My RD just recommended that I add Methotrexate to my Humira dosing. Any tips on taking the oral form to minimize side effects etc.? What dose is everyone on?
I take 15mg Methotrexate po weekly (I suppose you are starting po and not injections). As for side effects, Methotrexate depletes folic acid...your healthcare provider will probably add folic acid (Folgard 2.2mg). Let's see now, I'm on ASA, Bectra 10mg daily, Enbrel 50mg weekly, prednisone 5 mg daily, and on and on and on.
I have been on Methotrexate since August (15mg seems to be the median dosage with 20mg probably the max). They usually start you on the lowest dosage and work up. You are probably already doing weekly to monthly lab work. Methotrexate can cause aplastic anemia (anemia, leukopenia, thrombocytopenia) in addition to CNS & EENT & GI & GU reactions. So be sure to monitor you H&H, UA and liver enzymes.
I've had no problems with Methorexate. Together with prednisone, they saved me. The MCP's of my left hand were so red and boggy and painful that I could hardly work. My ankles looked like grapefruit (my family doc had me on diurectics...an orthopod I work with told me to loose weight...the plastic surgeon gave me some support hose...I had a co-worker draw some blood and off to the lab I went...Once again, a Nursing Diagnosis Triumphs!!!)
Did he say why he was adding Methotrexate? I always give my NP & Rhumy the 3rd degree, as I want to understand what is happening with my body.
Best of Luck. I sincerely hope that you feel better SOON!!!!
Mark -
I would suggest taking it at night if possible - when I was on oral to begin with I took it at night and it helped minimize the side effects but I had really bad side effects with the oral and they switched me to the injections - I still take it at night to minimize the side effects. I take 20mg a week. I also take daily folic acid.
Like Cheryl, I give my RD the 3rd degree. I too want to know what and why
Good luck with it! I hope that you have no side effects and that you have a terrific response to it!Thanks everyone. He is putting me on it Mtx because Humira is losing its effectiveness. I started taking Humira 1/2004 and was on bi-weekly injections for 11months. In November it started losing it’s effectiveness and I switched to weekly injections. Since it hasn’t gotten better he is adding Mtx. The thought is, maybe in combo it will be more effective. If not, the next option for me (Remicade) requires Mtx so one way or another we need to start. I am on 15 mg mtx and have had no problems with it. The doctor told me to take 1 mg of folic acid daily, and I drink lots of water the day of the mtx. Hope it helps!I started on the Humira shots back in 6/04. I do not have any side effects from the shots. My sister has been giving me the shots in my arms which is easier 0n your body. I also take Prednisone 10 mg (just came off 15 mg) a day, Mobic 15 mg a day and now I am taking the Methotrexate 10 mg once a week (5mg in am and 5mg in pm). I was not happy to start the Methotrexate and worry about the side effects. I am also on Folic Acid 1 mg a day. I do feel better and a lot of the swelling is down but for all this in take of medication I thought I would be feeling much better.
I take 30 mgs of mtx a week, this is a suggestion my dr. and it does seem to work. If the pills make you sick when taking them all at the same time stretch them out through the day. Example would be let's say you are taking 20 mgs take 2 pills every 6 hrs or one pill every 3 hrs. I could never get use to taking them at bed time because I am the type who usually only sleeps 3 to 4 hrs at a time get up for 3 hrs lay back downetc. Drink LOTS of water to flush it out of your system and get lots of rest. Good luck. Meme
i really dunno the long term effects of mtx which really scares me thinking about it. i read somewhere it could damage the liver and dunno what other negative effects it would give to the body. i just hope it wouldnt make things worse for taking this meds.
cookieCookie;as long as you go for your bloodwork when you are suppose to, the rd keeps a very close eye on your bloodwork anything looks wrong he or she will notice right away. meme
i must admit I really dont give much importance regarding lab. test. as long as im pain free and could go on with my everyday life, thats what is important. sometimes, i cant help but think what would be the end result to all of this.
