METOJECT/ METHOTREXATE

[skinclinic]

Hi

Does anyone know how long Methotrexate / Metoject stays in your system . I have been having unwanted symptoms for a few months and now advised by my Rheumatology Clinic to stop taking it straight away

[KittyJ]

I don’t know the official answer and I’d expect everyone to be different but if I miss two doses I start to get symptoms back so it must be wearing off by then 🤷🏻‍♀️

[skinclinic in reply to KittyJ]

Thanks Kitty J

I’m very grateful for your reply

[Mmrr]

Methotrexate on the dosages prescribed for RA is usually out of your system within a few days. It doesn't hang around too long so hopefully you begin to feel better soon.

[skinclinic in reply to Mmrr]

Thanks Mmrr

Yes … hopefully I’ll feel better soon . My most painful and frustrating side effects have been the large nodules on the soles of my feet - which thankfully my orthopaedic surgeon removed for me whist operating on my bunions . My rheumatologist said they were callouses but lucky for me my surgeon knew better … now I can walk without feeling that I had large pebbles in my shoes

My hands have now rapidly started sprouting hard nodules and they are multiplying rapidly - they are catagorised as Methotrexate Induced Nodules , Before any of you panic … please don’t as there are only a small percentage of RD patients that get them

The fatigue , inability to sleep and the continued stomach issues have also tested my patience but to see me you’d think I was in the picture of health !

This disease can be very frustrating to deal with I’m sure you’ll all agree

[bunnycaramel in reply to skinclinic]

I’m a bit like that but it’s a verrucae and very painful. I have had it for a couple of years. Seen podiatrist every 4-6 weeks even had treatment for it but a year on its still there. Told me it could be there for years due to the medication im taking for RA. It’s stopping me doing anything as quite painful. So I know how you felt

[vonniesims]

I assume about a week as most of us take it weekly

[skinclinic in reply to vonniesims]

Hi Vonniesims - thanks for your reply … yes let’s hope it settles sooner rather than later

[helixhelix]

The half life is about 10 hours, so should be practically gone in about 60 hours.

[skinclinic in reply to helixhelix]

Hi helixhelix

As expected you always give us a great technical explanation.. which is down to your experiences going through RD for many years . Your input is always appreciated in this group .

[Paula-C]

I thought it was around 12 weeks. If your trying for a baby you have to wait that long after stopping it.

[skinclinic in reply to Paula-C]

Thanks Paula-C for your reply

I’m 70 now so I won’t be in that situation now days … thank goodness

[helixhelix in reply to Paula-C]

There the actual drug breaking down, and then the extra time needed for all your cellular reactions to return to a non-influenced state. V important for health fertilisation and babies.

[Paula-C in reply to helixhelix]

I'm getting confused here helixhelix. My consultant once told me that if you've been on mtx along time and stop you shouldn't feel any different for at least 6 weeks because its still in your body working. I was told by my specialist nurse to still take folic acid when I had to come off my drugs once, she told me you've still got it sloshing around in your system. I know it can take weeks when first starting mtx to feel any benefit from it, so stopping it I would think would be the opposite.

[helixhelix in reply to Paula-C]

I think the difference is between the actual drug molecule exiting your body, and the effect it has had vanishing. This is not exact (as no one quite knows why MTX works) but say the effect of MTX is to stop your body producing antibody X. Once you stop MTX although the actual MTX molecule is no longer in your system it takes a while for the production process of antibody X to get going again, and get into full production.

[Paula-C in reply to helixhelix]

Thank you.

[AgedCrone]

From ….NHS ENGLAND

The estimated length of time it takes for methotrexate to be removed from your body is: For low dose methotrexate ranges from 16.5 hours to 55 hours. For high dose methotrexate ranges from 44 hours to 82.5 hours.19

[skinclinic in reply to AgedCrone]

Hi AgedCrone

Thanks for the information- very much appreciated from you - and everyone’s feedback

[Knit12]

When I came off methotrexate my rheumatologist made me wait 6 weeks before starting something else. I had to take prednisone to help with symptoms. I hope that helps

[cosana in reply to Knit12]

That's crazy! My rheumy put me on another DMARD right away after stopped taking mtx.

[Knit12 in reply to cosana]

Not really the methotrexate made me look like a monster and my skin erupted with really bad acne (never had it before) so it allowed my body a chance to heal and they wanted it totally out of my system to it wouldn’t make any symptoms I had fr9m the next drug masked

[Haz58]

It gave me gastritis. Very painful. I also got finger modules which I still have a year later. My Rheumy told me they were osteoarthritis and still says that as I have more now.My stomach was recovered around a month after stopping it. All the best. You will get there. X

[jarujuda]

I have been on it for 4 years and it takes 2/3 weeks before I start getting a flare 🥴 what dose are you on? I take 12.5 mg 😊

[Gaz227]

it’s half life isn’t that long just a few days , but after about 6 weeks my symptoms come back with a vengeance , I had to stop MTX before and after a recent surgery it also coincided with my Co-vid booster so 6 weeks was to much for me . Back on now 3 weeks in and settling down thankfully .

[Runrig01]

sorry late to the party, have been in A&E overnight in a corridor.

MTX has a half life of 6hrs, it takes 5.5 half life’s to clear the system, so in around 33hrs it’s cleared the system. So you should feel better very quickly after stopping it. 🤞

[Intheend in reply to Runrig01]

Oh no🤦🏻‍♀️Sorry to here you have spent night in A&E… hope you are ok..

