methotrexate

[halsey18]

i just started my weekly dose of methotrexate injections 4 weeks ago, but i'm feeling the side effects getting much worse:

nausea, dizziness, headaches, loss of appetite,drowsiness

any advises to decrease this effects or even prevent it??

[Boxerlady]

Are you on the maximum dose of Folic Acid? Increasing from one to six days a week helped me when I was first on Methotrexate tablets. Staying well-hydrated, especially the days before, on and after Methotrexate day can help too.

For nausia, I find ginger and peppermint helps and eating small, regular amounts helps even it's just a small piece of toast or a banana.

[halsey18 in reply to Boxerlady]

nope, i just take 2 tabs weekly about 5 mg of folic acid

[Boxerlady in reply to halsey18]

Definitely worth asking your team about that. I'm on 6 x 5mg a week.

You need to feedback to them how you're feeling anyway - they'll just assume that everything is fine if you don't 😉

[halsey18 in reply to Boxerlady]

thank youuu so much!!😍😍

[Thingybob]

For the nausea you could try ginger tea, ginger anything really. Salty foods. Stay well hydrated. Rest if your body tells you to. But different things work for different people, its a bit trial and error really.

It might be worth talking to.your rheumatologist or rheumy nurse and explore changing to mtx injections. I changed to them after a month of persevering with the side effects that you describe . I still have some side effects but not as bad. Best wishes for a solution 🙂

[halsey18 in reply to Thingybob]

thank you a lot, i'll try the ginger tea

[allanah]

Take it at night with lots of water x also they can give you a tiny melt under the tongue anti emetic

( antisickness ) that can help if needed.

[runningbracken]

I have been on the the 20mg injection for 7 weeks now. I feel ok, am a little spacy the day after but ok compared to how i was feeling.

Like Boxerlady says, Folic acid everyday except your meds day and lots of water seems to help. Hope it helps

[halsey18 in reply to runningbracken]

good luck w your injections, actually my weekly dose is 7 mg

[nomoreheels]

Hiya Halsey. Is your dose the same as when you were on tablets by any chance? I ask as when I went on to injections I went up from 15mg to 20mg & had to come back to 15mg which whilst I stayed on that dose it was a little bit of a struggle for a few weeks until I got used to it. The thing is when injecting MTX more of the dose is retained as it goes straight into the bloodstream unlike tablets which has to go through the digestive system & in doing so less of the dose is retained.

Alternatively you may find an increase in your folic acid dose will help. I'm on 17.5mg subcut & take folic acid every day except MTX day. Have a word with your Rheumy team if you're taking fewer than 6 x 5mg weekly.

I hope it's as simple as you just needing to get used to regime & things will ease the longer you inject your MTX.

[halsey18 in reply to nomoreheels]

no my weekly dose is 7 mg and my rheumy said it can't be more than 10 and i just started it 4 weeks ago so it'll be gradually,

actually my dose of folic acid is 5 mg weekly but i didn't know that it will help, so what do you think should i do?

[Boxerlady in reply to halsey18]

That sounds like a low dose of Methotrexate to be aiming for - I'm on the "maximum" of 25mg by injection.

Is there a reason for that being your highest possible dose? 🤔

[halsey18 in reply to Boxerlady]

i don't know actually but i guess due my age? i'm 18 btw

[nomoreheels in reply to halsey18]

Have you gone straight on to injections Halsey, you didn’t have tablets first? I wonder, are you also on a corticosteroid, prednisone perhaps? It's just with only starting on the lowest dose, 7.5mg, maybe your Rheumy is being cautious. Possibly he'll introduce higher doses gradually, as your disease activity demands, equally reduce the dose to a therapeutic level when you're better controlled.

If you're only taking one 5mg folic acid weekly there is room to increase it if your Rheumy thinks it's warranted. I would say it is but I’m not him!

If I was you I’d definitively report the side effects you have, otherwise they'll think all is tickety boo when we know it's not. The reason for taking folic acid is because MTX is a folate antagonist, it reduces the folate that we store, which helps in the making & repairing of DNA & is essential in making red blood cells. If our folate levels drop too low we can have side effects such as mouth ulcers & the ones you're experiencing, so we take folic acid to replace what MTX takes.

I hope this helps.

[Mon82]

Hi I couldn’t tolerate the side affects even after 12 weeks. But what helps is the painkillers and drinking 4 litres of water daily and getting enough rest. With food I resorted to carbs and cornmeal porridge. I have Lupus and Vasculitis neuropathy. I felt the benefits of the medication was just not there. I was laid up in bed for 3 days each week

[Mon82]

And just to add, I was oral tablets at first for 3 weeks which caused havoc with my stomaching so I loved to injection. Watch out for the weight gain and I exercise 6 days per week