Sudden MTX intolerance

[Pink75928]

Hi all. I recently was treated for a basal cell carcinoma, so had to stop taking MTX for a short while (I got an infection). Since I’ve been back on it, I am struggling so much to take it. I find the tiny tablets get stuck in my throat, and I feel so nauseous soon after taking it. My most recent dose, I could only manage to take 4 of the 8 tablets. It makes me feel absolutely horrendous. I have been on MTX for around 3 years, with only side effects at the beginning. I also on Sulfasalazine and Benepali. Is this something anyone else has experienced? Would you say it’s a case of mind over matter and to persevere, or worth discussing with my Rheumy to see if this is an alternative?

[KittyJ]

have you tried eating something as you take them, takes your mind off the fact they’re tablets especially if you eat something nice.

[Pink75928 in reply to KittyJ]

Yes, I never need an excuse to eat a treat. My routine has always been Friday night, in bed with tea and biscuits.

[Deeb1764]

Definitely have a chat to RA team as it can be after being off them you are having a reaction and you can also get MTX in pen form too. I had a bad reaction with MTX and some other drugs so had to go down other routes. Good luck x

[Moomin8]

Hi, I use a mtx pen device - Metoject. I find it really easy to use. Maybe ask about that?

[AgedCrone]

I’d have a week off & try again..I agree it could well be mind over matter.It.’s a shock to the system to get a bcc…..try not to worry too much..one week off won’t hurt. you. ..I know cos I’ve been there.

[Runrig01]

if I’ve had more than 3 weeks off, my rheumatologist insists I taper back up to my usual dose of 25mg, to limit possible side effects occurring. I’m fortunate I get no side effects other than hair thinning slightly.

[Pink75928]

thanks all. I did speak to the rheumy nurse about tapering up to a full dose, but she said no need. She just said start the Benepali one week before starting MTX again. I will give them a call this week. Back to work after 2 months off tomorrow 😫

[Flor1rence in reply to Pink75928]

hope work was okay and you feel better soon x

[Sheila_G]

You need to speak to someone in rheumy team about this. It might be a temporary blip or you could have injections instead.

[Gjbrose]

Hi I had problems with tablets found it very difficult to push them out of foil, I have been using pen injection and it really is much easier 😀

[Aporiac]

I concur with those mentioning injectable mtx. I found tablets badly upset my stomach, which almost entirely went away after switching to intramuscular administration. I also tend to get adverse reactions if I stop and restart mtx. Fortunately, things settle down after a few weeks, but it’s unpleasant at the time (nausea and general aches and pains). Good luck!

[Happy5]

Deffo call your RD dept talk to the specialist nurse, try to make an appt with the Rheumatologist. There's alternative I was put on which was to use prefilled pen injections cos the nausea did for me & that method helped reduce it.

Also have you ever been offered anti sickness meds?

[Nana246]

I had similar experience to you after an operation. I was feeling like any tablets were getting stuck in my throat. I hadn’t had this feeling before. Also when I restarted Metho I had headaches and felt unwell for about 24 hours. I’m glad to say tis only lasted a couple of weeks. Hopefully you will be the same 😊

[AnnieJ123]

I have only just seen your post so forgive the late reply. I have had BCCs removed in the past and hope you have had successful treatment. I too am on Benepali and Sulphasalazine but not methotrexate, I could not tolerate it. I recommend you read the medication leaflets. There is a mention of an increased risk of skin cancer with benepali ,and other anti TNFs, but some question whether a bcc is a cancer as it is less invasive. We should all be checked each year , so the leaflet says. The leaflets also do not recommend a sulphazalazine and benepali combination. I am not clear why. Perhaps someone can tell us. I now have had low neutrophils which the benepali leaflet indicates happens to 1 in 100, but it has helped my RA. We need to evaluate risk and benefit as it seems to me no meds are without risk , as is RA disease. Sorry for the gloom but it is important to weigh everything up , after obtaining accurate information and communicating with experts. Sometimes it is hard to judge if a medicine caused something ,speeded it up or it was a coincidence. Good luck.