MTX Advice.... | Arthritis Information

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I’m scheduled to take my first dose of 12.5 mg of injectable MTX this coming Friday, 04/20/07. Like many who have been on here recently about to start MTX, I’m apprehensive about taking the drug since I have no way of knowing how it is going to affect me. Per info that I’ve found giving advice to others I am planning on taking the MTX close to bed time so if I happen to have any stomach related side effects I’ll sleep through the bulk of it. For those of you who take MTX would you recommend eating something before taking the drug or should I take it on a fairly empty stomach? Also, how many of you on MTX take Milk Thistle to help protect your liver? I’d like to do supplement with this but I’m found info on the net that stated that if you take Milk Thistle with MTX is can actually cause more of the drug to build up in your system which in turn would increase the potential toxicity of the drug. This is supposedly due to the Milk Thistle actually slowing the liver enzyme activity and filtering out less of the drug. I didn’t get to ask my RD but my pharmacist said that in his opinion it should be fine to take it. For those of you who take Milk Thistle, what dosage do you take? 

 

I just hope that I don’t have unbearable side effects. I’m taking it on Friday and unfortunately it’s a fairly big weekend. My daughter is being “Confirmed” on Sunday morning and we have a family get together for two hours afterwards. I’m contemplating taking a smaller dose of  7.5 mg this weekend to reduce the chances of unwanted side effects and then hitting the 12.5 dose starting next weekend and every weekend thereafter. I’d hate to be sick and ruin the day for my daughter.

 

Thanks in advance for any info!

I would eat a light meal before taking it, nothing to heavy or greasy though.  Sorry, I have not heard of the milk thistle thing.

Enjoy your family time this weekend!

I have taken a Milk Thistle/Dandelion supplement for a year and a half with great liver enzyme results while on 20mg MTX.  I just recently changed to injectable and do take it before bed with a little on my stomach.  I am fatigued the next day but I also take an Enbrel shot the same night.

Good luck.

I usually take mine shortly after dinner on Saturday night. Sometimes large meal....sometimes not; I'm not sure it matters that much.

Good Luck. Hope all goes well.

I'd suggest taking it Friday evening; so you can rest on Saturday and you should befine for Church on Sunday.

 

make sure you drink plenty of water the day of , the day before and the day after.  Being hydrated makes a difference.  I also agree with Lovie, don't wait until just before bedtime do it right after dinnertime.  That gives you a couple extra hours to process the med before bedtime.

Don't get too anxious about side effects, for most of us they are pretty mild if any occur

buckeye39189.3670023148

I do eat food with MTX, soy milk & crackers, etc, but i've heard it is better not to??How do we protect our stomachs? If you are having something special on Sunday,I'm almost sure you will feel fine. So good luck, I do feel a little tired, after taking mine but nothing too bad.  I'm taking prednisone also, which gives me energy. And tomorrow Remicade.

Sarah

 I started tx. with inj. mtx 5 weeks ago. I take it around 3pm on saturdays. the first two times i took it, it knocked me out. every time i take it the symptoms seem to get lesser(if thats a word) :) I havent noticed any benifit as of yet. actually seem to be worse than ever:( My side effects are very tired, headache if i dont drink lots of water, and a general ill feeling for two days. i was very scared to take it in the beggining as well, and put off taking it for three months. now i wish i had. than atleast i would have those months under my belt and maybe feeling better than i do now. the first two times i took it i made sure i had someone with me. i was afraid of some horrible reaction. Also the first time i took it i put a little less in the vial than i was suppose to, just becuase i was so scared. Now i wish they would up my dose so i can start to feel better. good luck. keep us posted.

kel

Fluids the day before, the day of, and the day after your injection will help.  I do my injection either way.  Either with a full or empty stomach.  I don't get the stomach problems that you do with the pills.  I do mine early evenings and then just relax the rest of the evening.  I am wiped out the next day from my shot whether it is a humira day with it or not.  Ta2d--

Good luck with the MTX...your doctor did prescribe either folic acid or leucovorin (folinic acid) didn't he?  Either one really helps with the side effects from MTX.

The firest time I took my MTX, I was scared to death because of everything I'd read.  But, turns out, I'm lucky--I don't really notice any side effects from MTX as all.  I take 15mg mtx/wk (orally) + 10mg leucovorin/wk. 

I hope you're as lucky as I am and don't have any side effects.

