PsA and maybe PMR

[Seal49]

Started on methotrexate 3 weeks ago. Did 20 mg first 2 weeks. Did 1 week so far on 15 mg and do to do 15 again this week. Then start 20 mg per week and stay at that. In the meantime my Rheumatologist has me reducing my prednisone 1 mg a week. Started this at 15 mg prednisone and now 13 mg and due to go to 12 next Monday. Other then feeling alittle tired the next day after I take the methotrexate, feeling fairly good as before I started reducing the prednisone. Do you see anything I'm missing at this treatment schedule. Thanks

[SheffieldJane]

If it is working for you, then you are a lucky one and more power to you!

[Seal49 in reply to SheffieldJane]

Thank you. Not sure why as everything I've read says that the methotrexate takes awhile to start working. I'm holding my breath and hoping the prednisone reduction isn't too fast and I flare up.

[SheffieldJane in reply to Seal49]

Sounds sensible.

[PMRpro Ambassador]

Sounds as if the rheumy thinks MTX starts to work immediately and it rarely does! Watch out for wobbles!!!

[Rachmaninov2]

I am presently taking 10mg prednisolone a day and have been back on 7.5mg sub cut methotrexate for six weeks. The consultant wants me to reduce the prednisolone but as I am experiencing quite a lot of pain I will wait until I feel that the methotrexate seems to be having a positive effect. As far as I know it could take up to 12 weeks. Hope it goes well for you Seal49.

[krillemy]

So you started MtX at 20 mg Weekly? I started at 7.5 and then up by 2.5 mg every other week. Doctor said that it was to avoid sideffects. And why down to 15 and then up again? I am on 15 mg now 7 weeks in. No miracle yet - let u’s know Joe it fors with you

[Seal49 in reply to krillemy]

I meant I started at 10 mg

[Naibor]

Hello.

I saw my Rheumatologist back in March after being referred by my GP, following a flare and not being able to reduce Pred below 10mg. He recommended starting MTX 20mg a week do this for 3 months and then start to reduce Pred. I was willing to do this but explained was planning to tour Spain and Portugal in our Caravan for 3 months. We agreed to start when I returned and he suggested i try and reduce Pred to 10 mg during this time. I was on 12 mg at that time. I managed the to do this, and started the 20 mg MTX on the 20 Aug a long with Folic acid 5mg. To date the only side affect I have had is mouth ulcers, which I’m managing with mouthwash and good oral hygiene. Just in the last week I have noticed a significant improvement in my pain levels. I have never managed to be pain free even on high dose of Pred. I do keep active regularly walking and gardening, and my hobby woodworking. I certainly no when I’ve done to much and suffer the following day or 2. I’ve learned it is a balancing act between keeping active and doing to much. I see my rheumatologist in 5 weeks time when believe he will suggest starting to reduce Pred.

Thought I would give you all my experience with MTX. Hope it wasn’t to much of a ramble. I will continue to update with my progress and experiences.

I have found this forum vey informative and helpful. Thank you all

Keep well.

[PMRpro Ambassador in reply to Naibor]

"a long with Folic acid 5mg. To date the only side affect I have had is mouth ulcers, which I’m managing with mouthwash and good oral hygiene"

is that 5mg EVERY day? Or just 1x a week? 1x a weeks is rarely enough some need as much as 6x per week, every day except MTX day. The mouth ulcers are due to the MTX inhibiting folate production in the body - and why you need the folic acid.

[Naibor in reply to PMRpro]

Hi PMRpro

To clarify. I have been taking 5 mgr 6 days a week. However since speaking with nurse was advised to take 10 mg the day before MTX and 10 mg the day after. Hoping this will help.

[Seal49]

Thank you . That would be appreciated. I meant I started mtx at 10 mg first 2 weeks