Methotrexate Side Effects Questions

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Hi All!  Just found this forum.

Diagnosed in Feb 2016 (after wondering for a year).  On prednisone since then.  Saw rheumy mid-May.  Increased my Vit D (had already been low a while) and prescribed Metho 10mg 12 hrs apart (20 mg total) once a week.  Also taking folic acid.

I've had naseua and sweats within about 6 hours.  Goes off and on for following two days. On the 3rd day I feel woozy, nauseous (not as bad), and generally like flu.  4th and 5th day upper back pain, very little but some nausea.

Fist two rounds worked at home on Mondays.  This week came in and wished I hadn't.  I'm going to move doseage up a day and start Thursday so I can work at home Fridays, Mondays are too busy.

So my questions -

Do the Metho side effects lessen over time?  I know there is 4-12 weeks to see results.

Should I got the full 12 weeks before looking to change?

Does the injections (instead of pill) help with other side effects beside naseau?

I see the rheumy next week, but wanted to get other's input.

Thanks much!

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7 Replies

  • Posted

    I was on MTX for 18 months. The nausea was consistant throughout that time. I moved off the pills and onto the injections and it continued however became less of an irritant over time.

    Most other side effects subsided after the first 4-6 weeks and became much more manageable. 

    The injections are IMO much better than the pills. 

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  • Posted

    Hi the side affects do lessen a bit specialy the naseau i lost quite a bit of weight at first and constantly eat popcorn smile i have changed to injections and i must say the side affects are much less. No sickness feeling, no foggie feeling, the tiredness is still there and my skin is a bit rubbish and get dry eyes the next day but nothing to the tablet side affects.

    hope this helps

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  • Posted

    Hi jbjb93 the injections are better for me stomach wise but after a couple of years I'm still blurred till about dinner time next day
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  • Posted

    I was on methotrexate 17.5mg/week for 4 months and now I've been doing injections 20mg/week for 2 months. It took awhile to work but either I've learnt to live with the pain or it's lessened to flares and joint tenderness. My numbers are still up so the rheumatologist wants to add orencio snd drop sulphursalizine and plaquenil. All this to say that ii will take time for methotrexate to work.

    I take prescribed zantac twice a day and my believe is that it helps with the stomach and nausea. Every now and then I'll get a nauseous feeling if I'm hungry. Folic acid comes with methotrexate. It replaces what the methotrexate removes and my rheumatologist was adamant that I take it at least 6 hours apart. I take the injection on a friday night and so far I'm okay. Tired on Mondays but I peg that on hating

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  • Posted


    Sorry to you are having side effects,

    I too suffer from these but after three years they are much better, just leaving me feeling a little light headed and tired.

    Perhaps a change in dose may help. I take mine late Saturday night so I have Sunday to rest, this works for me. I have never been offered injections just pills.

    It is all trial and error, works differently for everyone.

    Good luck hope your able to get it sorted.

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  • Posted

    Can only say that the injections do reduce nausea and other side effects related to the digestion
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  • Posted

    Thanks everyone for your input!  Good to know it will get better.  I'm not minding the nausea as much as the flu/foggy feeling on the 4th day.  I'm actually changing my work schedule this week to take the first dose Thursday evening, work at home Friday, and then will hopefully be better for work Monday.

    I will ask the rheumy about the injections, since most seem to have better luck with that.  Will keep you posted!

    So glad I found this forum!  I was on another, but much smaller so less input/help.

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