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On mtx and still in pain

Hi all i been on mtx for 8 weeks now and still in a lot of pain does this mean that the tables are not doing there job dr did say next step would be injecting which I do not want to do because fear of needles

10 Replies

Hi Elaine,

As far as I know MTX can take three months or more before it works well.



Hi Elaine, I agree with Mary that the tablets do take a while to work. I started on 7.5mg and moved to 15mg after 2 weeks. I've been on it now for 10 weeks and things have been gradually improving for me. I still have mild discomfort but none of the nasty pain I was in before treatment started.

Paula x


Same as mazza59 and paulywoo it takes a while to get into your system so just stick with them and hopefully you get to feel a bit more human ... but they are monitoring your bloods and if need be they will up your dose or add something else

Hope this helps

debs x


Mtx isn't a pain killer it reduces inflammation, swelling


hi Elaine, it also depends on when you got up to an effective dose of MTX. I imagine that you started with a lower dose, and have been working your way up to a higher dose? so the first couple of weeks you probably weren't yet taking enough to be really effective. anyway, shouldn't be long now before you start to see the difference. and if it turns out not to be enough for you, there's lots of other things that can be tried that don't need to be injected. Polly


Hi Elaine1

As the others have mentioned, the MTX can take up to 12 weeks to really take effect, and may even take as long as 6 months for you to really feel the benefit of the drug so try not to be too concerned yet. It may be possible to increase your dose if the MTX really doesn't feel as if it's controlling the RA as well as it should be, as Polly has mentioned. There are also many other DMARDs that can be used instead or alongside the MTX many of which are tablets.

I have included links below to our article on MTX, and also to our general article on the drugs used for RA which you may find useful:



If you did want to discuss things further please don't hesitate to call the NRAS helpline on 0800 298 7650 (Monday - Friday, 9.30am - 4.30pm)

Kind regards

Sarah Kate

NRAS Helpline


Methotrexate is a disease modifying drug, normally used in combination with another DMARD for best effect, the only result a Rheumy will be looking for is a reduction in the inflammation markers in your blood tests - ESR CRP.

It is an immunosuppressant and not a pain killer, it is to slow down the progression of the disease hopefully. For pain and in the case of ongoing inflammation you may require steroids, anti inflamms & painkillers, until they can find the correct combination of dmards for you.

Rheumys do look at the overall picture but in my experience its the bloodresults they are most interested in.

Some people find the mtx alone helped them, that was not my experience.

Regards, Gina.


Also, in my opinion injecting the mtx will not significantly increase the effectiveness of this medication.

Please go back & talk to your doctor.


Thanks for the comments will start to do some research for myself. Rheumy dr took me off steroids because she does like them and started me on mtx and frolic acid sorry took so long to answer but have been so tired and just wanted to sleep


Yes, the tiredness is a real nightmare...but that should get a bit better too, although I've never completely got over it and still have moments. Steroids are great as a short term treatment, but not for the long term as they can have some awful side effects, and coming off them can be hard and damaging. So you do want to keep trying to get stable with the other drugs. If you don't star to see an improvement soon, then talk to your rheumy about other drugs as there are quite a lot. Good luck. Polly


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