Side effects methotrexate

[Star307]

I am sorry if this has been posted lots of times before. I am new to methotrexate I take at around 8pm the injection. I feel so awful the next day and the second day. I wondered if anyone has any tips to help with the side effects?

[hazelcats]

Hi, I started methotrexate jabs, in May, and it took a few weeks for the feelings of bleurgh as in extra tired and kind of fluey to lessen. I also had a lot of nausea but increasing the folic acid to 6 days a week helped along with altering a med I need for hiatus hernia.I was ready to give in the mtx but persevered and it did get better. I still feel nervous on mtx jab day, and still a bit ' off ' for about 36 hrs but it now seems at a bearable level for me.

[Star307 in reply to hazelcats]

Thank you. Out of interest what day do take on and what time? I have an intense job so I take on a Saturday but no don’t have a social life so trying to find a the right day too.

[hazelcats in reply to Star307]

I inject on a Monday, around 6pm. Fortunately I dont go out to work so thats not an issue for me.I did read it helps to take it earlier in the evening in the hope that the person sleeps away some of the times the side effects occur.

[AgedCrone in reply to Star307]

Do you take Folic Acid 6 days a week…that usually helps?

[1974D in reply to hazelcats]

Stick with it. Unfortunately all Treatments for RA have potential horrible side effects. I had to stop methotrexate after a few years though. It didn’t work well for me and began to feel very sick every day. I had epi pen. Good luck though

[Colaba in reply to hazelcats]

Hello,

I wad diagnised with RA at Christmas 2020 and have been taking six methotrexate Tablets once a week, now on Thursdays. since the summer of 2021 when I was rather clumsily, weaned off magic steroids I have no odd side effects, certainly nothing immediately folliowing the dose. I have , it seems, comparatively few RA 'episodes' The initial pains in feet and nocturnal cramp-like leg pain sussmbed to effective wrigling and stretching. Reeently I had one terrible episode in my right wrist that lasted many hours. Curiously there was no parallel pain in the left wrist which left me grateful, but puzzled.

Apart from a colossal initial loss of physical strength, which has been permanent and a now slow futher deterioration, I am 85, there seems to be no significant side effect from the Methotrexate.

There does seem to be some kind of interest in its effects, insofar as I have very frequent blood tests, whose results are never passed on to me. I have virtually no contact with GPs, never about RA, only the odd five oer ten minute if something else crops up.

I hae had no contact with any RA specialist nor any RA 'team' for two years., but must assume that there my be some interest n the Methotrexate,

My biigest problem apart from the loss of strength is my buggered knees, which are probably not RA, however their absence of cartilage is unaffordably incurable within any probable life expectancy. I can walk quitee well on level ground with a stick, anad, mecifully drivig is not at all affected.

With RA - apart from gettong it, of which I am not proud, I seem to be under control with Methotrexate.

Long winded I have alwys been.

Good luck

[Boxerlady]

I find that, for me, the side effects come about 24 hours later so I usually inject on a Saturday evening and then plan a nice quiet Sunday evening. Being really well-hydrated seems to help too so I try to drink more on Saturday and Sunday.

[PSAWarrior28]

This what I did when I had the post methotrexate blahhhs 1. Hydration around methotrexate days

2. Took methotrexate in the evening to try and sleep through some of the side effects.

3. Increased folic acid to 6 days

4. Took dose of dextromethorphan with on day of and 12 hours later.

Hope you find something that works for you.

[Star307 in reply to PSAWarrior28]

4. Item I did Google. I will ask next for. I will try different times. The folic acid does help but unfortunately not enough. Thank you!

[PSAWarrior28 in reply to Star307]

Not sure which country you are from but dextromethorphan can be found in Night nurse and Robittussin dm in UK. I am not suggesting that you take this at all. You need to check if you are on antidepressants, you may not be able to take it. Also the pharmacy will only sell it for the purpose it was licensed for. Good luck. I hope you find something that works for you.

[Tonkie]

you’re not alone with the Meth hangover. I started on 20mg tablets and the nausea was so bad even with folic acid 6 times a week. They then changed me to injections which were great at first. But now the more I take the more nauseous I’m getting. I’ve got rheumatology Monday and I think I may be taken off it due to the side effects. I feel exhausted for 2 days afterwards and sometimes sleep the whole of Saturday away!

