I'm wondering if anyone has information to help me as I try to solve a problem I am experiencing. I was diagnosed with RA in Sept,05...started meds in October, including methotrexate. I'm on 17.6 mg of methotrexate now, taking it in split doses twice weekly. I take 4 tabs on Monday evening and 3 tabs on Thurs. evening. About six weeks ago, I developed what I thought was a canker sore. However, it's grown in size, it's covered with a white film, won't respond to rinses or the newest idea of the ENT doctor who put me on 1 gm Valtrex three times daily. About the time that the RA doctor increased my dosage to 2.0 mg per week, I got poor blood test results and he backed me off to 17.5. The important component of this problem is that until a week ago, I have not been on folic acid. I've learned that it is important to rid the body of the methotrexate. My regular doctor put me on 1 mg as soon as she learned that i wasn't taking it. The ENT doctor has me scheduled for a bioposy in a week, and I'm scared. Also, I don't want that in my file if it's not needed because I'm trying to get different insurance. My question is..would too much methotrexate cause this mouth sore and keep it around because I'm still taking the drug? Could it also be because I didn't take Folic Acid for so long while taking methotrexate? Am I taking enough now? I'm sorry to ramble on and on, and will really appreciate any help given to me. Thank you.I'm on MTX, & the doctor prescribed 1 mg. per day for me - she said to start it before I started the MTX, which I did. Having read peoples' posts, though, I bumped it up to 2 mg. per day for the reasons you are describing. Good luck! Keep us posted.
Hi chris and welcome. I get mouth sores quite a bit, but since I increased my folic acid from 1mg to 2.4mg per day I have noticed that they will start to come up but then start going down in less than 24 hrs. I only just recently increased the dose and I am hopefull that soon I wont get the mouth sores at all. I also take MTX, but I take the injections to reduce the affects to the stomach. Maybe you could switch to the injections and increase your folic acid and get some results. Good Luck!!
PS-I have found that using things like orajel help relieve the pain, but should be used sparingly (3-4 times per day or less) because it can slough off the top layer of skin and thus slows the healing time quite significantly. Taking some Ibuprofen actually helps with the pain, and the occaisional warm salt water rinse.
Thanks for all the good advice. Since I'm delving into this subject in an effort to at least delay this biopsy thing, I'm also visiting different drug sites in an effort to find out if we should be afraid of overdosing on Folic Acid. So far, I've read of people taking anywhere from 1mg to 4mg. I have tried rinsing my mouth with perioxide solution, Amosan and salt water...no improvement. The Valtrex doesn't seem to be working either. I did up my Folic Acid, so we'll see if that helps the situation. I'm just trying to play detective here and find a better solution. I'll certainly report back any info or progress I make in this dept. Meanwhile, thanks again to all of you. Oh well, at least I can laugh about it, right? I did up my folic acid to 2 mg daily, and I've added yogurt and acidopholous...what the heck, it can't hurt, right? Ok, just an update, I'll keep you posted. Thanks!Mouth sores can also be a symptom of Lupus. Do you have any wierd rashes on your body?I'm glad it's not cancerous, but how frustrating to still have the mouth sore. I am on 20 mg mtx a week, and usually take 10 mg folic acid a week too, but I recently developed a number of mouth sores that just wouldn't go away. I increased my folic acid to 15mg and they've gone away, thank goodness. There's nothing uglier then a whole heap of mouth sores. Not to mention the pain with eating and talking. I hope yours goes away soon. Well, thanks for the additional info and suggestions. Re the possibility of Lupus, I don't have any other rashes on my body that I know of. Somehow, I just feel this is all mtx/folic acid related, but i can't prove it or make it go away. I thought I was being a "rebel" by up-ing my folic acid to 2 mg (double the internist recommendation) but, wow, 15 mg! I might have to delve into this some more! No side effects from so much folic acid? And do you take it all at one time daily or ?? I see my dentist on 5/11, so I'll let him take a few peeks and offer his two cents worth...can't hurt, right? Besides, perhaps all of our mouth sores are not alike, and are caused by different things. The first doctor I talked with about it and actually looked at it was the rheumatolist, and didn't mention anything about putting me on folic acid or that it may be drug interaction...he just said I should find an oral surgeon. Haven't seen one yet...we'll see. Anyway, as I learn more about folic acid, drugs, mouth sores, dentist opinions, etc, I'll share whatever may be helpful to the group. Thanks!I hope you get it worked out. Let us know what you find out. It will be interesting to learn what it is or if you can get ride of it.