Methotrexate concerns for elderly mother

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My mother suddenly contracted polymyalgia rheumatica which has led to onset of rheumatoid arthritis.  She was put on prednisolone which reduced the pain and swelling and made life more comfortable.  The consultant now wants to put her on methotrexate and she says steroids have bad side effects for the long term.  She is 86, partially sighted and hard of hearing - all of which affects her mobility.  Have researched the side effects of methotrexate and am horrified and worried to death!  Seems to me the prednisolone has less bad side effects that the methotrexate.  Can anyone advise me.  She is due to start this toxic medication on Monday. 

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  • Posted

    I was on steroids (prednisolone) for three years after a misdiagnosis of PMR. It turned out to be inflammatory arthritis for which I take 15mg methotrexate once a week.

    The steroids gave me osteoporosis. I have had no problems at all with mtx.

    At least with mtx your blood is regularly tested so it can be stopped immediately if it causes problems. Not so with prednisolone. Many of the side effects are hidden.

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    • Posted

      Thank you Dinah54.  Read so many terrible things about it.  Reassuring to know you had no problems.  Medics have reduced mum's dosage to 10mg to start as she is very small framed and quite frail.  Fingers crossed.
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  • Posted

    Hi gloria,

    I understand your concerns about the MTX. I have been on MTX for over 15 weeks and the side effects have been rough but get better with each passing week. I understand there is less stomach discomfort with injections. My mother is also 86 and if I were faced with the same issues I would NOT rush to start her on this medication.   I suggest that you slow down and take time to evaluate how much pain she is in and how aggressive the RA is at this point. I suggest trying to find a Geriatric Specialist first and see if you can get a consult. The elderly may not need such aggressive treatment. Steroids and pain management might be enough for now. I would start slow and keep re-evaluating as time goes by. What does your Mom want to do? Has she been given the options? The MTX does effect my quality of life, I lose at least one to two days a week to nausea and fatigue (although the severity is getting better). I am 54 it may be harder to bounce back at 86. I also have noticed some dizziness at times and loss of balance. (always bad for a senior). Remember, you have a choice whether to take this medication and when to start. You are in control, it is ok to watch and wait, if she is comfortable and the disease is manageable. The MTX also compromises the immune system, which in an 86 year old is already delicate.

    I would wait an watch...research Geriatric care. Good luck, hope she feels better.

    Sally

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    • Posted

      Thank you for all your comments Sally.  Mum started on MTX on Monday but on 10mg after I queried the original dose of 15mg. Mum said she would give it a try because been advised against long term usage of steroids.  However, I will research Geriatric Specialist as you suggest.  She has been in a lot of pain, so it's a bit catch 22 situation - not knowing what to do for the best.

      Thanks for your advice.

      Gloria

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  • Posted

    I am on methotrexate and have had a positive experience. About once a year or so I have a flareup that makes me resort to a "short burst" of prednisone to halt it. Pred works, but it is not a drug a person can take indefinately because it leads to dire consequences long-term. I really don't think you have much to worry about......I have been on it for over 10 years and I am doing well. You did well to send her to a rheumatologist. 

     

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  • Posted

    I would like to add to my reply.......There is serious research to using the spice turmeric to reduce the inflammation of RA. I take turmeric each day in capsule form which has enabled me to reduce my MTX intake over time. Even my rheumatologist has come on board. Talk to him/her about this.
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    • Posted

      Thanks so much for your reassurance and info.  Mum has been on MTX for 4 weeks now and apart from feeling groggy/dizzy on the first day, is coping very well.  I do wonder about getting the dosage right and perhaps an individual's body frame - as well as condition - should be taken into account.  Not an easy one.  Thanks again - I'm feeling better too!!
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