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Should I start Methotrexate .

Posted , 14 users are following.

Divya2006
Divya2006

My wife was recently diagnosed with RA by rheumatologist after blood test, x rays of both wrist and MRI of left wrist to confirm. 

She was taking levothyroxine for 6-8 years. Some how her HYPOTHYROIDISM slowly turned into HYPERTHYROIDISM, (may be because of autoimmune disease) and now she takes methimazole to treat hyperthyroidism. 

She had total knee replacement surgery in 2008 for right knee and in 2017 for left knee. 

Other than mild bilateral wrist pain she is in good health. No other RA symptoms.  

She is 66 years old,does regularly yoga and stretching exercise. 

Dr is suggesting methotrexate 10mg once a week to start with,increase to 20mg down the road along with Biologicals. 

I am retired pharmacist by the way. Our daughter is physician and strongly suggest to start methotrexate to minimize damage. 

Myself and my wife are very reluctant to start such a strong medications. 

Any suggestion and inputs will be greatly appreciated. 

 

1 like, 43 replies

43 Replies

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  • lyn1951
    lyn1951 Divya2006

    Posted

    Simply YES, it will settle the immflamtion in her joints, if it works well for her.

    ?and YES, she does need to start off on a low dose, to see how her liver copes, some don't and then they need to stop taking, also needs to take ONLY ONCE A WEEK, with folic acid in the two days after.

    I have been taking now for 14 years, keeps my arthiritis under control.

     

  • sez66
    sez66 Divya2006

    Posted

    I have been diagnosed for 4 months now and titrated up to 20mg of methotrexate also 200mg bd of hydroxychloroquine as i nurse i did look into this before taking but the pain relief is worth it and now the possibly that I am in remission so review in 3 months may be reducing dose. My understanding is but hit hard with medication and have the possibly of reduction as remission occurs. Hope this helps as I know the questions you will have before starting the meds side effects rec. I had a few but got through them which glad about so not having to change at present time. Affects my MCv at the moment but just starting to drop so fingers crossed can continue

  • cherylnanny
    cherylnanny Divya2006

    Posted

    Hello Divya2006. I tried Methotrexate for 12 months / weekly injection. It did settle symptoms, but my liver function became compromised. I changed to Etanercept/Embrel, and it changed my life. I have been on this for 8 years and have been in total remission for most of the time. I am 57 and it has helped me to continue working and live a pain free life. I felt that Methotrexate was too strong somehow. When taking it, I never felt very well. I hope this helps. All that said Lyn1951 has coped really well with Methotrexate, so I suppose it's trial and error. Good Luck.

  • sarah75478
    sarah75478 Divya2006

    Posted

    I was diagnosed two months ago and I started taking 10mg methotrexate.. I'm 49 and still in constant pain.. some days I get a little relief but then it feels like my legs stop working.. I'm giving it a good go so I'm not ruling it out yet.. I've had some horrible side effects but I think they might be easing too.. I still know very little about this illness but I'm trying to gather as much information as I can. I hope you can decide soon what way you want to go.. xx

    • blair97497
      blair97497 sarah75478

      Posted

      Hey Sarah, it took me a few months to really start to feel benefits.

      Hopefully you’re reviewed by your rheumatologist soon to see if they think they need to adjust your dosage. I had to go up to 25mg oral methotrexate after a couple of months.  In fact it then wasn’t for another couple of months and finally switching to subcutaneous injections of methotrexate that benefits became really clear, and my dose is now at 20mg.

      A little over a year in, I’m suffering virtually no symptoms currently, so I am hoping that continues. I’ve reduced from monthly blood tests down to 2 monthly - mainly as I understand it, still keeping an eye out for negative effects such as harm to liver function. 

    • sarah75478
      sarah75478 blair97497

      Posted

      Thank you Blair... it's good go hear some positive feedback on this drug.. I'm just not easing at all.. I'm in constant pain and I can't see the light at the minute.. but I'll keep hoping for relief.

