Flare up day after methotrexate is this usual?

[JanieJ]

Hi all,

I am hoping you can give me some input please.

I am still trying to get to grips with this medication. This week was week 3 after a week off following unpleasant gastric issues which had eventually settled down and I had been feeling really good during the day, with only mild swelling in one finger joint.

I injected in the evening and the next day I felt totally wiped out, all day with swelling and pain etc in the joints in my feet, knees and hands. The worst I had felt for some time.

Is this usual? Can the methotrexate trigger a flare up like this?

Many thanks in advance with any help with this

[Boxerlady]

I've never had this problem - sounds horrible 😢 I would have thought that it was most likely to be uncontrolled RA than the Methotrexate - probably just unfortunate timing? 🤔 Hope you feel better soon 💐

[JanieJ in reply to Boxerlady]

Thank you so much for your reply. I was expecting tiredness but not a worsening of the inflammation. It's just so frustrating that I felt better beforehand. 😊

[Downtime]

Yes I used to get this too. A definite flare the day after I took Mxt. It settled down and I don’t have it now . Hopefully it will fir you too.

[JanieJ in reply to Downtime]

Thank you.

It is just so frustrating that I felt better before I started taking it.

It has eased somewhat but not completely and the tiredness is still lingering, whereas the days before I started it after a weeks break I was feeling quite well.

I will continue and see how I get on.

Thank you for taking the time to reply, it's much appreciated.

😊

[stbernhard]

Have you talked to your rheumatology team? Everybody reacts differently to MTX particularly in the early stages of using it. I hope you'll eventually get on with MTX because it has worked for thousands and thousands very effectively. All the best.

[JanieJ in reply to stbernhard]

I haven't about this as yet. They have been very helpful but I don't like to keep troubling them but if I get the same again next week I will give them a call as I cannot afford to feel like this each week.

They told me to put ice and heat on the joints but difficult when there are so many!

Thank you for your help, it's much appreciated.

[snotts]

I think joint pain is a recognised side effect of mtx which is delightful... My friend takes it for IBD and he sometimes gets joint pain the day after. I definitely got increased joint pain the day after when I started mtx but it has settled down now that I've been on it a few months. It seemed that the joint pain post mtx affected all joints, even joints not affected by RA. Like I say it's definitely better now and totally manageable after a few months on a steady dose. Hope you feel better soon!

[KittyJ]

Until your mtx starts to work you will still get flares of RA, it may just be this and would have happened mtx or not especially if you are anxious taking it because of side effects, Mtx doesn’t work straight away so you can still get the ups and downs of joint pain/inflammation but do speak to your rheumy team if you’re concerned.