Methotrexate Side Effects???

[Blomps]

Im on 20mg methotrexate injections weekly now and eye pain appears to have increased. I have had lens's replaced in both a couple of years ago and sight has been fantastic. Since the onset of Polymyalgia and using Steroids (now down to 9mg daily) and been on Methotrexate 15mg for 6 months which has recently been increased to 20mg my eyes have deteriorated and have become painful. Is this common or am I just a one off? Graeme

[YuliK]

Mrs Nails will no doubt be able to advise you. I understand that this kind lady is also taking methotrexate.

[Blomps in reply to YuliK]

Many thanks G

[Blearyeyed]

Yes , if you look up Mrs Nails posts on Methotrexate she might have more details on it specifically , not sure if she is working today as she has been under the weather.

The one point I can make is that many medications , including steroids and some steroid sparers do have a temporary increase in eye pain and feelings of eye pressure , and occasional visual disturbances in the list of more common side effects when you are getting used to the drug in the first few weeks of starting it.

But as it is your eyes , it's better to be safe than sorry , so I'd suggest that you go and have you eye pressure and general eye health checked at the optician or GP , just to be sure that the side effect isn't causing any serious issue.

Then , if it isn't causing an issue you may want to see how you go for a few more weeks , it could settle down , or if it doesn't or it gets worse you could discuss coming off it or changing the dose with your Rheumatologist.

In the meantime , using a warm cloth on your closed eyes after spraying with a little water , getting plenty of fluids ( in case it's Eye Dryness and general dehydration from starting a new drug that is the problem) and trying a vitamin based eye drop or gel , like Vitapos A or Carmellose might bring some reduction in soreness. Giving your eyes more rest in between visual jobs and having less screen time ( phone , computer and TV) may all help reduce the symptoms while you get used to the MTX.

Hope you find more info in Mrs Nails Posts and take care x

[Blomps in reply to Blearyeyed]

Many thanks some very helpful tips. Best wishes Graeme Blampied

[Marijo1951]

I take 15 mg MTX per week orally. The only eye problem I have had in recent months is recurring blepharitis in my left eye, which I manage to keep reasonably under control with eye wipes and Systane eye drops. I have always assumed it's a side effect of pred, but of course it' s easy to blame everything on pred! Maybe it's the MTX. Like you I have bionic lenses for which I am eternally grateful.

I agree with others that you would be wise to have these symptoms checked out thoroughly, especially as your eyes are actually painful.

[Blomps in reply to Marijo1951]

Many thanks nice to know Im not unique 😉

[piglette]

I had “gritty eyes” at around 15-20mg of pred, but it improved as I reduced. My GP prescribed a product that turned out to be wrong, according to the pharmacist!

[Blomps in reply to piglette]

Life gets complicated doesnt it. Thanks G

[piglette in reply to Blomps]

It seems to be getting more complicated or I am getting old. I remember the days when a supplier answered the phone immediately with a real person instead of me having to spend half an hour listening to music, being told by a recorded voice they are very busy and how important my call is, then being cut off having gone round and round in circles pressing various numbers for which department I need.

[PMRpro Ambassador in reply to piglette]

So glad it isn't just me ...

[Hidden]

Hi Blomps

Any issues with your eyes should always be checked with an Ophthalmologist.

Are you in the UK? If so most GP Surgery’s have access to an Ophthalmologist where you can book in with a Registered Optician who will usually see you that day.

I’ve had issues with my eyes, but not on Methotrexate at the time, the first time l went to A&E (8hour wait) to be sent to the Eye Clinic the next morning, with the second one l went via PEARS & saw an Ophthalmologist that afternoon.

In my case it was a PVD - Posterior Vitreous Detachment.

Always take Professional Advice if you have pain in your eye(s) or any loss of vision no matter how small.

Kind Regards

MrsN

[Blomps in reply to Hidden]

Many thanks Mrs Nails,

I am actually in Jersey but am going to make an appointment with Opthamologist tomorrow. I have been wondering if it was anything to do with the medication. Thanks again Graeme

[Hidden in reply to Blomps]

Always best & let us know how you get on.

[PMRpro Ambassador]

Have you been to the optician to get it checked as a basic? Any such symptoms should be checked out - you can't always blame the medication or existing illness.

When I took mtx the only thing it did for me was increase what are usually regarded as pred side effects.

[Blomps in reply to PMRpro]

Thanks for the info. G

[Blackcat1M]

I take 20mg of mtx orally, and the only problem I have had is bruising.

I have had problems with my eyes blurring and pain, but the doctor and optician put it down to pred.

Best wishes

[Blomps in reply to Blackcat1M]

Many thanks, off to opticians today, kindest wishes in your recovery too, G

[PMRpro Ambassador in reply to Blackcat1M]

Interesting - I also had bruising and blurry vision when on mtx - had not been problems when just on pred.

[Blomps in reply to PMRpro]

Spoken to Opticians and they say both Prednisolone and Methotrexate can cause issues. Keeping them well hydrated is essential and not straining them in anyway important too. Best Blomps

[PMRpro Ambassador in reply to Blomps]

I know that - but for me pred alone wasn't a problem before.

[Blomps in reply to PMRpro]

From memory when I was on Steroids only I didnt have any problems too. Blomps

[Blackcat1M in reply to PMRpro]

The most scary thing with my eyes was when the doctor put me on Amitriptyline , I woke up one morning and it was like walking through thick fog, the optician told me to stop immediately , but doctor said its not that, needless to say I stopped it.

[Blomps in reply to Blackcat1M]

I have heard some horror stories with use of Amitriptyline. How are you now?

[Blackcat1M in reply to Blomps]

My eyes improved within two days of stopping it.

I do have issues with blurred eyes , but nothing to worry about, and I have had two appointments (six months apart) with the optician, who has been great thank you

[PMRpro Ambassador in reply to Blackcat1M]

In my book - anything that happens soon after a new drug is introduced is that until proven otherwise ... Why do they not think of that?

[Blackcat1M in reply to PMRpro]

It's funny , because it was the same with mtx, but they blamed pred for that.

I had to have two weeks off mtx because I was taking antibiotics , no bruising but I took my first 20mg this week and low and behold bruising ?

[Blomps in reply to Blackcat1M]

Are you on the injections? Bruising where injected?

[Blackcat1M in reply to Blomps]

I take tablets, and the bruising always on my legs.

When it first started I saw a gp who sent me to hospital as he thought it was thrombosis , but they said they could not find anything and sent me home.

[PMRpro Ambassador in reply to Blackcat1M]

I took mtx for 4 weeks. I am also on an anticoagulant. Bruising really wasn't too much of a issue until I went on mtx. Not sure what effect the mtx had on the anticoagulant - it doesn't mix well with one of the other cardiovascular meds!!! But I finally seem to have got the bruising back to where it was.

[Blomps in reply to PMRpro]

Very true sometimes the obvious is discounted too soon..