[Runrig01 in reply to Intheend]

Thanks. I’ve had severe knee pain for 8 weeks, which I’ve always suspected was my tendons. My gp continuously blamed my AS causing the issue. Pain had escalated this week to scoring 8/10. Was sent to A&E, orthopaedic dr is certain it’s my tendons, and she feels it might be torn, rather than just inflamed. After spending the night in the corridor, they are unable to do mri today, do have been allowed home to wait. Staff were great, had IV morphine, a voltarol injection and large dose of diazepam to help with the muscle spasms. If they have a cancellation they may call me back today, so 🤞. I must say my rheumatologist did order an mri of my knee when I seen him last week, however 48hrs after seeing him, I was housebound for 5 days, then bedbound for the next 48hrs.

[Intheend in reply to Runrig01]

Sounds as if you have had a dreadful few weeks… really hope you get the MRI asap and that an appropriate treatment plan can be put in place. Must be particularly frustrating for you as I think I recall your career was in orthopaedic nursing.? Sounds as if you were right all along in your suspected diagnosis 👍

[Runrig01 in reply to Intheend]

Yes, you’re correct I worked over 30yrs in orthopaedics 😂. I was a textbook case for patella and quadriceps tendonitis. I even challenged her on my numb lower legs, pointing out if it was due to the spine the thigh would also be numb. It’s frustrating that I’ve suffered for 8 weeks. A paramedic did a home visit Thursday and went back and recommended stronger analgesics. Her response take butec patches off, don’t take anymore tramadol then tomorrow we’ll start zomorph at half your current opiate dose 😂😂. Told her whilst I’m happy to switch, in the middle of a severe pain episode with an 8/10 score, holding off pain meds is not an option. She asked what I wanted, so told her if this was my patient, I’d be advocating for oramorph for breakthrough pain. Won my case and she prescribed oramorph, but is phoning on Tuesday to discuss the switch. Hoping tendons are just inflamed and steroids do the trick, although orthopaedic dr suspects I may need surgery.

My daughter has been here visiting from leeds, she was going home today, but I’d stopping till Monday. She has just helped me shower, so feel more human. It’s sad the amount of people left in corridor’s sleeping, although the staff were brilliant. Take care and thanks for your kind words 🤗

[KittyJ]

skinclinic, may I ask how they differentiate between mtx induced nodules and ordinary nodules that many of us have please?

[skinclinic in reply to KittyJ]

Hi Kitty

My diagnosis was confirmed when the lab results came back after they were surgically removed at the same time that I had my feet / bunions operated on

[Sunset54]

Hi

What a shame it has. It worked for you. It has been brilliant for me. Been on it for many many years successfully. Recently Ihad to stop for a long course of IV antibiotics- 6 weeks . I was ok for the first three then I started to notice the changes. So I guess it’s individual. However if you have just started it and are now stopping it should clear your system pretty quickly as you have no ‘build up’ as long term users do. I hope they find you an alternative which is successful. Best wishes

[Nyreedw]

It stays in the system 12 weeks, that's why you must be off 12 weeks before planning to conceive.

[Witness2]

Hope you feel better on something else soon. I’m also facing treatment changes - can anyone tell me if injected methotrexate causes digestive/stomach problems? I was hoping that it would bypass the stomach if injected. Thank you!

[skinclinic in reply to Witness2]

I even got stomach issues with the Metoject …. But they didn’t start straight away … got increasingly bothersome after about 6 months of staying the injections. I was changed from Methotrexate tablets to the Metoject because the tablet form was giving me stomach issues . I also took Folic acid tabs on the day I didn’t inject but it still didn’t alleviate my problem

Once the nodules started to proliferate and enlarge and I started to get nausea and insomnia - that’s why the told me to stop any methotrexate immediately

Now I’m just back to 6 Sulfa a day

A BIG THANK YOU to everyone who replied to my post

[Witness2 in reply to skinclinic]

Ugh. No easy solutions are there! Thank you.

[Pamak]

Six weeks

[Tkat10]

Methotrexate takes up to 13 weeks to have full impact and therefore 13 weeks to totally leave your system. If in doubt speak to your rheumatologist/ nurse or a pharmacist.

[Welshwomanprestatyn]

Hi

My experience on Methotrexate was that after stopping it it took three weeks for symptoms to return.

Out of curiosity I live in North Wales and am under Wrexham hospital can’t say I have had the best experience there. I now have problems with my feet is there a podiatrist service for RA in North Wales?

Thanks

[skinclinic in reply to Welshwomanprestatyn]

Hi … Yes Wrexham with Mr Barwendi

To be honest I can’t fault the service I’ve experienced there

Had RD for 3 years … initially good control with sulfa … then hydroxy added … due to lack of control … Methotrexate then added … and changed to Metoject

Had reasonable control for a few months and then all went haywire with endless side effects

Seeing pharmacist on 2nd Jan to start Biologics - but I’ve noted that it’s a Biosimilar that’s been ear marked for me

Sorry to hear that you’ve not had a good experience with Wrexham.

I see a private podiatrist who is NHS trained and she is amazing

[Welshwomanprestatyn in reply to skinclinic]

Hi

Yes think I have been unlucky with having locums and telephone consultations. I am on a biologic now Rutoximab which has been really effective.

Could you give me the details of your podiatrist as I have some issues with my toes which I think are related to RA