Methotrexate - first dose: Hi, this is my first post... - NRAS


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Methotrexate - first dose

fangrock profile image

Hi, this is my first post here because I've finally plucked up courage to take my first dose of Methotrexate. I've been really scared and had some panic attacks, but I need it, so today is the day. I'm going to take it before I go to sleep tonight.

I'm not sure I have a question. Just need a bit of support :-)

53 Replies

It is scary, I know. Very scary. My friend has been on it for over ten years. She is pain free and dancing her heart out. It is a miracle medicine for many!! All the best!

Welcome and well done for deciding to take it - I'm sure that you'll be fine! Try not to think about it too much (easier said than done, I know) and hopefully it will be "the" one for you 🤞 If not, there are plenty of other options 😉

Hi fangrock and welcome to the forum. Don't worry too much about the MTX, not everyone gets side effects and it's been the saviour of many sufferers. It does take a while to get into the system though so don't expect instant results. It usually takes about three months but some people experience benefit quicker than that. I've been on it for just over two years now but there are some people on here who have taken it for many years. Any questions, just ask. xx

Cheylann profile image
Cheylann in reply to springcross

Has it helped you?

springcross profile image
springcross in reply to Cheylann

Yes, definitely.

Look at it from another viewpoint, it might have some side effects or might not, might not work but just might and so give it a go. Nothing to loose really. Fingers crossed and try not to overthink things. If 10% get side effects then 90 % don't so chances are your in the 90%.

Go for it, welcome to the MTX warrior crew. xx

Welcome to the 'gang' I agree with everything that has been said, there is always someone here to answer your questions and to reassure you.

Wow thanks everyone! I've wound myself up to the point of not caring if it works, the fear of side effects has taken over. Thanks for the support 👊😊

Kookyboo profile image
Kookyboo in reply to fangrock

Hi fangrock, I'm exactly the same,I'm so terrified of side effects I still haven't started taking it,I need to be brave as well lol x

It is scary but Worth trying. I do have a side effect but it doesn’t last long and mx is definitely helping me. Go for it

You will be ok and remember many of us have done it and still here but also it is ok to worry as it is something new. However fingers crossed in 12 weeks you will see the drug taking affect and helping you 😘

Well done you. We have all been in that situation. The first time you take medication is always a bit scary but there are hundreds of us on here and we have all got through it. You will feel relieved as soon as you have taken it as the decision is then taken. Sending well wishes, urging you on.

I know the feeling! I took my first dose just over a week ago, now taken my second. Hope you slept well 🤗

Cheylann profile image
Cheylann in reply to Amandaazz

Did you have any side affects?

Amandaazz profile image
Amandaazz in reply to Cheylann

Not really, apart from feeling tired on the day I take it, that's it so far!

You can do it! 👍👍😊

Hi Fangrock, welcome to the club. I have to tell you although this probably isn’t a club you thought you’d be in, these are the most beautiful positive understanding people I’ve had the honour of being a part of.When I 1st took MTX I drove myself crazy with the “what ifs” like you at 1st I wouldn’t touch it but eventually logic (and pain) won out.

For me I did feel nauseous at the start, but after awhile my body got used to it and now it doesn’t effect me at all. Between MTX , biologic injections etc I have a good part of my life back :0) stay positive and strong the medications we are lucky enough to have access to can be life changing 😃

Hi , I’m a newbie too (about to take my 13th dose of MTX today) and like you was very worried starting MTX tablets but so far I’m very glad I did. Have had a few episodes of feeling a bit nauseous- if I ate a slice of buttered toast I was fine, seemed worse on empty stomach. My folic acid has been upped from one a week to six which has helped. No fatigue and best of all my ankles and wrists don’t ache anymore. Early days I know. This forum has helped me so much. I hope all goes well for you, best wishes.

Go for it! I hope it works for you. Don't be put off while it settles though. It's been around for so long, so any reactions are widely published. I take folic acid on day 4 up until I take mtx again- so 4 days of 5mg of folic acid. I find this helps. I ended up having the injection version of methotrexate, with is Metoject. I find it easier and less intrusive on my day-to-day living. Don't expect an overnight result though, it takes a few months to do it's magic.

Remember: RA doesn't define your life - life still happens 🙂 Keep in touch with us for support. Also NRAS helpline are amazing!

Call the NRAS Helpline

Call us on 0800 298 7650. The Helpline is here to let you know that you don't have to face it alone by offering information and emotional support for people with RA, their family, friends and colleagues.

