Methotrexate

[Lynnray]

Hi got down to 5mg of preds for pmr felt great but have osteoarthritis in hand which started to swell up and was really painful so rheum decide to try methotrexate , so fri/sat/sun folic acid then methotrexate Monday ,he said to increase preds to10mg while trialing methotrexate. Which wasn’t happy with but tried ,now thur/fri/sat/sun pain free hands mon /tues /we’d hand so painful swelling up so frustrating bloods every 2 weeks fine not seeing the rheum till Oct nurse just said carry on thought methotrexate would help not sure now has anyone else tried it..

[PMRpro Ambassador]

I'm rather confused - do you mean osteoarthritis or rheumatoid arthritis? Have you had x-rays or other imaging done of your wrists?

Methotrexate is the standard first line approach for rheumatoid arthritis and rarely has an effect inside 4-6 months so that makes sense for him to see you in the autumn. It is also sometimes used in an attempt to reduce the pred dose in PMR but I think any doctor who chose to add methotrexate to pred for that reason at such a low dose of pred as 5mg needs questioning. The limit now is more likely to be adrenal function, methotrexate won't affect that in any way and 5mg is less steroid than the body produces naturally so the adverse effects are minimal at that level.

Interesting though that the methotrexate seems to be causing you joint pain and then the pred seems to take control again - at least, that is how I understand what you have written?

[Lynnray in reply to PMRpro]

Thankyou pmr. Pro it’s osteoarthritis had all X-rays etc yes that’s why I find it so confusing that I have so much pain when I take the methotrexate!

[PMRpro Ambassador in reply to Lynnray]

I wonder if taking folic acid daily except the dose day might make a difference? Many doctors do say to take it 6x per week and the dose varies a lot too.

I found while I was taking methotrexate that I developed what are so-called pred adverse effects that I had never had before. Including joint pain and constant hunger! I put on a good 2lbs in weight in a month and have struggled to lose it despite stopping the methotrexate.

But I really would be demanding a good explanation of why add mtx at this stage.

[Lynnray in reply to PMRpro]

Thank god this need to eat cake is normal on methotrexate🤪 I’m trying so hard to love carrot sticks but it’s a losing battle🤪🤪

[Yellowbluebell in reply to Lynnray]

Oh I have sympathy over trying to eat carrots rather than cake!! my weakness is chocolate but cake will do!

[PMRpro Ambassador in reply to Lynnray]

No, don't think I got to that stage! But I really was starving and it had never been a problem with pred!

[jinasc in reply to Lynnray]

Try Flexiseq a bio-mechanical cream. It is expensive, but one tube will tell you if it works.

It was introduced by ARC specifically for knees, but because when you put it on you have to sit for ten minutes. That mean you cannot wash your hands straight away.

I used it for my knees and have been doing so for quite awhile.

I told a member about it and she tried it, at the next meeting (3 months later) she came up waving her hands..................look I can knit again, I have not been able to knit for years and now I have knit a christening shawl. That lady had osteo in her knees and because she had it in all her fingers, that waiting time had worked.

It works like WD40 and as it is bio-mechanical, it is not a drug.

Worth a go?

[Lynnray in reply to jinasc]

Thankyou will give it a try anything to stop the pain

[SheffieldJane in reply to Lynnray]

Flexiseq really works for my knees! Thank you for the recommendation Jinasc. X

[SheffieldJane]

Thank you opening this question.