How much methotrexate?

Posted , 6 users are following.

Just curious how much is a "normal" dose of methotrexate on a weekly basis for auto ammune? My dose has been slowly increasing and they want to go higher, right now I'm at 20mgs and I feel horrible with the bowel symptoms which I'm sure is because of my IBD. But phernegan helps with the nausea and the tiredness gets better by Mon, then I have to turn around and repete it all again on Wed. They still are up in the air as to why I have this rash on my stomach, chest, and back but its been almost 9 months now and it gets red hot like a sunburn off and on, itches but never goes away. The plaquenil for my inflammatory arthrits has helped it, but rash and joint pain with muscle weakness and pain is hopefully going to improve with metho...so my question is how high will they go and do the side affects get worse as we go up? 

2 likes, 8 replies

8 Replies

  • Posted

    Hi. I was in a similar situation with the nausea, tiredness and rash. I do have an autoimmune problem but don't have IBD. They tried to get me up to 25mg MTX but after months and months I couldn't tolerate the pills ( vomiting and diarrhoea) and they let me have the injections instead. The injections bypass the stomach route, so less GI problems. I would ask them to swap you over and see if you can be managed better on them. The injections are easy to administer and done once a week. You still need to take your folic acid every day apart from the day of your MTX though. They never explained why I got the rash ( never had it until I started treatment), I manage mine with antihistamines and take double when it gets really bad. Hope this helps, good luck with it.
    • Posted

      Thank you so much...my rash came before any meds but they only say its a connective tissue disease...will ask about injections!
  • Posted

    Hello Patti, I was on 20 but continued to have flare ups. So I was given some additional pain killers for a week or so. And then I was increased to 25mg. MTX doesnt seen to affect me. i just get the occasional stiffness in my finger joints, but it doesnt last too long. One can have MTX using the needle if tablets upset your stomach.
  • Posted

    Hi Patti

    I too have an auto immune disease and I currently take 10mg once a week and they will be steadily increasing me to 20mg.  Sickness and tiredness are my main issues.  I have been taking it for about 12 weeks now and I am considering an injection instead.  I have been told they can't do anything about the tiredness.

    I wish you well; it's not much fun is it?

    Ali

    • Posted

      ...I think your dose has to be higher for injections. I will find out on my next visit, because I will be up to 40 mgs then. Not fun at all...
    • Posted

      Hi, they told me dose doesn't need to be any higher as injections bypass the gut, so better absorbed. They just need to suss out what your optimal dose should be depending on your symptoms, think it depends on your size/weight. You can try cyclizine or metoclopromide for the sickness, they work but made me more tired. I have switched to something else now, less side effects than the MTX, am giving this a go for the next few months, see what happens.... as for the tiredness and fatigue, they tell you to pace yourself.... if it was that easy to do, no one would ever complain , would they? I still haven't learnt to pace myself properly and its been more than two years now. Keep trying though, not going to give up that easy
  • Posted

    What do you guys mean? I get methotrexate intravenous over 4 hours (I'm getting it right now) but it's 18800mg. Why are the numbers so different? I have it on week 3 and 4 of a 4 week cycle. It makes me feel pretty sick, but my other chemos are worse. I've got osteosarcoma btw.
    • Posted

      zakzafar...you are on chemo (methotrexate) for cancer, it is also used in much lower doses for RA and other auto ammune/connective tissue diseases. The infusions are shot form and even the very lowest dose of methotrexate can make you feel nauseous, tired and just not good. I can't even imagine taking the dose you are so I am hoping it works for you quickly and you bounce back fast!

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