How long does mtx work?

[Grubbypaws]

Hi everyone. Does anyone know how long mtx will continue to work after you stop taking it? My blood test showed elevated liver enzymes (ast and alt) so my rheumatologist is sending me for an US and has told me to stop taking mtx for 4 weeks (and then a new blood test before he decides on what meds to put me on). His last words were 'if you're in pain, call me'! So I'm wondering how long it's going to be before that happens and also, will the new meds regime mean starting from scratch again in terms of how long it will take to work? Thank you.

[Neonkittie17]

High G-Paws 💗 Hopefully you won’t flare before you get on another med. The rheumy is doing all the right things sending you for the US and blood tests too but do get in touch with them if you start to have pain if the RA creeps back in. Sometimes it’s longer for others how fast pain and inflammation may return and you’ll need to contact the rheumy ASAP if so to talk pain relief/tiding you over. I would say in my own experience of Mtx as a solo med it took about 6 weeks for me once I stopped it to feel anything returning re pain from RA inflammation creeping back, but some people are sooner.

Did your rheumy talk of returning to Mtx if your bloods were good? We all react a little differently. I hope the blood results and US can be done swiftly then the rheumy can make their decision and you can be on something to control the RA again. Most people have break inbetween meds .. a wash out of the med ... as such. I’ve been bridged in the past with a general steroid injection to stop pain and inflammation. Worth an ask if you feel you need that. I hope your new med works well and your changeover goes smoothly but as you were told by the rheumy .. get in touch with them if pain is troubling you. Sometimes it takes a little longer for some of the meds to work when starting a new one. Good luck.

[Grubbypaws in reply to Neonkittie17]

Thanks Neonkittie. I've been on mtx for over a year now and it was all going well then bam! Rheumy seems fairly confident it's the mtx causing the liver problems but wants to rule out possible other causes before adjusting my meds. I've got the US next Tues so moving along quickly!

[Neonkittie17 in reply to Grubbypaws]

Yes that’s quick for the US and hopefully they will be quick with another med for you or returning you to Mtx. 🤞🏻

[KittyJ]

If I’ve had to stop mtx for some reason it’s two missed doses before I start to flare but it’s probably different for everyone. 🤞🏻 it lasts until you’re on new meds. It will depend what your rheumy puts you on next as to how long before it takes effect, but they will tell you what to expect.

[Boxerlady]

I had a problem after 3/4 weeks off Methotrexate when changing from tablets to injections. I contacted my nurse helpline and they had me in for a steroid injection to tide me over.

[Judyloo]

Hi, I have had periods in the past when I have been taken off methotrexate. Six weeks has been my experience. The problem then can be that if you go back on to the drug later it can take some time for it to work again. I've been really lucky and side effects for me have been less problematic. Praying your consultant can sort this out soon.

[Grubbypaws in reply to Judyloo]

Yes that's a fear - it took a long time to work initially and it took me ages to get off the accompanying prednisone so I really don't want to go back on that again!

[Hidden]

If it helps, I had a similar situation. I was doing well on MTX, but my ALT suddenly rocketed. I was told to stop MTX for 4 weeks, but a blood test after about 2 weeks showed the ALT back to normal and I restarted MTX after missing just 3 doses. I had no ill-effects at all from pausing MTX for that short time. When I resumed taking it I was put on half the previous dose and my blood tests have been fine ever since. I hope things go well for you.

[Grubbypaws in reply to Hidden]

That's great news!