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I really do need some advice on the " next step " for me. I just contacted my

rheumy, and she wants me to go on either methotrexate, or Arava. So big

question here, what are the advantages/side effects of each, and which way would

those of you who have been there would recommend?

Noreen

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I don't like the sounds of that! A dry cough that came on shortly after

starting MTX therapy should not be taken lightly. Did your physician

perform a baseline chest x-ray (recommended by the ACR) and/or pulmonary

function tests before you began MTX (recommended recently by others)? To

be safe, he probably should order one or both now.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: Methotrexate

>

> Curious, when did you get the tummy problems from it? I have not had

that- YAY! altho I have a runny nose, and dry cough that began almost

right away- but the doc was not concerned, even tho I was scared to

death.

> ANd yes, I am confused cuz I swear doc said 15 mg and then it was 2.5

pills and it said take 5 pills, which is 12.5 mg. I stuck to the 12.5

mg- but is the difference cuz of you taking the shots? Are the side

effects less with the shots? I thought if you got the lung thing, you

HAD to stop MTX totally? (gosh scary thought for me at the moment)

> I DID get dried blood in my nose a little every day- mildly annoying-

and my monthly- ACK it was MUCH heavier---- that scares me a little,

might be ?? liver?? I only began MTX 2 weeks ago - and I go back to

rheumy next week. (I saw GP last Fri)

> ANd yes, I take folic acid, too- but- I am not sure I am taking

enough- I better go recalculate it- I think my doc said take 1 mg, but

then when I bought it it was sold in mcg.

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Methotrexate was not very effective for me. It also brought down my

white blood cell count, so my rheumy switched me to Arava. Arava worked

very well in easing the pain and lessening the inflammation. My sed

rate and C-reactive protein levels returned to normal. Unfortunately,

my WBC count continued to decline. I'm now on Enbrel, and my WBC count

is still below normal.

We are all different, and what works for one person might not work for

somebody else. I guess our rheumies have to experiment until they find

the right combination of meds to suit us.

Sue

On Wednesday, March 3, 2004, at 08:11 PM, Noreen Saukko wrote:

> I really do need some advice on the " next step " for me. I just

> contacted my rheumy, and she wants me to go on either methotrexate, or

> Arava. So big question here, what are the advantages/side effects of

> each, and which way would those of you who have been there would

> recommend?

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I started on Arava and it worked well for me for the first year after I was

diagnosised. I had no side effects at all and it was working well for a year,

then the RA got worst and it stopped working. You can take Arava and

Methotrexate together.

Both drugs require close monitoring via blood tests of liver and kidney

functions.

I am on Methotrexate and for me its is a miserable drug to take. I have

gotten all the bad side effects and in many cases still have them: nausea,

diarrhea, vomiting, dizziness, throat sores, headache and most serious drug

induced

pneumonitis(lung problems). I started on pills and had to stop due to the side

effects and the pneumonitis. My doc restarted me on injections. I get all

the other side effects and so far no lung problems.

Methotrexate is a chemo drug at high doses but for RA its used in far lower

dosages. I also experience fatigue for a few days after taking my weekly dose.

Arava is taken daily and is in pill form.

I hope it helps.

Toni

In a message dated 3/4/04 1:21:16 AM Central Standard Time,

writes:

> Message: 9

> Date: Wed, 3 Mar 2004 19:11:44 -0600

> From: " Noreen Saukko " <nsaukko@...>

> Subject: Re: Re: Methotrexate

>

> I really do need some advice on the " next step " for me. I just contacted my

> rheumy, and she wants me to go on either methotrexate, or Arava. So big

> question here, what are the advantages/side effects of each, and which way

would

> those of you who have been there would recommend?

> Noreen

>

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Thanks , Cary, Sue, and anyone else I forgot, for the info. Now I'm still

confused! Both drugs have bad side effects, but I know I have to do something.

Next question: Which one would help lessen the fatigue, instead of making it

worse? I don't need any more of that.

