Methotrexate daily dose?

Posted , 11 users are following.

Hi ya

I have just been diagnosed with RA and doctor got me started with Methotrexate, folic acid, prednisone and neurontin. I was asked to take methotrexate on a daily dose 2.5mg per day and to return to him after one week. This is my first week taking it. I have been reading up on this medicine and apparently it's supposed to be taken once a week. Should I go back to ask the doctor? Is the daily dose normal? Does anybody take daily dose when they first started? 

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  • Posted

    Hi Normally mthxte is given once a week 7.5mg to 15mg. The dose varies according to the severity of the condition. In your case the doctor has prescribed 2.5mg daily which is 10.5mg a week because some patients complain nausea stmach ache skin disorders or infections etc. So may be ur doc wants to see how much dose u can tolerate and how u feel. Once ur condition is stable you will be advised to take it once a week. The rest of the meds are common. In the begnning go strictly as per ur docs advice. Later on when u feel improvement u can reduce or split de doses under consultation with the rheumi. Good luck
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    • Posted

      This sounds plausible too. Thanks for the assurance. Btw I was given medicine for 7 days. So it's 17.5mg for this first week. I am not too sure if this is considered high since it's my first week 😳

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    • Posted

      Syedq - I strongly feel you’re on the wrong track with this advice. Where did you hear this from?

      Although I have seen reference to potential splitting of a dose, I’ve never heard of a split being spread over every day of a week. I don’t think it is safe to encourage this casually at all - this has the potential to cause harm.

      I am really averse to putting alarmist postings up here, but I strongly feel Celine needs to get medical clarification on this prescription and not assume this is safe until the doctor spells out that this was intentional.

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    • Posted

      Sorry but this seems a massive dose to me, this is a very potent drug with serious side effects and is normally started on a small dose and then gradually increased if necessary, please be very weary of this advice and check with your doctor or pharmacist.
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  • Posted

    I have seen only strict warnings AGAINST ever taking methotrexate daily. 

    I am for you taking no more than a single dose per week. There are clear warnings in multiple reputable government drug regulatory sites around the world of the danger of mistakenly taking daily methotrexate.

    Is this doctor a rheumatologist?! Are you sure he wasn’t referring to the prednisone? Prednisone will be taken daily but NOT methotrexate. 

    You will not be harmed by stopping methotrexate at one day. Seek confirmation and if you don’t get an absolutely clear explanation about the reason for this treatment, get this confirmed by another doctor.

    Note that you can’t take this measure with prednisone once you have started. Your prednisone dosage should be maintained, as it should only be stopped with a planned tapering of dosages.

    Take care. If you could let us know what eventuates? This is a very concerning question. 

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    • Posted

      Please see my post - it is a technique that is used as a means of reducing side effects and 2.5mg/day is a normal enough dose. The risk is when a patient mishears a weekly dose to be taken daily - and then you get nasty overdose problems as you know. 

      But you are quite right - it needs clarification, urgently.

      With regard to pred - it all depends how long you have been taking it and the dose. Up to a couple of weeks you can stop taking pred suddenly without any problem. Any longer, especially at higher doses, you must taper. 

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    • Posted

      Thanks Eileen, I tried replying when I read this from my mobile but evidently it didn't work.

      I know that I know very little, but I felt in Celine's situation caution was the best approach. I don't want to be scaring anyone but if nothing else I think Celine should understand her doctor's rationale for this approach. Here's hoping all is well.

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    • Posted

      Of course you were quite right to query it. Her doctor should have explained better why he was dooing something unusual. But you never know whether they haven't a clue either!!!!!

      I had the advantage of being able to get medical literature to check - wouldn;t be that easy from a phone!!

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