MTX Wearing Off Each Week? | Arthritis Information

Does this happen?

I take MTX on Sunday night. Only 3 weeks so far, at 10 mg.

Last Saturday and Sunday, LOTS of pain. Took it Sunday night.

Still in pain Monday, but better Tues, Wed, Thurs.

Going downhill today.

At first I thought it was that I'd gone swimming Saturday, and was just recovering from that, but today, just going to the grocery store did me in.

I really feel like I was able to catch the RA just as it was about to explode. It was my right wrist only at first (but really bad). Three months later (a month before MTX), my left wrist started some, my left ankle is definitely involved, and hips were nagging me. Now my hips are getting out of control. I can walk and all, but when I sneeze, it HURTS like nothing else.

Sorry to ramble. What I'm trying to say is that:

1. I feel like the MTX is working, but

2. I feel like I started the MTX at the beginning of a huge, "welcome to RA" flare.

Edited to add: it's not really, truly, "working" yet. But it's doing something. I still don't have ROM back in my wrist, but I felt this week like I was carrying (slightly) heavier things without problems for the first time. Could just be that I got overconfident, thinking it was working, and overdid it...

KatieG2008-04-18 19:10:35It took about 2 months for the MTX to kick in for me- I think-but I was also taking prednisone so maybe it was the combo. Both kept being increased until I was and am still on 15 mgs. MTX and 40 mgs. prednisone.

I'm down to 9 mgs prednisone and still doing pretty good so I'd say the MTX is working. My experience is I take it Monday- Tuesday & Wednesday I'm really tired and have my worst brain fog. As the week goes on I feel less tired and less stupid.

Hi Katie, you're on a low dose of MTX and it may have to be adjusted by your RD. Also, it doesn't usually reach the apex of working until about 3 months. I didn't notice a difference for 6 months and that was after I went from 12.5 mg to 15.5 and am now at 17.5 two years later. You need to call and talke to your RD. Take care. LindyI don't know why I decided to take it on Sunday nights, as I'm already dumb enough on Monday mornings without MTX!

Yeah, I guess I'm just trying to differentiate between feeling bad and worse. My RD is still convinced that I'm going to get 100% ROM back once MTX kicks in, so I'm constantly checking my ROM to see if its better (which it totally isn't yet). The Vandy guy thought the damage was permanent though, so it's hard to be hopeful.

I even printed out a protractor at work so that I don't make myself crazy. I'll convince myself it's more than 20 degrees and get all excited, and then check and it's not. I go see him next week. I'm pretty sure he'll bump it up. It hasn't touched my old symptoms, just keeping new ones in check?

I have only been on pred once. I guess I prefer to be on NSAID to pred but I wonder if pred would restore my ROM. But that's how my hand got so messed up to start, they put me on pred and I overdid it big-time. Huge flare.

My RD just gets my hopes up so much. He is baffled since it presented monoarticular and keeps saying "I'm sure this will clear it up." First it was the steroid shot that would, then the Mobic, now the MTX. He seemed to think we could get it under control in 6 months. I just need to be patient.

I guess I feel crappy tonight just because, and not because of MTX!

KatieG2008-04-18 19:26:53Katie-

How long has it been since your onset?

I've been on MTX for I guess 5 years....maybe a little longer. It's been the best medication for me. I've had to raise it to 25mg though. Anything lower isn't effective.

If you feel it wearing off before your next dose is due; even an increase of one pill could make a big difference.

It's a hard wait for some of these meds to kick it, isn't it? Hang in there Katie. Maybe you should give your RD a call and tell him/her what's going on. Maybe he won't change anything this early in your treatment, but then you will be able to stop wondering if you're on the right path, ya know? I started having obvious wrist involvment last November. Before that, I'd had issues with my hip, before I was pregnant with my son, and issues with my right foot starting back in 1999 that had me on NSAIDs for a couple of years, and made it so I could no longer run. They never figured out what it was, just said RSD, which was ridiculous because the pain was not excruciating except when I'd run. I looked back at the very first thing I was dx with back then, at the very first visit: inflammatory arthritis. Ha! Docs moved away from that, probably b/c of my age then (21).

But, the obvious RA started last Nov. My pain is under control with NSAIDs as long as I don't carry anything heavy in my right hand (and avoid shaking hands, etc.) but I have lost so much ROM that I'm truly worried about having to have it fused down the line.

My RD is seeing me next Wed. I am quite worried about my hip, since it is a bigger joint, and figuring out if it is OA or RA. I think he plans to increase the MTX and add plaquenil but he's just doing it slowly. Ugh.