Emailed my rheumy nurse, and the rheumy doctor phoned me today. As the nausea is constant, she doesn't think it's the mtx - more likely the hydroxy as I take that twice every day. She suggested I try cutting that down to one a day, and if that doesn't work - go back up to two and increase folic acid instead - anything up to one per day except mtx day. I can also take Gaviscon as long as it's not around hydroxy time as it can affect absorption. So, we'll see what happens!! If there is still no improvement - I must contact them again and they'll bring me in for 'an alternative'!!?