Methotrexate side effects
Methotrexate side effects
Author
Discussion

martinbiz

Original Poster:

3,613 posts

165 months

Tuesday
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After losing most of this year being laid up and almost house bound some days, after more tests and scans than I can remember to rule other more sinister stuff out, I have finally been diagnosed with Polymyalgia rheumatica and Psoriatic rheumatoid arthritis. I have been on a decreasing 8 week course of steriods which have worked wonders, literally within a week of starting them 99% of the joint and muscle pain went away. The course is due to finish in a couple of weeks and they are proposing moving over to Methotrexate for more long term use, but after doing a bit of reading up they do seem to have some strong side effects. Anyone on here have any experience of taking them long term? Any Medic comments extra welcome

blue_haddock

4,722 posts

87 months

Tuesday
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I have rheumatoid arthritis and have tried various treatments over the years.

Because of issues with my liver they were reluctant to put me on methotrexate so initially i had gold injections which 8 months down the line they stopped as they did absolutely nothing.

They then tried me on sulfasalazine, i got to about 4 weeks in with them increasing the dose each week and the sickness became too much for me to cope with.

So in the end they put me on methotrexate which ive been on now for probably 10 years or more and its really brought my symptoms under control, the inflammation levels are pretty much normal so now my main issue is the damage done to my joints in the previous 30 years my RAS was undiagnosed and uncontrolled.

Side effects for me on MTX have been minimal and now apart from remembering to take them once a week its not an issue for me.

I had to come off MTX for a while when we were trying for a baby and at first i didnt notice any difference but i did get gradually worse after 6 months so as soon as we had conceived i went back on it.

Notsofastfrank

250 posts

215 months

Tuesday
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I have Large Vessel Vasculitis, another auto-immune disease.
I was originally given steroids and the pain disappeared overnight. I was later prescribed methotrexate and tapered off the steroids.
I have been taking the methotrexate for over 4 years now. I have occasional fatigue, mild feeling of upset stomach and nothing else I’ve noticed. I am also prescribed Folic Acid which is to supposed to help with side effects.
I find the biggest drawback to methotrexate is having to watch your alcohol intake and not eating liquorice!
I have recently been put on Tocilizumab, by weekly self injection, and will start to taper the methotrexate later this year.

Squadrone Rosso

3,453 posts

167 months

Tuesday
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I’ve been on it for 15 or so years. Was a tad rough to start with but soon the positives outweighed the negatives.

Mine are mixed in with Sulfasalazine & Otezla.

Psoriatic arthritis sufferer.

blue_haddock

4,722 posts

87 months

Tuesday
quotequote all
Notsofastfrank said:
I have Large Vessel Vasculitis, another auto-immune disease.
I was originally given steroids and the pain disappeared overnight. I was later prescribed methotrexate and tapered off the steroids.
I have been taking the methotrexate for over 4 years now. I have occasional fatigue, mild feeling of upset stomach and nothing else I ve noticed. I am also prescribed Folic Acid which is to supposed to help with side effects.
I find the biggest drawback to methotrexate is having to watch your alcohol intake and not eating liquorice!
I have recently been put on Tocilizumab, by weekly self injection, and will start to taper the methotrexate later this year.
Not eating liquorice?

That's a new one on me.

Although one of my other medications means I can't eat grapefruit or drink grapefruit juice.

martinbiz

Original Poster:

3,613 posts

165 months

Yesterday (13:00)
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Thanks all, some interesting comments

pavarotti1980

5,949 posts

104 months

Yesterday (16:32)
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Most likely to be a journey of trial and error to determine which DMARDs (MTX, sulfasalazine etc) are most effective, and then if not tolerated or contraindicated then biologics such as anti-TNFs. Linked is an example of treatment pathway that you may experience. Dont be afraid to say if things dont work or you feel worse

https://www.hweclinicalguidance.nhs.uk/all-clinica...

Notsofastfrank

250 posts

215 months

blue_haddock said:
Not eating liquorice?

That's a new one on me.

Although one of my other medications means I can't eat grapefruit or drink grapefruit juice.
Liquorice leaches calcium apparently. Now you mention it I can’t remember if methotrexate does this or one of the other meds I’m on!

Deep Thought

38,240 posts

217 months

Wife has RA and has been on Methotrexate for 10+ years

They will almost certainly start you on tablet form. This, my wife found to be particularly harsh in terms of having bad nausea literally all the time with it. BIL went on it recently and he'd the same issue.

If that is the case for you, push for injections. The nausea is more contained.