methotrexate question/concern? | Arthritis Information

It is unusual to take that much orally. it can be tough on the stomach. When mtx was having its injectable shortage I did take 27.5 mg by mouth. You metablize more of the injectable than you do injestable. You likely won't see an increase in side effects from 25,g to 30 mg. What reason is she giving you about not prescribing injectable?

Personally I would give some really hard thought to keeping the mtx dose where it is and adding a biologic. If 25mg of mtx isn't working for you it is unlikely that 30 mg will

I got to agree with buckeye, I think I would consider adding a biologic instead of upping the mtx dose, that's a lot of mtx. As to the side effects have you ever taken Musinex(sp), the chest congestion medicine, with your mtx dose? Even at 25mg injectible I have had very few unpleasant side effects if I also take 2 Musinex tablets the morning of my shot and at night when I take my shot. My rd is actually the one who suggested this and it has worked for me. He explained it to me but I don't remember. Lots of cancer patients that use mtx as a chemo drug take Musinex tabs or Robitussin to help combat the nasties it causes. Just my thoughts.

jamie

All of the above are great suggestions. I'm really curious why your RD won't prescribe injectible MXT? Doesn't make any sense to me. I would add a biologic before I increased to 30 mg. which is a high dose of MXT for RA.My Dr. wouldn't take me over 20mg. I just started enbrel last week.10 pills per week is 25 mg which is normal. I've been taking that orally for years without any problems. Years ago I went from 8 pills I believe to 10 and that bit of an increase did help me. I know of several people who take 10 per week (25mg) without any problems.I was at 8 pills a week (20 mg.) and when that wasn't effective enough I was switched to 0.8 injectible. My RD said the injections are 20-30% more effective so I should see an improvement with the same dosage, but in injectible. He was right and several weeks later I was feeling nearly normal most days. It was only when he dropped me down to .6 that the problems came back after several weeks. Before taking the big step to a biologic, I'd certainly try the injections first. Try to convince her. You have the right to refuse a medication but I don't know how you can force her to give you something she doesn't want to, but I'd try anyway.

Also, I also used to find I sometimes felt a bit worse after the injections or pills, for a couple of days. I believe there are others who also had that experience. Good luck. I know you're in a tough situation here.

My RD recommends injectable at doses higher than 20mg, so when I dropped down from 25mg to 20mg, I went back to oral. While I was glad to go back to oral, I'm thinking I may ask for injectable next time around to see if the relief is better with inject (I agree with Jesse that oral may diminish the effect of the mtx) Seems to me that 30 is a little high for oral, but just my opinion.

How long have you been on mtx? I added enbrel when the 25mg dose wasn't taking care of the RA - my RD felt if it wasn't working by the 4th month, it was time to add biologic.

Usually if 25 mg of MXT hasn't helped or has stopped working then going up to 30mg won't help. My RD said that anything over 25 mg. won't help if 25 mg. isn't helping. I was having little success with MXT until I went to injectible. Within the month I had a good response. Don't apologize for having anxiety or stress. We all go through it and we post some crazy posts. LindyI agree...no need to apologise..I think we all understand your worry. I think probably what you need to do is talk with your doctor a bit more about what she really wants and let her know your concerns.I have no knowledge on the subject but just wanted to say sorry you are having symptoms severe enough to be causing this anguish in how to treat. I fear the biologics myself.

Hope you get a change for the better.

My doctor told me when I started Humira that if 25mg wasn't working well enough going any higher wouldn't either. He won't go above 25.

I now take 25mg MTX & Humira and have really good results with few if any problems. I'd seriously consider a biologic. I know they sound scary; but they are safer than they sound and many, many of us have great results from them.

If you are taking 8 pills a well I'd suggest going to 9 this coming week and see how you feel. Then go to 10. Often just one more pill will help you. Skipping from 8 10 12 pills a week might not even be nessesary. Experiment and see what works best for you.

Lovie2008-07-21 04:22:06I just wanted to say 'hi'! I've been wondering where you were. I'm sorry it's been a rough time, but I hope you can get you meds sorted out to something you are comfortable with and that will help. Take care.

My rheumy also won't go higher than 20mg orally.

I switched over to injections a little over 4 months ago - and wow - what a difference! I never thought I would be able to do the injections myself - but it really was a piece of cake. And - the injections (for me with my insurance) are way cheaper than the oral pills. I was paying per month for pill version - for the syringes +bottle of MX + alcohol wipes + BIO box - I pay .64 a month!

I would definitely try to switch to the injections before trying a biologic. Good luck to you hon!

Hugs

~Brenna

Madison is a beautiful city - GO BADGERS! My parents are season ticket holders - so I always get to attend a few football and hockey games every year - it's so much fun!

I dread the day that I have to start biologics as well - I'm hoping I can just stay on the MX and plaquenil...but if the day comes when that stops working - I will have to look into the biologics. I'm hoping that you are able to switch to injectable MX - sounds like you would do fine with it (maybe since you do your DH's injections...he could do yours?). And since it bypasses the stomach - hopefully you wouldn't have the nausea anymore.

Good luck hon - let us know what happens!
Hugs

~Brenna