[Star307 in reply to Tonkie]

Sorry to hear sounds similar to me. Lots of hair as fallen out too

[fangrock]

I experimented with lots of times and days. I now take it about 8 am on a Friday knowing I’m not at work the next 2 days. My side effects kick in about 36 hours after the injection, so it all happens when I’m asleep on the Saturday night and gone by the time I wake up on Sunday. My advice would be to work out when your side effects kick in and time it so you’re asleep!

[JenniferBut]

How much folic acid do you take? Drink TONS of water, 2 litres each day. Rest!!

[Happy5]

The body has to adjust to it. I was prescribed anti-sickness meds to help with nausea, injections are better than tablets form me.

My routine is take anti-sickness meds about half hour before doing my MTX injection, which I do bed time. I also take one Co-codamol to sleep through worse of my symptoms. I have my water bottle next to my bed to drink in the night. Next day I drink water and smoothies to flush out my system.

Hope it works for you.

[Tibatha]

I take tablets and for a long time it has been very effective

[Alwaystrytobebetter]

I take mine at 8am then have breakfast and usually have a bit gastric “activity” a couple of hours later. I used to have a fair bit of stomach pain when on methotrexate tablets but this has been eliminated moving to the injections. It may be worth trying a different time of day when you are more active than in the evening. Hope this helps.

[B3ntl3y]

Hi

Yer I used to take MTX injections

I came off it hair fell out put on weight and the blah feeling also you to feel tiered

So I stopped it feel ok still get a bit of brain fog but thing that’s the rheumatold

[Pebblescat]

hi. I took Mtx for 17 years by injection. Initially I worked my way through a lot of the side effects and it wasn’t pleasant. But it did settle down. I used to inject on Sunday morning so as not to loose the entire weekend. And I was working on Mondays in an office until the pandemic and now from home. Mostly it was manageable. Although Sundays were a washout as I had nausea and shaking and generally felt ill. If I made it to the Monday morning without being sick, then the folic acid really helped, I’d also recommend mint tea. And eating eggs on Sunday or Monday made me really sick so I avoided them. It is different for everyone and you will find what works best for you.

[Angels54]

Hi , Ate you taking folic acid with it ?

[Star307 in reply to Angels54]

I do 6 days

[Poshcards]

Do it before you go to bed, that way you sleep most of it off, I found 'Queasey drops' helped with the nausea, get them online, totally natural but brilliant

[Spanelmad]

You need to be drinking a lot more water!!

[Lilyneo]

Hi

I've been injecting methotrexate for several years as part of a dual therapy with Kevzara. At first I was given tablets but they made me feel so sick I just couldn't continue. So I switched to injections with a single dose of folic acid the following day. I do experience nausea after but only briefly. I tend to do my injection in the morning. Sometimes I can feel sick by the afternoon. When that happens I take the folic acid then and that seems to stop it. Hope that helps.

[Star307 in reply to Lilyneo]

Oh I might try and you can eat normally through the day?

[KittyJ in reply to Star307]

In the UK we don’t take folic acid the same day as mtx as it can stop it working properly.

[Breadseedpoppy]

hi Star,

I inject Sunday mornings 15mg MTX and take folic acid 7 days a week. No side effects. I began by taking tablets but it raised my liver enzymes. The only flares I’ve had have been periods of fatigue, horrible. And last summer, a month of intermittent fever and much fatigue.

I hope your side effects dissipate soon.

[Star307 in reply to Breadseedpoppy]

Oh I might try in the morning. You can eat normally during the day?

[Breadseedpoppy in reply to Star307]

I do. But I didn’t have side effects even with tablets but took them in a divided dose, half in morning and half with dinner.

[Chockyuk in reply to Breadseedpoppy]

Hello 👋

Can I just ask, is the injection better for the liver then than the tablets? I’ve been off the tablets for 2 weeks, after 5 years no problems my ALT is very high, I’m teetotal, don’t drink, eat healthy. I’m still on sulphasalazine which I hope is keeping a flare at bay.

[Breadseedpoppy in reply to Chockyuk]

The shots have been better for my liver than the tablets. I wasn’t able to tolerate sulphasalazine. I have maybe one drink a month. I hope the injections work for you.

[Yakamatutsy]

I was on methotrexate tablets for a number of years, but had to come off it as I was told it had damaged my liver, which after 12 months of investigation turned out to be a misdiagnosis. I now take sulfasalazine tablets which have turned out to be a miracle drug for me as my RA is in remmision.