Methotrexate Reaction-first week? worried | Arthritis Information
Greetings all. Just diagnosed and doc put me on methotrexate, 2.5x6 per week. It is the first week and I feel worse than I have in years, all symptoms exacerbated for some reason. Does anyone know if this is common, temporary or if this might indicate that I might be among those few who cannot take methotrexate?
I know that genetically I have an inability to metabolize folate, and that the metho knocks down folate. Does anyone else have this?
In so much pain....
Thanks for listening.Sam will know more about this but I thought taking extra folate went hand in hand with taking MTX.
I'm on a daily dose of Folate.
Sorry, I am taking folic acid as well....Actually whem I started Methotrexate, I started at a very, very low dose and then they upped it slowly so I could get used to it. I take folic everyday too. I also take folic acid. My doc upped the folic acid because I have side effects from the methotrexate. I do sometimes feel like my muscles and joints hurt worse with the metho. It is kind of weird. I have problems with it around 3 days after taking it, injection form, then side effects ease up before my next injection. My doc also put me on the injections verses the pills hoping it would help with nausea. I would definitely talk with your dr. It might take some adjusting to get it to where it is tolerable.
For starters, I question the high dose right out of the starting gate. WHOA!
You should be on 1-2mg daily of folic acid, just like the others above have indicated. It's a godsend.
There's also such a thing as "leucovorin rescue" which I've not undergone and is reserved for people with extreme reactions. Check with your doctor about this. Here's a link that gives you an overview.
My own experience with beginning MTX almost 20 years ago was awful. Luckily I had a rheumatologist that believed in starting small. As I recall, I took 2.5 mg one week, 5 mg the next week, then a couple weeks later went up to 7.5 mg....... Back then they weren't talking much about folic acid and even on the really low doses of MTX [without folic acid] I was really sick. So much so that I told the doctor to find something else - that I'd rather die than continue taking this. He switched to injectable form, which was pretty avante garde back then. A few years later I switched back to the pills.
Incidentally, in my case, so many years later and I still have one "down day" each week. For me it arrives about 36-48 hours after I've taken my weekly dose. It lasts between 12-24 hours.
Talk to your RD about possibly switching to injectable and gradually upping the dose. And by all means.....get an Rx for the folic acid.
MTX has been a godsend for me. I'm a huge fan. Good luck!
[QUOTE=Sam1234]For starters, I question the high dose right out of the starting gate. WHOA!
My RD believes in aggressive treatments of RA.. He started me with
exactly the same dose at 15 mg and increased me to 20 in the two month
check up that followed....
Initially, I had some issues w/ MTX... Hair loss... some mouth sores..
very tired the day after dose..... I felt that the symptoms of my RA were exacerbated too..... but that
feeling gradually went away. I am still on MTX at 20 mg for 30
months now..... (also w/ enbrel)
Getting better w/ these meds isn't going to happen quickly......... it
takes time..... be sure to get a script for the folic acid.. for some
reason my RD feels it is better for us to have that than OTC.
I understand your worry... I can only say, I worried too..I still
worry.. But I am feeling much better due to my meds.
I am thankful for my RD's approach to this disease .... I was actually
working HARD in my gardens today after taking my MTX at bed last night.. and
this is the first year I have been able to do that since I flared in 6/07.
Good luck.
I was just dx right before Easter. My dr started me on MTX 10mg once a week and predisone 10 mg a day. It's been almost a week and I feel like my pain is worse. I also have lots of nausea and a dry cough that wont seem to go away. I too take folic acid every day except the day I take the MTX. I'm nervous about being on the MTX b/c there are so many things you can't have that will counter act with the med.
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