Methotrexate questions | Arthritis Information

Newbie here. Diagnosed with RA 7-10-08. I am on 10mg Methotrexate once per week and 7.5mg Prednisone daily with 1mg of Folic Acid daily. I just took my 4th week of 10mg and sometimes think I'm improving but joint pains keep popping up some old some new.

Is it too early to be seeing positive results? I'm not experiencing too many side effects - I do get the brain fog for an hour or so after I take it and some gas and have to pee bad a couple of times the evening when I take it - sometimes there's rumblings in my stomach but not vomiting or diarhhea. I go back to the RD next week and I believe that he is going to increase my dose to 20mg, is that commom practice? Is that when I will unfortunately have more side effects? How high can a person go on methotrexate- can you get to remission on this alone?

Hi and welcome!

It can take up to 12 weeks to see full effects of methotrexate. I, infortunately, didn't have any luck with methotrexate so I'm not sure how high the dosage can go, but I don't remember seeing anyone taking more than 25 mg.

Maybe someone with more experience will see your post soon.

Good luck.

They may increase you up to 20 Mg. before you see results. I agree that I would give it 3 months.You could be seeing some results now. I'd ask the Dr. if you could bump up your dose a little at a time and see if you can get more results from less than 20 mgs if possible. Better to try and then increase if you have to in my opinion. You may need that increase more later down the road.

I've been on 25mg for years with great results at times. I have added Humira though but I was on MTX for years with great results alone. Over time the effectiveness is less but you could go for a long time without adding anything.

I've recently reduced mine down to 20mg due to my liver test. Make sure to keep all lab appointments. My liver has always tested fine though until now. Hopefully it will be back to normal without decreasing it anymore. MTX has always been a great medication for me and I'd hate to have to stop using it. Less than 20 hasn't been that effective for me in recent years but I'm hoping with my Humira I'll be fine.

Good Luck to you. Welcome to AI. Stick around. We've got a great group here.

Welcome Bonnie - as others already said, it can take 3 - 4 months for mtx to work. I went from 15 mg to 25 mg over a 3-month period, so an increase after a month seems reasonable. Some find it more effective if mtx is injectable instead of oral - you can ask your RD that question. Hope it kicks in for you and all that is needed is mtx. Bonny--
I'm currently on 15mg MTX. My RD started me out on 10mg about three years ago, and over the course of two-three months increased it up to 15mg. I noticed some improvement within the first two or three weeks, but I continued to notice improvement for about three months. I was on MTX alone for about a year before my doc decided to add Enbrel as well.

Hope the MTX works well for you!!

dordale dordale82008-08-22 15:17:37Welcome Bonnie! I have been on 15 mgs per week since November 07 with good result. Not sure how long it was before it kicked in because I think a high dose of prednisone in January prompted my return back to health.

I'm thinking he's going to have me go right to 20mg and he did mention the posibility of having to add a biologic because of my high RF titer 1:640 and anti ccp antibodies <250. I do have erosions on baby toes already.

Welcome Bonnie. I didn't see any change until almost 4 mos. and with 25 mg. per week.

As far as the side effects, different things work for different people. For me, I need to eat 3 good meals the day of MTX and I take my pills right before going to sleep. It's great, I sleep through any side effects. I also think your body adjusts to it, you haven't been on it very long.

Good luck!

I too started on a low dosage of MTX,my rheumatologist is only increasing it gradually. I may need the increased dosage down the road but I am managing on 7 tablets a week at 2.5 instead of five. I wouldn't jump to the higher dosage immediately. There was no noticeable side effects when increasing the dosage. I have no unpleasant side effects. Make sure you eat something beforehand though.

I don't think I can add too much other than to share my own experience.

I started on 7.5 mg. At the next appointment, my RD increased the dose to 10 mg. That is where I have been for 1.5 to 2 years. ( I never remember time frames) I only take MTX, have had few side effects and am pretty much under control at the moment knock on wood.

The MTX kicked in pretty quickly in my case...not 100% initially but I did feel a decrease in symptoms very quickly.

MTX has been a life saver for me.