Methotrexate

[Loughrig]

I have been on methotrexate for 2 years. 6 months ago due to side effects my consultant advised me to reduce from 8mg to 4 mg. I am experiencing worsening side effects ie: fatigue, ‘being punched’, headaches. Has anyone had these symptoms?

[Marijo1951]

Hi. I've been on MTX since December 2017, starting at 10 mg per week and increasing to 15 mg a couple of months later. That's been my dosage ever since. I'm very fatigued a lot of the time, but this has been so ever since I first became ill, and it's difficult to know how much is the direct result of the illnesses and how much is a side effect of pred or MTX. I do know that if I take MTX in the morning, I'm collapsed on the sofa for the rest of the day, so I take it late at night shortly before bedtime. I'm not sure what you mean by 'being punched', but I certainly haven't experienced anything that I could describe that way and MTX doesn't give me headaches.

I don't know which of 'our' ailments you have, PMR or GCA or both, but the fact that you have headaches raises alarm bells regarding GCA. If you could provide a bit of information about your diagnosis and a description of the headaches, the more medically knowledgeable forum members may be able to advise you.

[piglette]

I am not on Methotrexate but I got similar symptoms at around 5mg. I assumed it was my adrenal glands.

[MrsNails]

I presume you mean reduce your Prednisolone from 8mg -> 4mg? Did you do that in one drop?

So did the Consultant think the side effects were from the Pred or MTX?

[PMRpro Ambassador]

Do you have PMR/GCA? Is that the pred dose or the methotrexate - what dose of that are you on? Over how long was the change on dose from 8 to 4?

If the drop from 8 to 4 was the pred then what you describe could either be due to poor adrenal function that isn't catching up with the reduced amount of corticosteroid available to your body or it could be simply because it isn't enough to manage the PMR even on mtx which does NOT guarantee you getting off pred entirely neer mind replacing the pred.

[karegodd]

I’ve been on mtx for PMR for about three years. Presently on 5 and 1/2 mg of prednisone. I split my mtx- 7.5 Sunday night amd then 7.5 Monday morning to try and sleep through some of the side effects. Monday half day and all day Tuesday are right offs for me- headaches, terrible fatigue nausea and yes feel like I’ve been punched in the gut. Also experiencing burning in the feet which concerns me regarding peripheral neuropathy yet my blood sugars are consistently good. Don’t know if anyone else has these symptoms. I have a video consult with my rheumatologist in three weeks. So not sure if all symptoms are side effects of mtx or pred withdrawal and/or adrenal insufficiency.