Effects of methotrexate on lower doses of pred.

[Kailacobweb]

On the subject of methotrexate I think that now I’ve got down to 5mg pred the effect of the methotrexate is that it causes me headaches for 24 hours. Does anyone know if when you get to lower doses of pred the methotrexate dose should also be lower?

[PMRpro Ambassador]

I don't think so initially - though it might be worth trying the next dose down to see if it helps avoid the headache. Usually they would try to get you off pred altogether and then possibly start to reduce the MTX slowly. Though I don't think I have come across many people who did manage to do more than get to a lower pred dose, maybe a few managed on MTX alone. And removing MTX often seems to lead to needing more pred again.

[MrsNails]

Hi what dose of MTX are you on? It’s not usual to reduce or stop the MTX until you’ve stopped taking the Pred - l’m a long way off that (if ever?/!)It’s worth ringing your Rheumatology Nurse to ask her what they usually do at this stage.

Well Done & Good Luck 🍀 for the rest of your taper.

MrsN

[Kailacobweb in reply to MrsNails]

I’m injecting 25mg weekly.

[MrsNails in reply to Kailacobweb]

Same Dose as me - it’s worth a discussion with Rheumy Nurse but l think they may feel as l do - it’s not the time to rock to boat but continue your taper. Please let us know how you get on!

MrsN