Methotrexate

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Wondering what people's experiences with methotrexate are, in terms of fatigue. I'm wondering if people generally experience the fatigue the day they take it or the day following.

I swim a few times a week and would like to avoid it interfering with my energy levels on swim days.

The Dr. has me taking it once a week (3 tablets in the am and 3 at night).

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  • Posted

    Wow do you know what mg levels the tablets are and are they helping you with angry joints.

    I take 35mg once a week by injection into the front of my upper leg.

    Rheumo could not understand why the tablets were not helping me, my ESR and CRP were not dropping as they should have been on MTX, so she upped my dosage, still not helping. 

    In the end she arranged for a blood test 12 hours after I had swallowed my tablets, and they only found a fraction of the dose in my blood stream, that is when she said you are not absorbing them through your stomach, and told me I was going to have to inject, still once a week.  

    My first reaction was ahhhhhh!!!!!, I hate needles, she looked at me and said we have 8 year olds injecting themselves 3 times a day for diabetic condition, grow up, I did immediatley, I think she shocked me into not being scared.

    My local GP, sweety that he is helped me the first few times to inject myself, showing me how to load the needle, with the right dosage, and inject correctly without bruising myself too badly, or at all, plan was for top of arm, but cannot reach with, with damaged arthritic hands, so top of leg.

    He has since said any time he needs a nurse to do injections he will call on me, not happneing as I have no real qualifications.

    Husband has recently broken leg and had to have blood thinners daily by injection, nurses in hospital worried about me giving him injections, no problem at all, but had to demonstrate I could do it without a problem, told me very impressed, and even husband said I was better than the nurses, they I belive pushed contents of needles too fast, and only makes for bruising.

     

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  • Posted

    And yes I do get trashed the following day, or two, I take my injection on Friday night, after coming home from work, well now retired but keep the same routine.

    You don't mention folice acid, you must take your folic acid tablets for those two days following, that seems to pick me up no end. 

    I also take a multi-vitamin tablet usually every day, but not religious about it.

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    • Posted

      I think the tablets are 2.5 mg each so I guess I'm taking 15 mg/week. I haven't taken them yet. Just got the script the other day and am trying to decide which day of the week I want to take it.

      Yes, I have folic acid to take the following day. 😊

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    • Posted

      I'm on methotrexate and was on 15mg but in recent years I'm down to 10mg with folic acid 5mg the day before. I might be lucky but I haven't felt fatigued. I always used to take it on a Thursday morning and swim straight afterwards.  My thought was that my increased blood circulation from the exercise would take it to my hands and feet.😀( wishful thinking most probably).  My joints are well and I've just started yoga again after 10 years. However, I'm horrified how weak I've become. It's not comfortable, especially putting weight through my wrists but it didn't flair anything up and I'm better this week than I was last week so I'm going to persevere. If fatigue is a big problem contact your consultant through his secretary and ask him /her for advice. In my experience there are many different ways of taking methotrexate. Good luck.

       

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    • Posted

      I started on MTX over 10 years ago now, my Rheumo started me on 5mg, then when no result 10mg, still very little result 15mg and so on.

      I seemed to get some relief on 10mg dosage and for a while went into remission, but about a year later had a major flare up again and had to start taking MTX once more.

      Leflunomide 10mg is what I am on at the moment and it seems to be holding me at a comfortable level, is the best way I can describe it, hasn't gone away but alot better.

      Dr seeing that I responded well to 10mg leflunomide raised my dose to 20mg, which apparently as I understand it normal dose for most people, knocked arthirits over in those few days, joints felt great, but nearly killed me, about 4 days after starting got the most horrendous headaches, went back to local GP, he took my blood pressure and was off the scale 200/135, far too high to be safe, denied it was related to the new tablets leflunomide that the rheumo had given me.

      Got home was not happy, so rang manufacturer of leflunomide and asked could they be to blame, they asked who my GP was that had denied a link, and told me to stop taking them immediately, a known side effect for a very small number of patients about 2% apparently.

      Later the same day got a very abrupt phone call from local GP asking if I understood I must stop taking leflunomide.

      Other side effect of taking leflunomide is very loose bowels, I have worked out that I can take my doseage at night, just before I go to bed, when I get up in the morning, woooosh, and after that clean out, am fine for the rest of the day, my family know not to use my toilet in the morning, as result could be very nasty, you cannot wait.

       

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  • Posted

    Hi Jane,

    I was started on Methotrexate a couple of months ago (on 15mg at the moment). I've been taking it in one go at bedtime to stop me feeling sick and been ok so far.

    The main symptom I had was feeling totally wiped out the next day (been taking it on my days off in case get any problems at work), also quite a sore headache. But the Rheumatology Nurse changed me to folic acid 5mg every day apart from Methotrexate day and it has helped so much with the tiredness. Seems to also be helping with my nails and hair which were both breaking a bit.

    Good luck!

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  • Posted

    Hi Jane

    I was on 15mg had a lot of nausea reduce to 12.5 and now on 10mg of mtx and one 5mg folic acid every day except the day I take the mtx. I take mine on a Wednesday just before bed but I am wiped out the next day but not as fatigued as I was.  Has not done much for the pain but I am still walking.  Have not found a suitable pain relief as yet due to the side effects so only take them when absolutely desperate.  I use a heat bag which help.

    sorry to go on.

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  • Posted

    Hi Jane

        I think we all react differently to the drug and seems like the folic acid dose varies depending on the doctor    You definitely need to take that while on MTX.   I take 2 folic acid the day after the MTX.     I was started on 5 mg on week 1 and then slowly increased dosage by 2.5 mg weekly.   I take 5 pills at present/ week

         I don't experience a great deal of fatigue but I do have nausea and diarrhea after taking it.   Not as bad this last week though,  so I guess our bodies adjust but we are all different.   You will have to try it to determine how it effects you.  If  you work I would plan on being off the next day after you take it.     I hope it goes well for you

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  • Posted

    Hi Jane, 

    In the beginning, when I started Methotrexate, I was unbelievably tired. And, each new increase in does was even wose--that day and the next. 

    NOW, AFTER MANY YEARS, I INJECT 1 CC (EQUAL TO 25MG)  and I don't notice anything, other than my constant fatiquge-- but it has more to do with my disease ( I also have Sjogrin's) and am always tired, but no more or less on methotrexate days. 

    But it helps. It isn't enough for me alone, but without it, the pain would be intolerable.

    Good luck!!!

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  • Posted

    Hello Jane,

    I have been on Methotrexate injections since January 2016. Was on 15 mg once a week, rheumatologist had me decrease dose by 0.1 cc each week to see if I could go off MTX. That lasted for ten days before the pain in my forearms, wrists and hands was becoming too much of an issue. Restarted MTX 10 mg injections once a week. My experience with fatigue is long running. Upon restarting MTX I began experiencing the extreme fatigue once again. My fatigue begins within a few hours of the injection and is really noticeable for the next five days.

    Don

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