Hi I have been on 20mg for 7 years and have no side effects. It has worked wonders for me. 7 years ago I was in constant pain and now I am virtually pain free. Hope it works for you. I normally take mine with dinner and that works for me.

Cheylann profile image
Cheylann in reply to Bruce711

So good to know this as I also am terrified to take my first dose.

Hello fangrock - I think everyone here understands the feeling of panic before taking a new medication 🙃 So well done for deciding to take it! MTX works very well for a lot of people and I really hope it will help you. Let us know how you get on and the best of luck 🍀!!! All the best, Christine ☀️

Well done for deciding to take MTX. I've been on it for 13 years now. I also used to get a bit of nausea, but your body does get used to it and you'll start to feel better. Remember some days you may feel better than others, so a bit of self tlc is always good and tomorrow is another day to look forward to.

Hi like many here I use a biologic and MTX. I have ankylosing spondylitis which mainly affects the spine, but in my case affects every joint including the jaw, and lungs. The methotrexate helps the peripheral symptoms so much. I take 25mg at night and sleep through any side effects, I only suffered fatigue if I took it in the day, and not everyone gets side effects. On forums you generally get a higher proportion as those with no issues are generally getting on with their life. I take my folic acid 6 days a week, to prevent nausea. Good luck with it, fingers crossed it helps you 🤞

Good on you to overcome the first hurdle. I am on MTX since 2009 and I am glad I am because I know how much damage RA would be doing to my body without it. I always think that the side effects are much more bearable than the RA damage and pain. I hope it will work for you.

Don’t be frightened of it. I was on it for 30 years. I am still here although on other meds now. It will help you. Good luck

Welcome to the club mate, now you have started MTX keep going, but do remember one thing, alcohol and MTX don't mix so watch the booze. I've been on different strength's of MTX for the past 9 years along with Humira and my RA is still active, and slowly wrecking my body, so as you can read it can be a short journey, or a long one. But what ever happens keep taking your meds and good look to you, 👍👍👍

So glad you have bucked up the courage. They have to tell us about the side affects even though most poeple won't suffer from them. If you read the leaflet that accompanies any medicine it is enough to freak us out, even things like Paracetamol. xx

Good luck. I've been on it for over 14 years, now on the mtx ipen and it's fine. No problems with it and enabled me to continue working with no problems.

Thanks again for all the positivity and support everyone. Well, I took 10mg last night, and much to my surprise I’ve woken up this morning! My dose is going up to 20mg in two weeks and I have folic acid to take every other day. Anyway, that’s the first step done and the worry has now subsided quite a bit. Best wishes to you all 😀

I don’t have RA, I have Psoriatic arthritis (PA?!) with dodgy skin too. So I’m really hopeful it will help with both.

Garnacha profile image
Garnacha in reply to fangrock

I'm glad everything seems to have gone well, I too have psoriatic arthritis PsA & have been on mtx since November last year, I've recently gone onto metoject as I was getting nausea for 6 days out of 7 & a lot of brain fog, I was started on 15mg, then 17.5mg then 20mg, I'm not sure if its in my mind but it does seem stronger on metoject & think this is because it now bypasses my stomach straight into the blood stream.

This is a brilliant forum to ask any advice, when I went to metoject I had no information at all, not even how to inject but had great advice & tips from others.

Welcome to the group noone would normally choose to belong to 😘 x

Well done...we've all been there and totally understand. I've got PSA as well - I'm on biologics as well as methotrexate and I still am anxious some of the time. Just imagine the difference you should see 12 weeks from now. Here's to life after PSA 😊

smilelines profile image
smilelines in reply to fangrock

Yay!!! You did it!!!! I hope you are doing well and that it works for you!

Cheylann profile image
Cheylann in reply to fangrock

I have psoriatic arthritis as well. Like I said, I've been too scared to take my injection. I've got the arthritis part but not the skin.Pleased it went well for you.

Good luck! MTX changed my life for the better for so long. I was 28 and felt v.alone when I started this journey. No significant side effects for me and got my RA in such good control i lived a totally normal life. I really hope this is your experience too.

Good Morning fangrock,

Don't be fearful of Methotrexate ! - advice given to me 23 years ago by my doctor at UCH London. In fact, I hadn't even given it a thought; so little did I know about any treatment then!

It is a drug that has been tried and tested for many years, and is usually the first that comes to mind when treatment starts. Yes, you will feel anxious - you will be more aware than I was at that time of drugs. But even if it is not successful there are others waiting in the wings.

