 with breakfast and 3 with my tea. I take 5mg of folic acid X2 a week..... you should be taking at least one dose of folic acid (not on MTX day though) and there is scope to take it 6X a week if you need that amount. Drink plenty of water - not just on MTX day but the days before and after as well helps. Eat small, light and often might help.

All the best

Ali

[Moonjean in reply to Ali_H]

Thank you so much

[JulesCurrie]

I started on 4 tablets weekly 19 years ago now on 8 . I can’t say I have ever really noticed any nausea that I would relate to taking MTX. I take mine anytime and not necessarily with food either .

[nomoreheels]

If you recall I replied to your previous post, could you take a look to save my sore fingers writing it out again?! In short, I was advised to split the dose throughout the day with meals. With 4 tablets I’d take 1-2-1. Lots of water through the day as well.

Has your folic acid been increased? One is obviously the lowest we take so there's room to increase it. I take 6 a week, just missing out the day I inject. I hope they call you soon to have instruction to inject, you should find that better.

[Moonjean in reply to nomoreheels]

Thank you so much

[Monkeysmum]

Hi Moonjean, only thing wanted to add to the above, is that it might be worth asking your pharmacist for a different brand of methotrexate. I have been taking for over 2 years and a number of different brands with only mild nausea, but a few months ago they gave me a brand I hadn’t had before called Sandoz which gave me awful nausea. Since switching back off this brand nausea totally gone again. No idea why it would be different on different brands but it seems to have been for me!

[Moonjean in reply to Monkeysmum]

Thank you for that.

[Knit12]

I got anti sickness tablets from my GP that worked for me. One when I felt nauseous and I was soon better

[Moonjean in reply to Knit12]

Thank you.

[Moonjean]

Thank you.

[Cal48]

Take mine at 9.00pm with cup of tea & toast all ,at the same time good luckx Always with food. Some makes of tablets worse than others so I have the make named on my script. I have folic tablets every day except the metho.day

[Feank]

i had the same problem. ask to change to injection, its really easy and doesnt hurt but no nausea. may be worth a try. also take the folic acid every day except MTX day. hope this helps. stay well and safe.

[Simian]

i have injection MTX and i typically do it right before bed, the nausea generally takes a bit of time to get going so i can sleep through it 9 times out of 10. im also on folic acid every day except when i take the MTX which assists with the nausea