Hi everyone,
I’ve had a large ulcer ( about size of 5p) on the roof of my mouth, followed by red dots and now my throat has gone really red and blotchy. I tried calling the rheumatology nurses lots of times on Thursday but no reply. I’m a bit worried as I thought having these sort of symptoms was a bad thing. Not sure what to do, other than wait until Tuesday. I’m not going to take the methotrexate next week.
Show it to a pharmacist.
Hi Kati. Is it worth phoning 111 ? Hope you get some help soon.
Have you read the Patient Information Leaflet that comes with your prescription? That usually lists possible side effects and what to do about them, it would be worth speaking to your pharmacist about it. In the meantime it might be worth gargling with warm salt water to see if that soothes it.
When I was on Methotrexate I had mouth ulcers. Eventually taken off it. Just give 111 to a ring for advice
i got mouth ulcers after I had been on MTX for a year or so. They upped my folic acid which sorted them for a while, but they eventually came back so I was swapped to injections. That was about 8 years ago and not had them since.
Gargle with salty water.
agree with Fruitsndnutcase, I get terrible sore throats with Stills which manifests as RD and salt water gargles do help.
You need to ring 111. This doesn't sound like a rheumatological problem to me.
Because the mouth sores are caused by medication (rather than the RA itself), stopping or changing the dose of methotrexate can be one of the quickest ways to reduce or eliminate mouth sores or ulcers. They may have to reduce the dose of your methotrexate or increase your folic acid. Phone your gp if you can't get the ra team
Sore throats and ulcers can be associated with MTX. When I had severe throat pain after starting MTX, my rheumatologist stopped it, and arranged urgent review. You are doing the right thing in holding off till you sisal with them. It can still be taken a few days late.
That sounds like methotrexate!
I presume you are on folic acid every day except methotrexate day? If not, it's said to help.
I found that keeping my mouth absolutely as clean as possible helped with the pain, brushing my teeth after each meal, and cleaning between to remove any traces of food. Frequent mouth washes (I found salt water as good as anything, but don't swallow it!). I also bought over the counter Orobase, which sticks to damp mucus membranes like the inside of the mouth, and that gave some protection.
Eventually though I had to stop methotrexate - even having it as injections didn't stop the very large and painful ulcers (and the other side effects). Some (most?) people get on well with methotrexate but not everyone, so talk to your rheumy team about alternatives if the ulcers continue.
Try and get an appointment with your gp, last thing you need is to get an infection in it.
Try folic acid 6 days a week (not Mtx day). This sorted it for me.
My oral health declined for a while also. Buy some (non alcohol) mouthwash and an electric toothbrush.. also maybe sensodyne for a while til your mouth recovers.
I wouldn’t stop your Mtx without a chat with your Rheumatology team. This is a common treatable side effect.
As others have said gargle with salt water (personally I use VERY diluted TCP if I get a sore throat).
1 part TCP to 5 parts water is the recommended ratio *
I was getting bad mouth ulcers after starting MTX and for a few months afterwards. I was advised to take Folic Acid six days a week and use Cordosyl mouthwash every day.
This has sorted the problem out for me.
Mtx cause a flare up of abcesses for me I had to stop it.
Thanks for all your advice, it’s been helpful to understand a bit more about the effects of meds we have to take with this wonderful illness 🙄🙄. I’ve got a rheummy nurse appointment next week so will discuss this with her.
Sore throat 
Sore throat and ear but no sign of infection? 
Sore throat, head and taking mtx
Sore throat and mouth with methotrexate
