Methotrexate | Arthritis Information

What are people's experiences with MTX? I find that I seem to have some relief from the pain about 4 days after taking it for a day or two and then the pain is all back. Is this all in my head or do others find the same thing? I have only just increased the dose to 20mg but have been on it 6 weeks now and don't feel it is making a lot of difference. I am on 10mg Pred for another week and then have to try and taper that down.

I did not get any relief from it until my dosage was increased. I started at 17.5 mg, and finally when I upped it to 22.5 I started noticing benefits. I also take Enbrel and 400 plaquenil. You may need to up it or look at layering in Humira, Enbrel, etc if you are willing. I started with Humira and after six months noticed no change. I switched to Enbrel and upped the MTX 2 months later and finally started feeling much better. It is a fine line we walk trying to figure out the delicate balance of these meds. Hopefully you and your doc will figure it out soon. Good luck.

Dawn

I was on mtx for 5 months but had to switch to Plaquenil because of some side effects. I did get a bit of pain relief while on mtx, but I've had better results with Plaquenil.I was started on Plaquenil and MTX at the same time but was gradually bumped up to 20 mg. oral, (later switched to injections for more effect) so I'm not sure which helped first but I know it took several months before I felt a real difference. I often feel better 2-3 days after MTX and then sometimes I feel it wearing off. Some others here have also noticed a wearing-off effect. I've also had the experience when I've felt a bit worse with my symptoms (not side-effects) several hours after the MTX and then it gets better. There's no true, constant pattern for me so I'm not sure if it's really the MTX effect I'm feeling or not. I would think the body's reaction would be the same every time, true? Or would it depend on what's going on in our bodies that particular week? Anybody know? Hi Sal,

When I first started mtx my dose was 12.5mg and increased over a 16 week period to 25mg. Still not full relief so Enbrel was added. Stayed at 25mg for about 3 months after adding enbrel, then dropped to 20mg following 3 months of enbrel. I was feeling pretty good, but still some fatigue so we tried decreasing to 17.5 to help the fatigue. That didn't work as I had some activity start back up, so bumped back to 20mg in the last month or so. Still waiting for the full relief to come back - if it doesn't, then I guess it's back to 25mg. Have you been on mtx long? It may be that you need another increase.

I feel I have good result using 15 mgs per week coupled with 7 mgs prednisone per daywanttobeRAfree2008-06-15 05:16:54MTX alone did nothing for me at all.. but MTX in conjunction with the biologics was essential.

I am on remicade and MTX and believe me if I were to forget or have to go down in dosage I would sure know about it.

I am on 20 mg, but for a short time had to go down to 7.5 and it was awful my remicade might as well have been water.

MTX didn't work for me and at first it did to me what it's doing to you. I was on it for about 6 or 8 mos. My hair was falling out and turning white so my doctor took me off of itI'm just on MTX (and Mobic). Started at 10, then 15, now 20 (second week of 20 tonight). It hasn't touched the inflammation so far, even though it's only in one wrist. My RD is "disappointed" but is going to give me 2 more months on MTX. I wish he's add Plaq but I don't feel like being on more meds and he wants to wait. I met someone who said it took 6 months for MTX, but when it finally did kick in, she woke up one day and felt great. I have been on it for 3.5 months.Thanks for the responses. I have only been on it 6 weeks but Rheumy thought it would take 4 weeks to work. I go back to him in another 6 weeks so I guess he will reassess it then if it is not working. I also take Mobic daily and at this stage feel I am getting worse not better however that could all change as RA is so unpredictable!I don't do nearly as well on a lower dose. Hopefully an increase will net better results for you as well.I started taking mtx back in 1986, so I can't remember how long it took to kick in.

p.s. is it winter over there? summer will officially start this week, summer solstice is the 20th.

Hi Joie,

I noticed you're taking injections of MTX. That hasn't been offered to me. I was on 8 pills of MTX, but I have tapered down to 3 pills a week due to the ton of hair I have lost. Do you know if the injections affect hair loss as much? I would be willing to up the dose of MTX again if hair loss wasn't such an issue.

Thank you,

Nori

Nori,

I'm sorry, I don't know if injectable mtx would result in less hair loss. I switched to injectable cuz I had stomach issues and acid reflux. I'd been taking naprosyn and trilisate since 1977, so it took its toll on my stomach.

Hair loss wasn't a problem for me while on mtx pills or injectable. But I have pretty thick hair, maybe I just never noticed.

Now, I THINK 10 mg of injectable mtx is more effective than 10 mg of pills. Going through the stomach, the pills lose a bit of their potency, so by taking injectable you might be able to get by on a smaller dose than pills, and perhaps this may help minimize hair loss. I don't know for sure, just thinking, consider checking with your rheumatologist.

Sorry to hear of the hair problem, there's always some side effects to deal with sometimes. My stomach was a wreck from all the pills -- I lost 25 lbs --but then I gained it all back. Hi Josie,

Thank you for your response. I have brought this up to the rheumatologist, but I have found sometimes you have to make suggestions along w/ the concern for them to take action. That is why I'm trying to do my homework. My doctor just says I should learn to not let my appearance be a concern. My feelings are if there are other options where I don't have to experience the hair loss, why should I?

Anyway, again, thank you for your response.

Take care,

Nori

HI!

I started MTX last November.. first 10 mg.. then up to 20 at 2 month visit... I had some hair loss.. (thinning actually) which has stopped though I still take the MTX at 20 mg along with enbrel, folic and day pro.. oh, and I take 1000 mg biotin to help my hair

I believe that MTX did help and still helps, but not at the level that enbrel has..

good luck to you!

Hi Babs10,

I'm glad to hear your hair loss has stopped. I agree that enbrel has helped me a lot more than MTX, but I hear they make a good team. My hair loss is less since decreasing the MTX, but the damage is already done. The problem now seems to be a small amount of hair loss and no hair regrowth. I see the doctor in about 7 weeks, so I will see if there is any regrowth in that time.

Take care,

Nori

I was on it for 9 years....most of that time at the max dose. I experienced the hair loss as well as great fatigue, and little to no benefit for my RA. I was also sick at my stomach for a day and a half each week after taking it. I switched back and forth from the pills to the injections with no change in side effects. I started on Enbrel around 2 years ago and have since gone completely off mtx....and I feel great. Every once in a great while I'll have some mild break through stiffness, but the few times I've had that it was from overdoing it, and it was resolved with a dose or two of naproxyn.

I don't know what I would do without enbrel. It has given me my life back!

Hi Bizzalou,

I am also finding some success w/ Enbrel. It's the only thing that's helped and I had to BEG my doctor to go on it. I'm glad to hear you're doing so well!

Nori

Glad to hear it, Nori.....it's amazing how much better I feel. I hope I never have to go off of it...I just wish it wasn't so darned expensive!Me three! I'm doing well on enbrel. Been on it since Dec. Still have aches n pains with bad weather and when I over do it. I tried mtx and broke out in hives and itched all over. I was allergic to sulfa. I also tried plaqenil and humira and it didn't do much for me.

I hope you get the right combo soon. It takes some time and alot of patience but in the end it's all good when you find the right combo.

take care!

MTX has changed my life. I am thankful every day.

My RD started me on 7.5 mgs. and increased it pretty quickly to 10 mg. I felt some relief pretty quickly and it didn't take long before I felt almost 100%. I initially experienced some fatigue but really don't notice it now.