Can I take Methotrexate a Day Early ?

[Cofton]

Has anyone been able to take methotrexate a day early ? I’m having a bad flare of rheumatoid arthritis and I want to take it a day early if I can but can’t see anything online about doing that . Thank you 🙏

[DorsetLady PMRGCAuk volunteer]

You’ll probably get an answer here as many use MTX , but as a secondary drug as this is forum for PMR & GCA not RA.

You might get a quicker reply on the NRAS forum-

healthunlocked.com/nras/about

[Cofton in reply to DorsetLady]

Thank you I didn’t know about that and I’ll find it so useful 😘

[DorsetLady PMRGCAuk volunteer in reply to Cofton]

You’re welcome…

[PMRpro Ambassador]

A one-off probably wouldn't cause a problem but it mustn't been done regularly as it could increase the toxicity. Also depends a bit on the dose - some people are on well under the usual max dose of 22.5mg although that does seem to vary a lot. Never above 25-30mg in rheumatology though,

But if you are flaring - you need to speak to your doctor.

[Cofton in reply to PMRpro]

Thank you . Unfortunately due to long illness I had to miss three weeks. Monday is my usual day and I took my dose last Tuesday. I would like to get back to Monday today as I am in pain due to the lack of medication. I am on 10mg by injection. Thank you for your assistance

[PMRpro Ambassador in reply to Cofton]

At that level it is almost certainly OK then - and it is a risk you will flare when you have to stop for illness isn't it. If you want to get it back to Monday, I'm sure it would be fine.

But doesn't your rheumy provide pred to take the sting out of a flare until the MTX starts working again? Lots do.

[Cofton in reply to PMRpro]

Thank you I thought it’d be ok just needed a bit of reassurance and no I don’t have anything to take the sting out . I’ll ask my consultant when I see him but he keeps pushing my yearly appointment back 🤷‍♂️

[PMRpro Ambassador in reply to Cofton]

Do you not have a nurse helpline for emergencies? It isn't really good enough when you can't get specialist advice in a situation like this. You don't necessarily need to see the rheumy f2f.

[Cofton]

they have email service and try to reply in 5 days they don’t speak on the phone anymore

[PMRpro Ambassador in reply to Cofton]

And in an emergency??? I suppose they assume rheumatology patients don't have emergencies!!!

[Cofton]

The only port of call is to call my GP really . They handed patients over to GP during and after Covid . Not going to change that now .

[PMRpro Ambassador in reply to Cofton]

Our experience of GPs and MTX is they only know how to dish out a prescription!!!!

[Cofton]

I agree totally with that

[PMRpro Ambassador in reply to Cofton]

And it matters a lot more to you - it is only an add-on for us that might or might not work.