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Methotrexate to reduce Prednisone

Posted , 8 users are following.

bob14677
bob14677

Has anyone had experience adding Methotrexate to aid in reducing Prednisone dosage? After almost 2 yrs of taking Pred and unable to reduce below 8.5 without flare-up, GP concerned that controlling blood glucose is becoming a problem (current A1c at 7.8).  He has asked Rheum to help - appointment with Rheum in 10 days.

0 likes, 10 replies

10 Replies

  • donna60512
    donna60512 bob14677

    Posted

    Yes, I have taken Methotrexate from the beginning which was in May of this year.  I am now at 7.5 mg of Prednisone, hoping to be at 5 mg in four weeks.  My esr was down to 8 on blood work a week ago.  All of my blood work is in the normal ranges now.  I really feel quite well now and even have energy.  I know that so many people have just refused to even consider taking Methotrexate due to side effects.  I have had no side effects at all.  My rheumatologist is keeping a very close watch everything.  I also have had no weight gain which I know several people have mentioned with prednisone.  Good luck!!!
  • EileenH
    EileenH bob14677

    Posted

    I know 2 people who take mtx and who achieved a lower dose. I know more who tried it without success. There is no real evidence from studies whether it works or not - 3 studies, all with different results - and even they concluded it took a year to make much difference. Basically I have come to the conclusion it is probably worth trying and if you don't have side effects from it, fair enough. But there are no guarantees.

  • Dave-California
    Dave-California bob14677

    Posted

    Hi Bob

    I have been busy with PMR for almost 3 years and I believe that from 2½ years of taking Methotrexate (MTX), it has helped to reduce the activity of my immune system which typically is overactive in PMR conditions. Also my C - reactive protein and Erythrocyte Sedimentation Rate have dropped significantly – actually below the normal levels and have maintained these low levels for 2 years.

    Before I commenced MTX, I was having large flares that seemed to reduce with MTX taken (weekly) at the same time as my daily prednisone dose, I have had less flare and much less intensity of the flares that did occur. I think that these DMARDs seem to ‘dampen’ down the underlying disease process rather than simply treating symptoms. I remember that it takes a while (1-3 months) before the MTX seemed to become active.

    I don’t seem to have had any side effects – however, I distinctively notice more fatigue and a bit more pain as the end of the MTX week arrived and improvements in these issues after taking my weekly MTX dose.

    I think that MTX has definitely assisted me in maintaining my Pred taper with less pain and I’m currently at 4mg Pred.

    After 2½ years of MTX, I am currently in the process of reducing MTX, also on a very slow increment and keeping prednisone at 4mg without any reduction while I’m doing thisMTX reduction. My rheumatologist recommended that I start the slow MTX reduction following success with my very slow prednisone taper program (thanks Eileen!!) but not until I am happy with prednisone at consistent 4mg dose.

    I think MTX reaction differs with each person but in my opinion it seems to be worth a try.

    Dave

    • donna60512
      donna60512 Dave-California

      Posted

      I am also from California, maybe it is also our good weather.  Just kididing.  I am happy to see another person with good results.  From what I have seen, many people have just refused from the very begiinning to even give MTX a try.  I am very glad that I trusted my rheumatologist in this. I do not every want to have that horrible pain again and I think the MTX has helped me to avoid that.  I have spoken to two people in the last two weeks who have PMR.  Both have just refuesed to try it as they read side effects and just didn't want to go there.  Both of them have had many flares and are just not feeling really well.  All I can say so far is it is workign for me.  I will keep a close watch as will my doctor.  Donna

    • bob14677
      bob14677 donna60512

      Posted

      well I live in Florida, so hopefully the weather is a contributing factor! smile

  • Susanne_M_UK
    Susanne_M_UK bob14677

    Posted

    I was on methotrexate for 6 months due to being unable to reduce pred below 20mg without flaring. I had been asked over a period of about a year to go on methotrexate, but had rejected it due to the side effects I'd heard and read about. I finally relented and seemed to cope ok with them for the first couple of months.

    Then the side effects started to hit me. I was almost unable to function and spent most of my days prone on the sofa. It felt as if my body was giving up. Complete fatigue to the point where I just shuffled from sofa to bed.

    I came off them and although I still suffer from bad fatigue, it's on a different scale and generally due to my GCA.

    We all have different reactions and tolerances to methotrexate, some people tolerate it much better.

  • FlipDover_Aust
    FlipDover_Aust bob14677

    Posted

    I've been on MTX since December last year - it allowed me to reduce from 20mg of pred to currently 7.5mg. Ive had no real side effects, other than feeling a bit 'off' the day or two (usually day two) after my weekly dose

    • donna60512
      donna60512 FlipDover_Aust

      Posted

      I am glad to see that it has worked well for you too.  I try not to read all of the side effects on meds.  That probably has been a blessing for me.  I trusted my doctor and just went right onto MTX from the begiing.  I was very concerned about prednisone as it has a reputation that precedes it.  From all I had read about how hard it is to get below 10 mg, I was sure that when I went from 10 to 7.5 that I would be in agony.  I had teeny tiny twinges in my upper arms, nothing to ever complain about.  Now I am feeling really well again.  In a couple of weeks, I will make the jump to 5 mg.  With the help of MTX, I am sure it will work.  Since it also helps reduce the inflammation, I think it is a good companion to the prednisone. I know that some people cannot tolerate it, but I have had no side effects. Hair loss was my biggest worry and my hair is fine.  Even my fingernails are growing like crazy and they used to chip all the time.  I am taking hair and nail vitamins, so perhaps that works.  I wonder if some of the side effects that people feel are actually from the prednisone.  Anyway, may not be for everyone, but doing a split dose and taking MTX has worked well for me.  I have lots of energy too.  I am amazed at the energy have as I am no spring chicken.  LOL
  • BillyP
    BillyP bob14677

    Posted

    I have had PMR for 14 years..........tried MTX a few times but it made me as crook as ever tummy wise.......tried most of the equivelent things (forgotten  the names)...........

    But gave them away for the same reason...............if your roomy wants you to try them.....give it a go ........be guided by how you accept the medication.......

    after all ,your medico (hopefully) is not trying to poison you..............

    ....................Billy.......................

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