Hi All,
I started taking MTX 3 weeks ago and other than a metallic taste in my mouth for about the first 4 days after each dose, I seem to be escaping most of the common side effects....though my legs feel more tired walking back up the hill from school each morning since last Thursday or so. Not sure if that's related or not. My big concern, though, is vaginal bleeding. After my last period (first one since starting MTX), I had a couple of normal days but then started with spotting, which has progressively become worse each day over the last 1-1/2 weeks. Is this something that will continue forever and daily, or something my body is adjusting to, or a sign that the dose may be too high and I need to talk to my RD about reducing the dose? I've searched the web but haven't come up with anything.
TIA,
How much are you taking. My periods have gotten horrible but my dr can not find any reason other than he says it is natures way of not letting me get pregnant cause I am too sick right now...................TERESA
My doctor started me at the max dose, 20 mg a week.
Max dose is actually 25 mg but the usally start you at 12.5 so you can get used to it. I take 25 and am going to start injecting next week...........TERESA
Wow - I was started on 5mg a week [10+ years ago] and worked up. Never had any vaginal bleeding problem but I never went higher than 12.5 mg in all these years.
Here's what I found on the web: "Adult Rheumatoid Arthritis: Recommended Starting Dosage Schedules: Single oral doses of 7.5 mg once weekly."
I know MTX is used for some forms of cancer, starting the therapy in much higher doses, which begs the question: Is this a rheumatologist prescribing this drug?
I'd be suspicious that it was just too much the first time out of the starting gate. If it were me, I'd call the doctor [hopefully a rheumatologist] prescribing and explain the situation. Ask him if he wants to reduce [significantly] the dose. Then grandually increase it.
Just checked the web. Statement: "Do not use methotrexate if you are pregnant or planning a pregnancy because of its significant risk of birth defects or miscarriage. Contraception should be used for the duration of therapy.'
Of course, the bleeding could be due to other reasons, timing being coincidental to taking MTX.
Lee
Hi Lee,
The methotrexate was prescribed by my rheumatologist. When I read about the doses of others, I questioned him about it, and his reasoning was that my x-rays didn't reveal any erosions yet (reported as "normal for age" so he wanted me at the maximum dose in order to prevent any further damage (hopefully!). He has been in practice for about 20 years and is the head of the rheumatology department and the medical center I go to, so I felt he knew what he was doing. He called back tonight but I wasn't here, so hopefully I'll catch up with him tomorrow and will let you know what he says. My cousin was put on 20 mg weekly but her hair started falling out, so her dose was cut back to 15 mg weekly (different doctor) so I guess it's not unheard of to start with this dose...but it did kind of worry me. Will keep you posted!
Darcy MJ,
Sorry, but I am REALLY surprised. [We are talking about the pills and not IM injection, right?] I've never heard of such a high dose to start, especially when you do not have erosions.
Somehow it doesn't make sense to me. What does he plan to do if and when you DO have erosions?
http://www.rxlist.com/cgi/generic/mtx_ids.htm
http://www.rheumatology.org/public/factsheets/methotrexate.a sp?aud=pat
MTX side effects are available on WebMD. I would go talk to your doc.
"Tell your doctor immediately if any of these serious side effects occur: mouth sores, diarrhea, fever, fatigue, persistent sore throat, unusual bleeding or bruising, black stools, skin rash, enlarged glands/lymph nodes, dark urine, bone pain, unusual pain and discoloration of the skin."