cookie
I know what you mean Cookie, but for me pain is an everyday occurance. My rd was upfront with me and explained he would do everything he could to get me as painfree as possible, but i have to understand that I may have still some discomfort due to the porgression of my athritises. I am fighting ra, pa, and oa besides hypothyroidism and raynauds syndrome. I feel that when the pain is dull and I am able to still do my work I am having a good day. Granted i have every so often, a painfree day, they are coming fewer and fewer, but i try not to let it get me down. The enbrel and mtx cocktail have been helping somewhat and I have to tell you I am doing much better than I was last year. I thought long and hard about going on mtx before I started, and I can tell you if I had to do it over again I would still take my little cocktail just because I know it is working for me. This is something you have to decide whether or not it is right for you, Remember there are alternatives that you can try including holisitic methods. Take care and Good luck!! meme
I take all three pills (7.5 mg) one morning each week. I drink lots of water every day, all day long, and I don't usually drink more on the day I take the Metho. I do take one (400 mcg) Folic Acid pill every day.
At 7.5 mg/week, I don't have any reactions to taking the Methotrexate.
Good luck to you, Sue
Mark;
I take 22.5mg a week as well as Humira. It's been a good combination for me. I started MTX first and slowly worked up to what my doctor considered the max. dose for me. He didn't think raising it anymore would help me; so we then added Humira. It's taken months but it does seem to be helping although I have an appointment on the 10th and I plan to ask him about swithcing me to weekly doseage (Humira) as well. I feel like now at about day 10 or so the combination wears off. I take mine on Saturday night and will admit my Sundays are not always the best. Fatigue I would say is the worst side effect....but usually by Tuesday I feel much better.
Did you find much difference in the shot itself when you switched from biweekly to weekly?
Lyn; I'm so, so sorry to hear of the loss of your father. Complications can arrise from RA and certainly the medication itself; often the medication itself is what caused the most dangerous complications. However everyones body is different, and although we all appreciate the information as well as the warning I imagine there are still plenty of people that are willing to take a chance with a drug that has obviously made a dramatic difference in their lives. Some of us here have taken MTX for years with out any side effects or complications what so ever. I would be one of them.
Hi Lyn,
I am very sorry for the loss of your father. I took MTX for over 20yrs before I had to stop taking it. It was a lifesaver for me for many years, nothing else worked for me. I stopped because I had developed sudden shortness of breath and it was attributed to MTX.
Whether we decide to take or not take a drug, knowing that there are possible serious risks, is a decision we don't make lightly. My choice was easy; with MTX I could work again, without it I was incompacitated. I chose MTX and was able to work for many more years.
Barb
Hi Lyn,
I'm so sorry to hear about your father. Hugs to you.
From my understanding, aren't ALL RA drugs dangerous? They're all pretty potent meds, and I think the danger lies in the persons response to them, since everyone responds differently. Some people have serious reactions to meds, and they're even deadly reactions at times. But others are able to take the same meds without any problems at all.
Yes, RA can attack the lungs. It can attack any and all organs. RA, and other autoimmune diseases, are deadly diseases in and of themselves. But like Barb said, we chose the meds so we can function and hopefully lead a more "normal" life (whatever that is).
But thank you so much for caring enough to give us the warning. Take care.
Cris
Well thats just scared the life out of me. I started Metho last week and I'm gradually increasing over the next 5 weeks. No side effects as of yet and had my chest xray yesterday. Really paniccing now I've read that post.To Lynn...I know MTX is a dangerous drug. I refused to take my doctors advice to start the MTX in the beginning. I got progressively worse and then one day could not even get out of the bed. I'm not saying I was stiff and sore and it took me a while to get out of bed. I'm saying I could not move. My husband had to call an ambulance to take me to the hospital. As much as I was afraid of the MTX, I knew I had to do something. Once it started working, I was glad I had taken the MTX. Sure I still worry about it's dangers, along with the other drugs, but without these drugs, I know how bad it can be.
