Starting methotrexate injections
Posted , 10 users are following.
I have recently been diagnosed with psoriatic arthritis and prescribed methotrexate injections however I’m very unsure about using them due to the side effects. I have a massive phobia about feeling or being sick and know that this is one of the most common side effects. I have the injections as they don’t go through the stomach and also been given folic acid to take on the non-injection days as apparently they reduce the nausea but I still don’t know if I can make myself use them. If anyone has any advice on this I would be really grateful.
1 like, 12 replies
jane96717 alisonbhearts
Posted
I'm not on methotrexate, I'm on Sulfasalazine for my PsA but my Rheumy consultant wants me to go on it. Are you on Facebook? I joined a brilliant group called Psoriatic Arthritis Support UK, it's a really good group.
Good luck
alisonbhearts jane96717
Posted
sheila65847 alisonbhearts
Posted
I was on methotrexate tablets in 2012 and I was one of the unfortunate people who developed Methotrexate the induced hepatitis. This was quickly identified during monthly blood tests and treatment stopped. I cannot stress too highly the importance of monthly rheumy blood tests. However I will say Mtx works wonderfully well for the majority. My advice would be to try it, ensure that you follow up with blood tests and speak frequently to your specialist nursing team. Good luck
borderriever alisonbhearts
Posted
I have been on most DMARDs medications, they give Folic Acid to control sickness as you know.
The problem we all have is if we find we cannot take these drugs, that prevents us incorporating TNF medications.
In the past my original Specialist was understanding because I was feeling very ill taking these drugs.
When I moved to a different Area, they tried again to ge me on this drug again. I was very ill and the Specialist in all intents and purposes said my condition was in remission and I did not need to come back.
I was not in remission !!. I am now on Opiates with no Specialists
These medications used to treat Cancer, some of us are unable to take these drugs not just for sickness also because of the weakening of our immune system.
They will try different DMARD drugs although if you do balk at then your treatment will cease and you not be put on the most expensive drugs TNF medications.
Hopefully you will be ok, many are.
I wish you well
BOB
agriffa alisonbhearts
Posted
I have been on methotrexate on and off for 8 years.
It is very important to control the inflammation in the joints and methotrexate did work well for me.
Prior to it working the arthritis caused a great deal of joint damage and i have had two hip replacements and need shoulder replacements also!!
I only experience nausea on a couple of days following the injection and usually find that eating a dry cracker biscuit or two relieves it. On lower doses of the drug nausea is less of a problem. If you are just starting I imagine you're on a lower dose so it may not be a problem for you.
You can also get anti-sickness medication if the nausea is bad.
Okapis alisonbhearts
Posted
I used to take methotrexate orally - initially a small dose that was gradually increased to 17.5mg but after 3 plus years my liver objected and I had to change. Tried sulphasalazine but had no effect and so passed onto Etanercept for 12 years. Became ineffective and I'm now on fortnightly injections of certolizimab pegol (Brand Cimzia).
I was never nauseated by the MTX but it was a pain staying off the alcohol so it was much easier not to have to worry about it with the biologic therapies.
With injections is the dose increased slowly? Your body needs time to adjust to the drug. In the UK unless you have tried two traditional DMARDS such as MTX then you don't get access to the very much more expensive Biologic therapies. Cheaper options first I'm afraid
Take this injection before bed so you sleep through any initial nausea?
borderriever Okapis
Posted
Yes I have tried around seven DMARDs, and all made me ill, my immune system tanked and I was very ill. The injections in the first instance stopped over ten years ago
When we moved home the tried MTX once more and they really kicked back, my blood Whites fell and I was taken on the drug once more.
TNF has never been offered, although my immune system has on occasions been low when I get bloods done for other medications
Getting on now, sixty seven and I feel been put on DMARDs would be problematic now ?
Any suggestions would be appreciated
BOB
Okapis borderriever
Posted
Ouch! Seven DMARDS, you must have a right time of it! Makes me feel extremely lucky indeed.
No never to late to start DMARDS/TNF Therapy but given your history I understand why your docs are reluctant. I think mtx by injection was started for those who experienced nausea. I assume you're in the UK.
What size of hospital are you attending? I think with your problems I would want to be referred to a major teaching hospital with a rheumatology speciality - Leeds Jimmy's maybe.
You're entitled to a second consultants opinion in a different hospital in the NHS ie not the same trust so if youre attending a small hospital with only 2/3 rheumatologists then I suggest you consult your GP and get a referral to a teaching hospital.
I think ultimately what youre prepared to try depends on how much your quality of life is suffering and whether you can manage without DMARDS. I no longer tolerate codeine based painkillers - vomit without warning and the liver/kidneys object to NSAIDS so I'm very dependant on the TNF therapy.
borderriever Okapis
Posted
My hospitals were teaching hospitals. Then I was transferred to a different General Hospital, that serves the county. I moved again and found my new Specialist with attitude. in a Cottage Hospital attached to another General hospital serving our County.
I was having problems with NSAIDs medications I was bleeding internally and my white blood cells took a dive, this was made worse with the DMARDs drugs. They then changed these medications to Celebrex a Cox two NSIDS and that has been the case now for about ten years. I will be changing to another Cox 2 in a weeks time for a month to see if it will be a better medication
BOB
brian66997 alisonbhearts
Posted
borderriever brian66997
Posted
It took two years to sort out my medications, I take Tramadol for Pain. I also use a TENS Machine for my joint pain. I had attended a Pain Clinic and was put on various courses including the Professional Patients Course.
So now I am sixty seven, I am very wary with regards ointments they scar the skin and thin its covering of flesh. I prefer to use E45 and Epaderm, to replace lost moisture
BOB
diana77450 alisonbhearts
Posted
Go for it!!! I’ve been self injecting for over 2 years it’s very worthwhile I promise you. Take your folic acid get your vitamin B12 levels checked and if your lucky like me you will have zero sickness 👍👍👍 think about eliminating citrus and dairy as they don’t do us psoriasis or psoriatic arthritis folk any favours good luck xx