MTX raised my Liver Enzymes | Arthritis Information
My liver funciton test was fine, and has been fine for years ( my PCP tests it every six mo because I take Lipitor), before I started MTX a month ago. Now my liver enzymes are elevated and my rheumy called and siad to stop the MTX. I see her next week. Has anyone else had this trouble with oral MTX. I was started out on five pills a week. Is the injectible MTX any easier on your vital organs? I am wondering what is next if I can't take MTX. I am really sensitive to drugs, and I have many drug allergies, some food allergies, and many environmental allergies. Right now I am taking Tramadol for pain, Celebrex and 15 mg of prednisone a day. Any info would be greatly appreciated. This is a bit discouraging. No easy answers, are there?!? This happens to me at least once a year. We stop or decrease the MTX for a few months then take it again. My dr. used to tell me that when levels are 5-10 times the normal range is when they get concerned. That is why bloodwork is done so often.
Hope your levels come down pretty quickly.
Same thing happened to me on several occasions when I was taking MTX. My RD reduced the dosage for a couple of cycles, then resumed my normal dose when the LFT's were back down to normal. I no longer take MTX, but have been on Arava for almost two years. I occasionally have a mild elevation of my LFT's, but not enough to warrant stopping it or reducing the dosage. You're right about one thing Vee...there are certainly no easy answers as far as RA is concerned. Good luck, and let us know what your RD says.
WHAT CAN BE DONE TO HELP METHOTREXATE SIDE EFFECTS
13 Things to consider before flushing methotrexate
Methotrexate is an important drug for Rheumatoid Arthritis treatment.
Many patients give up on it before fully considering their options. If a
physician has recommended you discontinue methotrexate either due to
liver toxicity or kidney malfunction, then you must do so. Also, you can
never take methotrexate if you are pregnant or drink alcohol heavily.
For the rest of us (most Rheumatoid Arthritis patients), here are a few
things to consider which may moderate methotrexate side effects.
- Are you taking your folic acid regularly?
Is it the dose the doctor prescribed? Did you tell her all of your side
effects? Sometimes the folic acid dose can be increased to alleviate
methotrexate side effects. Some RA patients also take some combination
of folic acid and folinic acid (leucovorin).
- Several companies manufacture generic methotrexate. Sometimes, it
can be important to make sure that you are getting the same generic
methotrexate with each refill. You can tell by the color of the tablets,
or you can ask the pharmacist. Patients have reported a distinct
difference in effectiveness if their brands are switched.
- Methotrexate doses can be decreased to reduce side effects and then
built up slowly again because the body can learn to tolerate the drug.
- Methotrexate can be dosed as either a once a week or spread out over
a few days. Perhaps if one has not worked well, switching methods will
work better.
- Methotrexate can be administered either orally or by injection. The
injection provides a stronger dose simply because absorption is closer
to 100% (none is lost in the digestive process.) Injections are an
option if there are digestive issues or a higher dose of methotrexate is
required.
- Digestive issues with methotrexate are often prevented by a daily
regimen of omeprazole magnesium (generic for Prilosec) or a similar
medication which blocks histamine receptors in the stomach. Taking some
type of acid inhibitor is also recommended by many doctors for
prevention of damage from NSAIDs.
- Pink bismuth tablets (generic for Pepto-Bismol in the US) also
provide effective relief for digestive symptoms due to methotrexate and
are generally considered very safe.
- Many people find that certain foods help alleviate side effects of
oral methotrexate dosing. For example, oatmeal eaten directly before
the pills are swallowed prevents stomach upset for some.
- I have personally found that sucking hard peppermint candy helps so
much with the “metallic taste” side effect that comes with long term use
of methotrexate. Peppermint has a long list of beneficial properties
and works in a few seconds. It also relieves nausea naturally.
- It is well known that grapefruit is a food which has the opposite
effect to oatmeal. It increases absorption of medication. So, if you are
worried about trouble with methotrexate, don’t eat grapefruit.
- I read a book written by a physician who suggested taking
methotrexate at bedtime so that you can sleep through lots of the side
effects which are worst during the first day. I know people who even
take their dose on a certain day with a plan to take it easy one day
every week.
- Check for drug interactions. Perhaps the methotrexate alone is not
what is causing the problem, but the combination of drugs. Ask a
pharmacist to give you advice. It’s also pretty easy to research drug
interactions on Google. Type “interaction” and then the name of each
drug in quotes. If you find something, ask your doctor about it. Never
change your medicine without talking to the doctor.
- Since the body can become accustomed to drugs, side effects often
resolve with no change in treatment. I call this “pushing through it”
because if you endure, often your tolerance of a medication will
improve. A rheumatologist once told me that most patients who give up
methotrexate do it too soon and against doctor advice because they do
not know that the side effects may not be permanent.
http://www.arthritisjointpaingone.comGreat info re: MTX. Thanks!
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