how quick does increase in MTX take effect - NRAS

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how quick does increase in MTX take effect

Newbie73 profile image
10 Replies

Hi,

I was diagnosed early March and was on steriods to bridge gap until MTX started working. I was initially on 15mgs. Whilst on oral steroids I became pain free but as I started tapering down I had aches/pains in feet /hands/shoulder and hips. Whilst not too bad and seem to plateau recently I have been back to taking naproxen and pain relief most days, it’s not bad enough to take co-codemol but 2 x 500mgs of paracetamol isn’t getting rid of it either.

I ran out of blood cards so called rheumy nurse who also did a review. I had the MTX increased to 20mgs last week. Bloods to be done in 2 weeks with further review in 4 with the intention of being passed back to GP for monitoring and scripts if stable.

I’ve not had any side effects to MTX up until now But I do seem to have mild ones now, mouth ulcer nauseous and off stomach. Strange things is my joints especially wrists are getting worse rather than better. I am now using my prescription ibuprofen cream it doesn’t seem to be helping either.

How quickly should the increase in medication kick in? I know you are not medical professionals but was hoping you could share your knowledge on this.

Thanks,

Clare

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10 Replies
KittyJ profile image
KittyJ

If you’ve got a review in four weeks then it seems like your nurse expects it to be starting to work by then? I never had an effect after one week and your pains can get worse until the increase starts to work I would think. Good luck 🤞🏻

Madmusiclover profile image
Madmusiclover

I can only share my experience. It didn’t work for me and I felt very poorly on 20mg whether by mouth or injection.

Bookworm55 profile image
Bookworm55

My mtx dose was increased to 15 mg from 12.5 mg in the middle of June and 2 weeks later my blood results showed a decrease in inflammation ( crp of 6 down from 18). I can’t say the pain and fatigue decreased that dramatically though!

Chockyuk profile image
Chockyuk

Morning 👋I tapered off Pred while I was on 10mg of Mthx, this which worked well for about 2 years, then after 3 flares I had to up the dose to 15mg then 20mg. By this time it wasn’t working on its own so my Consultant added in Sulphasalazine. But this was all over the space of a year.

Give it some time, they do say 3 months, but if it doesn’t work they may well start adding something else in.

I hope it gets better for you 😔

X

HappykindaGal profile image
HappykindaGal

It’s a difficult question to answer as mtx may not work for you. Which sounds depressing, but it’s not as there are lots of other dmards and then there are biological meds too.

This period is punishing as it’s finding what does work for you and the docs like to trial each option for three months to see if it’s effective or not. You will find something in the end 🤞🏼🤞🏼🤞🏼💋

Newbie73 profile image
Newbie73

Thanks all. It did seem to working, I think it is still doing a lot of the heavy lifting but definately plateaued. Hopefully this does the trick

Increase in dose can take about 3 months to take effect, which is why you will be closely monitored during this time. Ask for folic acid to be increased to 6 days a week (not Mtx day). Also an antiemetic such as cyclazine can be prescribed to take (an hour) before Mtx dose. I also take omeprazole daily for my stomach. Have a chat with your Rheumatologist re all of the above x

Mine took ages to stabilise. I had Sulfasalazine added to the mix too, which really helps me. Your Mtx dose may also be increased again. The steroids will have been ‘masking’ things, which is why you will prob feel worse before you feel better ☹️. You’ll get there, it just takes time. They use a tapering approach so you don’t take more meds than you actually need.

Nuttyshirlz profile image
Nuttyshirlz

That’s like saying how long is a piece of string. I didn’t have any side affects for a few weeks then I did for a few weeks then one morning I woke up and I knew I felt better not a 100 per cent my nurse said it can take up to 12 weeks some it happens in a month some a bit longer. I was always told to look at like a hill you gotta get to the top before you come back down. I’ve being on it since 2017 always remember no pill is magic I get my good days and bad.

Dobcross1 profile image
Dobcross1

Hi when I first went on MTX it took 14 weeks to improve. Then, when I increased to 25mg it took around another 12 weeks to clear the flare I'd been in. In regards to side effects , tbh I get less with 25mg than I did on less dosages but maybe my body has just got used to it. I take folic acid 6 days per week. For mouth ulcers, try Lysine from a health food shop which helps me. Good luck!

Swanfull profile image
Swanfull

Hi had a lot of similar symptoms to you also I’m am suffering with ulcers in mouth and lips, on mtx and Benapali can’t seem to get rid of them 😩 any advice would be appreciated? Feel for you x

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