Best of luck!

dordale :)

Thanks for all of the advice! I am supposed to take 1mg folic acid per day. Also my RD said it was OK to continue my daily multi-vitamin which will actually put me at about 1.5 mg folic acid per day. Hopefully this will help to prevent any sides. He said I could go as high as 5 mg/day if I have bad sides but I'm supposed to check with him first. As far as the suggestions for adequate hydration, I've got that covered. I drink at least a gallon of water per day (water is all I drink). I'll keep my fingers crossed and I'll let you all know how I do.

Thanks Again!

If the vial has been refrigerated, take it out 30 minutes before you prepare the shot.  Also wave away any alcohol fumes on your skin.  Cold MTX on freshly alcohol-ed skin will sting.  I'm one of the lucky ones with no side effects, except dehydration.  Listen to the group and drink plenty of fluids.  I take mine on Wednesday morning at breakfast time, just because that's a convenient time for me.  Any slight fatigue is worn off by the weekend. :)

I've been doing my own injections for a year now, and find it's much more effective and has fewer side effects than the oral dose.

Good Luck!

Ellie

Great name Ellie!!!  My 2nd daughter is Arielle and we call her Ellie lol. 

 

I think with mtx you should make sure you drink lots of water (8 glasses a day), also i take 5mg folic acid every day except the day I take my mtx dose.  I couldnt take the mtx without the folic acid, had too many side effects.
also, ive read that , like milk thistle, cranberry extract is good for protecting your liver.
anna_uk
Hi Ta2d,
If you are injecting the mtx you shouldn't have any stomach problems
from it because it doesn't go through your stomach.
I was wondering about this:
"Also, how many of you on MTX take Milk Thistle to help protect your
liver? I’d like to do supplement with this but I’m found info on the net
that stated that if you take Milk Thistle with MTX is can actually cause
more of the drug to build up in your system which in turn would increase
the potential toxicity of the drug."

Could you post a link to the source of that information? I looked for it
myself but I didn't find anything about that. I'm wondering because I take
milk thistle daily, and now I'm worried.

[QUOTE=Gimpy-a-gogo]Hi Ta2d,
If you are injecting the mtx you shouldn't have any stomach problems
from it because it doesn't go through your stomach.
I was wondering about this:
"Also, how many of you on MTX take Milk Thistle to help protect your
liver? I’d like to do supplement with this but I’m found info on the net
that stated that if you take Milk Thistle with MTX is can actually cause
more of the drug to build up in your system which in turn would increase
the potential toxicity of the drug."

Could you post a link to the source of that information? I looked for it
myself but I didn't find anything about that. I'm wondering because I take
milk thistle daily, and now I'm worried.
[/QUOTE]

Gimpy,

   I wouldn't worry about it. Everything that I'm finding now says it's a good idea. My phamacist also says that it's a good idea. I can't find that article now. I'll keep looking and post it when I find it.

Ta2d

I have another question for those of you who use injectable MTX. My pharmacist didn't have any of the Multi-Use vials of MTX (with preservatives) as he says there is a shortage of this and it has a release date of the end of April to early May. He ended up giving me a 10 ML preservative free, single use vial of MTX as that's all that anybody in town had. I called my RD and he said that it was fine to use this "for now" until they can get the other in, but to keep the unused portion refrigerated. Do any of you use the preservative free, single use vials and refrigerate it?

Ta2d

Ta2d39191.3348263889I used it once by accident and did not refrigerate it. Used it just like the one I generally use with the preservative multiple times. I don't inject, but drink it. DIdn't have any problems but sure wouldn't have done it if I had read the vial!

I was given the preservative free single use vials this refill because of the shortage.  I do not re-use on the advice of my pharmacist...but now that you said your doc said keep it refriged I might call mine about it.  I used to get the kind you could use multiple times.  It is cheaper that way too.  But hey...if i have to do the preservative free kind this time I don't care as long as I have my shot! 

I have never heard of drinking the mtx before.  Does it taste nasty?  Does your RD say that is ok to do? 

Yes. He did not want me to inject and I told him I had a nausea problem so he didn't want me to take pills. No taste at all and I have no stomach issues from it! No side effects except a headache ever now and hten if I don't drink enough water the next day. Less13139192.6281944444Less 131, I drink mine too and I mix it with pepsi or juice. My rheumy says that it is absorbed better.          I think you and I are the only two that do drink it! My rheumo told me water or juice. Since I have to have so much water anyway, I just get one of the 8 oz's out of the way!
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