    • lyn1951
      lyn1951 sarah75478

      Posted

      I too had to go over the unjections once a week, as the inflammation didn't settle at all, rheumo amazed I was taking up so little through my stomach, they did a blood test.

      ?Inflammation tests are ESR & CRP, your regular Dr should be able to test these for you, and you should be seeing a fall in the levels from your previous tests.

      ?I have been trying diet and cutting out ALL WHEAT has helped with inflammation, levels down as low as they have ever been, after 14 years with rheumo issues, why did this not occur me to try this earlier, and it has done me no harm to cut the wheat, just replaced with rice, & corn, although I still do miss a slice of toast, I feel better without it.

    • blair97497
      blair97497 sarah75478

      Posted

      I’m so sorry to hear things are bad. 

      Are you taking pain relief? An anti-inflammatory? 

      Did you have any course of steroid to bridge you onto your DMARDs?

      I had a few months with courses of prednisone at the start, to relieve things while I was phasing onto Hydroxychloroquine and then methotrexate. Prednisone relieved the pain and other RA symptoms... it just also happened to make me act a little weird as well. (I still think it was a small price to pay for the relief from the pain). 

      I did become pesimistic about how long it would take for my DMARDs to have any impact. It took months. I didn’t spare any pain relief I could be prescribed during that time. 

    • carole78111
      carole78111 blair97497

      Posted

      I read with interest about your becoming a little weird on Prednisone. I have been on these on 6 per day reducing every 2 weeks since last October. I have only managed to get down to 3 pills per day before major flare up forces me to increase dose. I was on etanercept for 8 years and it changed my life, been a sufferer for 29 years. I have also been on methotrexate on and off during this time, but my consultant decided last March to double my dose, even though my medical notes said that I could not tolerate high doses of this drug. As a result I developed pneumonitis in July which almost killed me. Off all meds’ except Prednisone since then, awaiting new biological treatment. The last year has been hell.  As for the steroid pills, I cannot sleep at night, I manage about 2 hours and ten am wide awake, I have lost quite a lot of my hair, and my face looks round and swollen. I cannot wait to get off these pills ! But a kidney infection is now threatening my start date for new treatment which is Friday 9th. Feel so down. 
    • blair97497
      blair97497 carole78111

      Posted

      Poor you. I know I’m a newbie, just over a year in. Yes, the prednisone is infamous for the round face shape. All of what you describe sounds distressing. My sleep has been fragile for years and prednisone screwed it up too, But then, so had pain... The weirdness for me was more behavioural. I would respond inappropriately to things. My care and judgement in social interactions changed. 

      The hair loss must be upsetting! As a man at 51 I can’t blame my thinning hair definitively on age or drugs, as it might be either or both. Although I don’t like it, for a woman it has to be very hard. :-( 

      I hope you get past this infection soon, and onto your new drug. Take care,

    • cherylnanny
      cherylnanny carole78111

      Posted

      So sorry to hear you are struggling. What happened with Etanercept? I am also on this 'wonder drug', but have recently been put on a maintenance dose of hydroxychloroquine as I am experiencing damage occurring in certain joints after years of remission. This secondary drug is playing havoc with my hair and nails. I hope you get back to feeling better. Perhaps we become immune to these meds and need to try something new. Good luck.

    • Tammyshernia
      Tammyshernia cherylnanny

      Posted

      Can you tell me what meds you were on I to lost my hair and nails on methotrexate I’m not sure it you are talkim
    • Tammyshernia
      Tammyshernia

      Posted

      I will be starting a need drug after I have knee replacement in may I can’t start it yet do to the infection 
    • cherylnanny
      cherylnanny Tammyshernia

      Posted

      Hi. Sorry for the late reply. It's the Hydroxychloroquine that is playing havoc with my hair. Methotrexate didn't really cause a problem when I was on it.

    • Tammyshernia
      Tammyshernia cherylnanny

      Posted

      I’m still on hydroxychloroquine and my hair is growing up I need to start a new drug but can’t now do to having knee replacement in may I’m in so much pain😩

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