Kelly
Guys I'll admit it is scary...but life as I knew i before was scary as well. I look at it this way...and remind you this is just my opinion...may not be the same for others:
I'm super scared of being in a car accident. I'm so paronoid about being in a car crash, why I don't really know. It's just one of my biggest fears. Millions of people die every year driving their cars; yet everyday I go out and I get in my car and I take that chance because it's nessesary to function in my everyday life. I have to get around. I have to go to work, I have to pick up my children, I have to go to the store. I look at my medication (including MTX) the same way. It's a chance I'm willing to take to enjoy my life. To be able to function in society.
Another example (which doesn't realy apply to me) are these NSIADS that have recently been taken off the market. There are lots of people even right here on these boards that continue to take their last remaining pills despite the warnings because they know the dramtic differences they have made in their lives. They are just willing to take that chance.
Now I'll admit if you have RA and have functioned well without these more powerful medications by all means don't start taking them. But if you are like so many of us here that could barely move, was in constant pain, had severe fatigue and could not function in your daily life anymore these medications are life savers in my opinion.
Again...this is my opinion; and others might not agree....but I'd rather have another 30 fairly good years than another 40 or 50 where I was misrable the entire time. It's more about quality of life verses quantity.
i gotta say mtx has been recommended for me too, but having come home and looked it up, i put it on a burner way at the back!
Not from the liver point of view, from the being only 25 and probably wanting to add to my family and stuff point of view.
As far as i understand, most of the drugs need regular blood monitoring for probs with things like liver. I take sulfasalazine and am checked at least 3 monthly if not more.
Tori,
You bring up a really good point. I'm only 34 and have been in menopause for more than a year now. Whether the MTX caused it or not I can't say...and my doctors hesitate to say; but they have said it's likely.
Definatly something to consider for some of you younger girls. I would have hated to have waited to start my family only to find out too late that I could no longer have children.
Hi, I have been reading through some of the other posts in this and some other threads. Im currently in my 2nd week of taking MTX, 3rd session on Sunday when I'll be taking 7.5mg, so far so good and no side effects. Easing off the Pred and feelin ok except slight pain in my right wrist. I take folic acid every Friday (5mg) to limit the side effects. Was just wondering if this dose of folic acid is a large, moderate or small amount and if it will have an effect on limiting the side effects? Im pertified of them all and the idea of hair loss is scary as I'm only 20. Whats everyones experiences? I'll eventually be on 12.5mg of MTX and 5mg of folic acid a week, is this an average amount? Anyone wth the same dose, did the acid help the side effects? Thanks x
X~
I take 22.5mg (along with Humira) and I don't take the Folic Acid at all. My doctor told me if I wasn't having to many side effects it wasn't nessesary...it was optional. I question whether it's something I actually need or not; but have no true facts on that. I feel like if it was really nessesary in my case my doctor would insist.
MTX has been a life saver for me; but at a higher dose. 7.5 wasn't very helpful at all for me; and eventually even 22.5 wasn't enough. It helps many though at the dose that you're on now.
I wouldn't be overly concerned with hair loss. There are a lot of dangerous side effects from this medication; I'm more worried about MTX than I am the Humira...but the benifits out way the risks in my opinion. I have a very thick head of hair...and I have also been coloring it since I was in high school. Yes; my hair falls out; but is it from the MTX? I doubt it. I think the hair loss is really at much higher doses like used to treat caner. Honestly; I'm not sure.
You've probable read this entire thread but above I mentioned to Tori that now at 34 I'm in menopause. Whether MTX is the cause of that or not no one wants to say for sure, but it's something I want all of you younger ladies to be aware of because it's something that was never once mentioned to me.
I'm from the Philippines and im trying to sell two box of humira for only 1600 us dollar. the said drug was prescribed by my wife's doctor for treating fertility i already bought three and consumed one box if any one is interested please email me. THANK YOU
You are selling drugs without a license. This is illegal.Xjennax:
The usual dosing is 1mg daily for each of 7 days a week for a total of 7 mg of MTX.