You have joined an interesting forum here at Health Unlocked, and you will always find fellow sufferers ready to share their experiences, so no need to feel alone.

Everybody reacts differently to drugs; for me, Methotrexate has been very successful after years without anything much at all.

I send my best wishes for your treatment - try to relax and look forward with confidence.


I was on it for 20 years and definitely helped me during that time. Good luck

Good Luck! Well Done! I was on it 13 years and it was very successful for me. It's when you let your mind wander about these drugs and their other possible side effects that we panic (know the feeling!) Once you're on it and it hopefully helps hopefully you can relax more about it. It's probably the most widely used drug for RA so many people have success from it & it can do a great job. All these drugs are weighing up risks and benefits. As others say - there are plenty more options if things don't work out. Go for it!

Brilliant glad.youve taken it and hope it works its magic for you x

Only natural to feel worried about taking new drugs, it's alot to get our heads around x

Welcome to the group , warm hugs

I was the same as you...took me 4 months before I plucked up the courage to take it...nothing to worry about, I had no side effects whatsoever and I am still taking it once a week 1.5 years on..o am sure you will be fine with it

I was just like you when I started in the summer just found I've been tired the next day so make sure you rest

I know it’s scary at first,especially if you read too much into it. I’ve been on mtx since 2006 ish and, along with a biologic, it enabled me to lead a normal life for about 10 years.

Hopefully you will be one of the majority with no real side effects. I've found MTX to be the best drug for me, taken it for over 40 years (dx. 1971 age 6).

I still haven't had enough courage to take my first dose. I'm terrified of an allergic reaction.My injections are on top of my cupboard and I look at it everyday. Not sure why I'm so scared.

Anyway, good luck for your first dose.

What mg are you on. Also is it injection?

Let us know how it goes.

fangrock profile image
fangrock in reply to Cheylann

I was worried about the allergic reaction too. I took the first dose (tablets) on Saturday. I made sure I wasn't on my own and waited until as late as possible so I was exhausted and would sleep. All was well. I felt a bit sick for half an hour on Sunday, but feel normal today! As people say, it's weighing up the minimal side effect risk, compared to the excruciating pain on a day to day basis. That's no way to live and I thought it must be worth giving it a go!

Cheylann profile image
Cheylann in reply to fangrock

You are right. It is worth giving it a go but I'm still a bit apprehensive. I have injections so hopefully I avoid the nausea.

High pet, started on methotrexate in August this year shortly after being diagnosed I've had less pain and few problems. Some fatigue and tiredness now getting sorted out. Good luck🐕🐕

Hannah-NRAS profile image

Thanks everyone who has provided excellent words of encouragement and shared their experiences.

To fangrock,

It's quite normal to be concerned about starting a new medication but the possible damaged associated with leaving RA unchecked outweigh the possible risks linked to being treated.

It's important to note that as many of our community members have said already, most individuals do not experience any side effects to their medication and where people do, they tend to be minor and short lived.

Additionally, there are little things you can do to help minimise the likelihood and severity of any side effects, such as drinking plenty of water on the day you take your MTX (and the following day) and/or having it after the evening meal and just before bed so that you can sleep through any side effects.

And finally, your healthcare team is there to support you so that if you do experience side effects you can get the help you need and if required change the dosage or drug treatment being used to find one that suits you and your RA. For instance, injectable rather than tablet MTX, bypasses the digestive tract and so can reduce nausea for some.

What is worth remembering is that whatever happens, there is support out there to help you deal and that it is never too early to begin treatment but if left too long, irreversible damage can be caused by the RA.

For more information, check out our webpage on Methotrexate here:

I hope this information helps but should you require any additional support or information please don't hesitate to get in touch with our helpline on freephone 0800 298 7650 or via email at

Wishing you all the best,

Hannah - NRAS

fangrock profile image
fangrock in reply to Hannah-NRAS

Thank you 😀

Hi, I have just joined this group. I have been on methotrexate for 2 years which most of the time works for me but I struggle with slowing down, I hate it I keep over doing it and then I get a flare. At the moment my hand and wrist is on fire . Paying the price for over doing it 😏

Wishing you all the best in your treatment. Keep us updated. 💐 🌼

I had a bit of a dizzy spell yesterday (2.5 days after taking the first dose). And felt quite nauseous. It’s still there a bit now but not as bad as yesterday. Does that sound normal? I get panic attacks and it triggered one which makes everything feel worse.

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