Methotrexate

[trexhater]

Keeping in mind everyone is different - Has anyone been on 10mg trex and then changed to 5mg and how has this worked for you. Also how much folic acid with 5mg.?

[helixhelix]

10mg is generally considered to be the lowest therapeutic dose (ie the dose that actually does something). And folic acid doesn’t necessarily change with minor changes of dose. But ask your consultant.

[MidWhitgiftian]

Am on 10mg once and Folic 5' @ 6 Days a week. Tolerating fairly well . Never any suggestion of a decrease to 5mg. Had to decrease from 20' after an immediate side effect reaction when increased to that value. Just stopped Prednisolone after long run-down period. As I understand it Trex is a poison and presumably we all have a toleration limit when taken long term. Hope you are not in the recently flooded part of Oz.

[bienassis]

I have recently changed from 10mg of Methotrexate by weekly injection to 7.5mg injections. There isn’t an injection “pen” for 5mg (in tablet only). The changeover to the lower dose has been trouble-free.

I don’t think the folic acid would change - the 5mg tablets of folic acid are still, for me, 1 tablet on 4 days per week. I miss out on 3 days - that is, the day I have the MTX and the day before and after. That has never changed in all the years I’ve been taking it, whatever the dose.

A word about doses by tablet and injection of MTX: more of the medicine is absorbed by “sub- cut” injection than by tablets. So a 10mg injection will be “stronger” than 10mg by tablets.

Hope that makes sense!

[CagneysMum]

I’ve gradually reduced my methotrexate injections from 20mg to 10mg over 18 months. My consultant regards 10mg as the lowest therapeutic dose and suggests I maintain at this level as it’s working very well for me alongside my biologic. I take folic acid 6 days a week.

[KatAD]

I tried 15mg tablets for 2 months then 1 month break then tried 15mg injection for 2 months in 2024 but couldn't tolerate the nausea and it making me feel tired, achy and yucky. I tried 1 folic acid of 5mg per week and 6 of 5mg per week during that time but none made much difference. Then had a break for about 2/3 months, all symptoms came back then started taking 7.5mg tablets in November and have been on 3 x 5mg folic acid. Things have been ok but I think it was because I had a steroid injection in November and once that started to wear off I've been feeling gradually a bit worse since mid Jan but it's bearable. However I'm in a situation where the consultant is not 100% sure what is going on and he'll only commit to 'probable early RA'. Anyway not exactly what you asked but I have halved from 15 to 7.5 and it has been a lot more tolerable I suppose is the short answer, I'm coping with the side effects much better.