Sudden bursts of heat and nausea

[Caloo650]

Three weeks ago I had to stop methotrexate after 5 months because of developing nausea. With PMR and GCA and tapering prednisone now down to 10mg I find I am still experiencing short bursts of nausea and short hot flushes daily. Is this to be expected from the disease or the drugs?

[MrsNails]

Hi Caloo

Is there any pattern to your nausea? Is it before you eat or drink or after? Or maybe just randomly? I get ‘hot flushes’ when l’m on too low a dose of Pred.....

The effects of Methotrexate are longer lasting, they take a while to build up & work and likewise when you stop taking it.

Did they not consider the injectable MTX?

MrsN

[Caloo650 in reply to MrsNails]

No rheumy said he may put me on a different drug. I missed the name not actemra. It seems to be after I've eaten and only lasts a minute or 2 same with the hot flushes but several times a day. I'm now on 10mg pred for a month. I've been on that for a week. I was really good until the nausea started.

[MrsNails in reply to Caloo650]

Sometimes we have to be aware that it isn’t always the PMR/Meds....

Usually they try the injectable MTX first, are you in the U.K. as Actemra is not an option here for PMR but there are other DMARDS but my experience is limited to MTX

Nausea can be debilitating, have you discussed it with your GP? Try keeping your food simple for a few days & see if it helps, l had bouts of nausea after about four months on MTX but stuck it out & kept to a very simple, plain diet as even the mention or smell of food made me feel very sick! Your GP may offer you a simple antiemetic to help, also how much Folic Acid were you taking?

MrsN x

[Caloo650 in reply to MrsNails]

Maybe I should have stuck it out because I felt better on it except the last few weeks of nausea. I also can't get actemra as I'm in Australia. I'l try a smaller and simpler diet. Thanks for you suggestions. The nausea is random as I just had it again and I'm about to go to bed!!

[MrsNails in reply to Caloo650]

Actemra is a game changer for some but not without its challenges & some of them are quite major.

When you have time, read my MTX Story it hasn’t all been plain sailing but for me it’s worth it.

Re Folic Acid - how much were you prescribed as l was/am on 5mg a day except MTX Day & that certainly helps with side effects.....

[Caloo650 in reply to MrsNails]

Sorry yes I was only on one 5mg tab a week of folic acid. Rheumy perhaps should have suggested I take more. I might need to ring and have a chat

[MrsNails in reply to Caloo650]

It's often the Rheumys Preferance but an increase to Daily Folic Acid at 5mg (except MTX Day) works.....

[Caloo650 in reply to MrsNails]

I'll talk to him if nausea still happening by Friday. Then it will be a month of no MX. Thanks again Carolyn

[diana1998 in reply to Caloo650]

Anti nausea pill should help

[Caloo650 in reply to diana1998]

Thanks just bought some

[PMRpro Ambassador]

If it was due to the methotrexate, then the effects of mtx can take a couple of months to wear off. The hot flushes may be due to the PMR/GCA or to the pred.

[Caloo650 in reply to PMRpro]

Thanks I can live with the hot flushes but the nausea is hard to take. Hopefully it's the MX and will wear off soon