Conquering MTX

[Robejo]

So, I'm about to embark on a 2nd stint of mtx after a 9mth break. I'm going to take it by mouth again, likely 15mg + 10mg folic acid a day later, maybe slightly higher mtx initially to smash the current flare. Injections might be ultimate route, but before that I am very keen to hear any success stories with combatting side effects like nausea, fatigue, fog, general mental weirdness inc hallucinogenic dreams etc...

[Amnesiac3637]

Have to mention that the only success story I had with Methotrexate was to stop taking it………..Have posted about this very topic before as have many others so might be worth your while looking at very recent past posts. Best of luck if you continue with it - many do!

[Robejo in reply to Amnesiac3637]

Thank you - I'll take a look

[welsh12]

I take 15mg orally did have some nausea settled now I tend to not arrange too much if you can on the day after taking it. Dreams always been a bit weird so i go with them. Fog is often part and parcel of menopause so not much different. I seem to adjust after a few weeks of taking it but everyone is different. I try and chill not get stressed take a pill a ny sign of headache and eat when I feel like or not. Also pop some acid reflux stuff sticking to 4 hours before or after if needed.

[Robejo in reply to welsh12]

Thanks for sharing - makes good sense!

[KittyJ]

sadly mtx won’t smash a flare as it can take a few months to work but I’ve been on it 25+ years now and although I had nausea etc it eventually decreased with folic acid 6 days and tweaking the dose a bit, it’s helpful to drink plenty of water the on the day and before and I took it at night to sleep through the worst side effects. I hope it helps you and any side effects are short lived. 🤞🏻

[welsh12 in reply to KittyJ]

Good point taking at night

[Robejo in reply to KittyJ]

thank you - good tips. I used to take it on a monday morning so that the weekend was unaffected, and typically have luxury of WFH on Mon, so I can hide away from people. Perhaps sunday night is worth a try moving fwds - although grogginess during the school run / breakfast prep!

[dancersize2]

I split the dose and take 10mg night before and 10mg next morning. Folic acid five other days. Prior had nausea. So far doing OK after diagnosis of PMR 2017 was changed to RA in April 23. Chat to rheumy every six months for blood tests and prescriptions.

[Robejo in reply to dancersize2]

oh that is interesting, splitting the dose - I can see how that might be beneficial by reducing the metabolic burden. When I was taking 7.5mg, there were few side effects too.

[Runrig01]

I take 25mg of mtx with no side effects, other than hair thinning. I take it with my evening meal, so that I sleep through any side effects. The only time I struggled was once when taking it through the day, it caused severe fatigue. The hair thinning did settle eventually.

Your rheumatologist is taking an unusual view, with starting at a higher dose. It’s not generally helpful for flares, as it takes around 12 weeks to reach therapeutic levels. Also it can be harsh on the liver and kidneys, which is why medical advice is to start low and build up, depending on the results of the weekly blood tests initially. You would get better relief from a course of steroids while the MTX builds up. You also need to bare in mind, that you will not get a true reflection of MTX on a forum, as those who have no issues, are generally busy getting on with their life, rather than contributing on forums. Hope it works out for you this time. 🤗

[Robejo in reply to Runrig01]

thank you - such a good point on the inherent bias towards the negative effects and so easy to get absorbed in it due to the anxiety of the situation - mustn't let things spiral. the higher initial dose was uneducated guess work from me. When I started on 15mg a few years back, the idea was to potentially increase it if it wasn't effective. I think he would have liked to increase it to completely combat the swelling, but I was reluctant for reasons listed. Now it is back with a vengeance, I thought maybe it would need more significant dosage. I should stop guessing and wait for my appt!