Second methotrexate dose

[Pink75928]

Morning all. I hope you are all well. I have just had my second weekly dose of methotrexate and today as well as tired and sick, I have the most uncomfortable bone pain. It feels the same as tooth ache but in every bone. Not really joints so much. Is this a usual side effect? Thank you xx

[Helen-NRAS Moderator]

Good afternoon. If you would like support, information or just someone to talk to, our NRAS helpline is open every week day from 9.30am to 4.30pm nras.org.uk/helpline/ 0800 298 7650. Or have a look at our website nras.org.uk. Kind regards.

[Soundofmusic52]

We all get different symptoms I felt nausea aches all over liked I had the flu it did ease for me after about 4 weeks so good luck hope you feel better soon tc 😷

[Downtime]

Hi Pink, it was 6 years ago for me but I still remember how I felt when I started on Mxt. As well as stomach ache, nausea and tiredness it seemed to make my RA actually much worse the following day. Gradually all these side effects disappeared as my body adjusted. These days I’m on the injection and apart for feeling a bit blah the day afterwards I don’t have any problems. Hope this quickly eases for you too. Take care.

[Nuttyshirlz]

First few weeks are tough. It just needs time for your body to adjust to it. I’ve being taken it 5yrs now and 99 per cent of the time it’s great but still get odd week when it doesn’t. Just hang in there we’re all being where you are. 🤗

[nomoreheels]

Hiya Pink. Unfortunately nausea is a common MTX symptom & can be at it's worst when you first start taking the tablets until your body gets used to taking it. Feeling tired, or fatigued, is too I'm afraid, again it can ease but bear in mind that fatigue is also a sign of not being controlled so could be due to MTX or not. Some people do complain of having an MTX hangover, some never tolerate it & have to move on to another DMARD but hang on in there, it can be a good med, as I have found it can be really good. I've tried 3 other DMARDS, none have controlled me close to how MTX has but that's my experience.

You have a few options to ease the nausea, the natural way with ginger or mint in all sorts or forms, tea being one, but often anything with either in can ease nausea. Drinking plenty of water on MTX day can help too. I think what must have helped most for me early on was my Consultant recommending I split the dose throughout the day rather than taking the full dose in one go. He suggested taking them with meals & as I started on 15mg I took 2 tablets with breakfast, lunch & my evening meal.MTX is the one DMARD that is also available as an injection. Many of us have changed up to them, I did after a new Consultant questioned why I hadn't when I needed an increase in dose, 11 years ago now. It's often the case in the delivery that we have fewer side effects or they're eliminated altogether if you're fortunate. It's an option for you if MTX does control your RD but side effects from tablets continue to be bothersome after giving them time enough.

You should have been given a prescription for folic acid, these are intended to help with symptoms such as nausea. If they don't help in the next few weeks you could ask for an increase if you're prescribed them less than 6 days, missing MTX day. When I first started MTX I was only prescribed 1 the day before but it was increased to 1 the day after too when I had some unwanted symptoms. Nowadays (12 years on) I take it 6 days, my last Rheumy's choice.

I hope some of this helps but if you're still really struggling do let your team know, they'll assume all is well otherwise.

[craigsif]

Hi th you on tablets with the MRS or injection, I had a hard time with the tabs, including vomiting ,blood blisters feeling like I had been hit by a train, , I was switched to the injections which helped tremendously, I take it in the evening, which helps me to sleep through the rough period.

[Tillie20]

Hi I can not really advise you It is best if you speak to your Rheumy it was a few years ago that I started MTX x

[Happy5]

Agree with the others' replies . Try to hang in to see if it settles and provides relief from RA.

If no benefits after a reasonable time no harm in discussing alternatives with your rheumy team

[smilelines]

I did not get bone pain from the methotrexate but I did have to stop because of intestinal cramping. My rheumatologist said we have to respect the medication when she took me off the methotrexate three weeks after I started so I think you need to contact your doctor just in case.

[SNOWYROSE in reply to smilelines]

Did you go onto something else which helped? Thanks, R

[smilelines in reply to SNOWYROSE]

I started on leflunimide in February and it seems to be working but I still had two boggy joints when I saw the rheumatologist. She said she would be adding another medication in the fall. The leflunimide is way better for me.

[SNOWYROSE in reply to smilelines]

Thanks *

[PaulRI]

Hi Pink75928

Sorry to here you are having some side affects on mtx, I did feel sick most off the time (only been on them for 10 weeks). As for bone pain I never had this but as others have said side affects are on a per person basis. I would not know if my bones were hurting or if its just the RA pain.

The sickness does pass, its hart to think that there will be any relief but hopefully there will be for you.

🤗🤗🤗 sending hugs.

[J21S]

Hi Pink,I agree with the folic acid/ injections/ nighttime then off to bed soon after. I also have a good carbohydrate heavy tea that day - daily tai chi seems to help as well. Good luck all our thoughts are with you.

[Hidden]

Hello I‘m on week 10 and got switched to i jettisons half way because of the nausea and still feel terrible after every dose…it also makes me feel as though all my joints flare for about 24h a day or two after the methotrexate 🤷🏼‍♀️. I m hoping it will get better but starting to feel a bit hopeless about it! Fingers crossed you will feel the side effects less very quickly x

[Pink75928 in reply to Hidden]

Obviously in an ideal world no one would go through this, but I’m so glad someone else gets a flare up feeling after methotrexate. I’m wondering if I’ll be put into injections too as the sickness and headaches are too much. Do you self inject?

[Hidden]

They switched me to the injections immediately as soon as I said the tablets were making me sick. They Tablets gave me stomatitis and a really inflamed mouth as well as horrible tummy pain. It‘s really easy to inject, the rheum nurse showed me how and the hardest bit is the fact I get hit by waves of sickness in anticipation! The injection is fine. Switching has helped hugely with the inflamed mouth etc but not so much with the nausea and the weird 24h of joint pain. I’m just tired of being told to give it a few more weeks when I still feel terrible each time and when my bloods are a little worse each time. But you are right, not being alone is a definite positive xxx

[Pink75928 in reply to Hidden]

Maybe i should mention something then, as now you mention it I’ve definitely had really irritated gums this week. I’m due my third dose of methotrexate tomorrow. I might give the nurse a call.

[Twitty999]

Switching to the MTX injection was the best decision ever.. so easy to do (they’ll show you how). I drink lots of water that day & inject in the late evening . I do it in my “spare tyre”. 😆. No side effects at all even on the highest dose 🤷🏼‍♀️… good luck on this crazy journey 🤗🙃