Methotrexate, stomach bloating

[JsyAnne]

Hi

Suffering from terrible stomach bloating and trapped wind at end of day. Seems to have started when I was put on Methotrexate. I'm a bit confused with everything I've read so can anyone tell me if I can take Gaviscon or something similar if I'm on Methotrexate, Prednisilone and Lansoprazole. Awake now at 4.00am drinking Peppermint tea to try and ease pain.

Used to be kept awake from pain of PMR but now it's the stomach pain stopping me sleeping

Help!

Anne

[Hidden]

Hi JsyAnne

The Methotrexate can interfere with your digestive tract & one of the options is to have it by injection as it then by-passes the gastric tract.

Ring the Rheumy Nurses they may give you some options or an additional Stomach Protecting Medication.

How long have you been on MTX; how much Folic Acid are you taking & is it affecting your stomach all the time or just on MTX Day?

MrsN

[JsyAnne in reply to Hidden]

Hi

I've been on the MTX for 6 weeks now, on 15mg for the last 3 weeks. I seem to have a bloated stomach and discomfort most evenings but yesterday was really bad and I had taken MTX. I have 5mg of Folic Acid each week. (Lansoprazole 15mg)

I have an appointment with Rheumy on Thursday so will see what can be done. Thanks for the info

Anne

[Hidden in reply to JsyAnne]

That’s good you’re seeing Rheumy next week, do make sure you have the Nurses Helpline Number as they are really helpful.

I take Folic Acid everyday except MTX Day to lessen side effects.

Are you drinking plenty of water when you take the MXT? As Pro says you can try the Gaviscon but I’m thinking you may be a candidate to bypass the digestive tract.

I take my MXT after my lunch with a good glass of water, it maybe helpful to take it at a different time from the Lansoprazole too.

Let us know what Rheumatologist thinks.

MrsN 🌷

[JsyAnne in reply to Hidden]

Thank you. I'll try taking MXT at a different time. I live in Jersey and don't believe we have Rheumy specialist nurses! I'll go armed with all the info you've given me and all my questions on Thursday.

Anne

[PMRpro Ambassador]

MrsNails is the resident mtx knowledge bank but I can't see any reason why you can't try gaviscon. I assume you were put on Lansoprazole at the same time as pred and were OK with it on its own?

There is an interaction between mtx and lansoprazole which will potentially make mtx side effects worse - as if you were on a much higher dose:

drugs.com/drug-interactions...

You may need the lansoprazole dose reducing or the drug changing to something else.

You might find this interesting if you like coffee:

atlasofscience.org/coffee-f...

I think you need to contact your rheumy team and tell them you have unpleasant side effects - only you can tell if they are bearable in the long term or not. A large proportion of patients are forced to discontinue mtx in the long term because of adverse effects - a shame because it is a very effective drug in rheumatoid arthritis. How good it is in PMR is a matter of dispute.

My only unbearable effect in the short time I took mtx was the fatigue which was overwhelming, up to 6 days out of 7 by the time I stopped. But I couldn't have coped longer term with it and my rheumy accepted that without question. As I say, it could be the mix with lansoprazole and changing that may be enough.

[JsyAnne in reply to PMRpro]

Hi

Thanks for all info.

I love coffee so I'll give that a go I think. Worth a try!

Anne

[PMRpro Ambassador in reply to JsyAnne]

I think it works because it suppresses the methotrexate effect so might not be a good idea in someone not on lansoprazole. But do discuss it with your doctors - maybe a lower dose of mtx might be better.