Noreen

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Provigil helps the fatigue. It is FDA approved for narcolepsy, excessive

daytime sleepiness, and shift worker fatigue. It is a non-stimulant and does

wonders for me. I had a long battle with my insurance to get it approved.

Finally, they approved it and I just got an approval letter today that they have

to pay me back since last June, when I started taking it! It's around $160-$190

a month. I have no trouble sleeping at night as it does not keep me awake. I

take one in the am.

Becky

Re: [ ] Re: Methotrexate

Thanks , Cary, Sue, and anyone else I forgot, for the info. Now I'm still

confused! Both drugs have bad side effects, but I know I have to do something.

Next question: Which one would help lessen the fatigue, instead of making it

worse? I don't need any more of that.

Noreen

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Noreen,

Arava was a wonderful drug for me, since it helped my pain and

inflammation so much. Because of this, I had less fatigue than with

methotrexate, but I still had fatigue. Enbrel, that I'm on now, does

help with fatigue. I still get tired easily, but part of it is from old

age, I guess. I'm not the oldest one on the list, but at 64 I'm

probably near the top. I try to keep exercising, and I think that makes

me feel better.

Sue

On Thursday, March 4, 2004, at 10:30 PM, Noreen Saukko wrote:

> Thanks , Cary, Sue, and anyone else I forgot, for the info. Now

> I'm still confused! Both drugs have bad side effects, but I know I

> have to do something.

>

> Next question: Which one would help lessen the fatigue, instead of

> making it worse? I don't need any more of that.

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Wish I could tell you, Noreen. Both drugs can cause fatigue and both can

improve it, but it's impossible to predict what effect they will have on

a given individual.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Re: [ ] Re: Methotrexate

> Thanks , Cary, Sue, and anyone else I forgot, for the info. Now

I'm still confused! Both drugs have bad side effects, but I know I have

to do something.

>

> Next question: Which one would help lessen the fatigue, instead of

making it worse? I don't need any more of that.

>

> Noreen

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Thanks again, .

From the info I've had so far, I think I'm leaning toward the methyltrexate and

see how that goes, but I'll talk to the rheumy (when I can get in to see her.

Not an easy thing) and find out which would be better with my other meds. I'm on

atacand for high blood pressure, and prozac

Noreen

Re: [ ] Re: Methotrexate

> Thanks , Cary, Sue, and anyone else I forgot, for the info. Now

I'm still confused! Both drugs have bad side effects, but I know I have

to do something.

>

> Next question: Which one would help lessen the fatigue, instead of

making it worse? I don't need any more of that.

>

> Noreen

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I am on methotexate too have been on it for almost 3 weeks I am just

know getting over the nausea of it was thinking it was just me

thought it wasn't worth it I take my 3rd dose of it on wed well see

how it does

Hope you feel better soon

Angie

--- In , " lisaplumeria " <lisamolino@h...>

wrote:

> Hi all,

> I got put on this because my rate was high and my rheumy decided

> that waiting until September until my insurance came through was

too

> long. Has anyone else had nausea? I am normally a trooper and

work

> through EVERYTHING including fever, etc. This is kicking my

butt.

> Maybe it is the heat of CA and this at the same? Or have I just

> become a big wimpie?

> in CA

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, I was on MTX before, and it did cause nausea with me also. You

may also experience fatique, and some other side effects. I have

heard the MTX injections have hardly any side effect. Good luck, and

will be praying for you, Tawny

--- In , " lisaplumeria " <lisamolino@h...>

wrote:

> Hi all,

> I got put on this because my rate was high and my rheumy decided

> that waiting until September until my insurance came through was

too

> long. Has anyone else had nausea? I am normally a trooper and

work

> through EVERYTHING including fever, etc. This is kicking my butt.

> Maybe it is the heat of CA and this at the same? Or have I just

> become a big wimpie?

> in CA

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> > Hi all,

> > I got put on this because my rate was high and my rheumy decided

> > that waiting until September until my insurance came through was

> too

> > long. Has anyone else had nausea? I am normally a trooper and

> work

> > through EVERYTHING including fever, etc. This is kicking my

> butt.

> > Maybe it is the heat of CA and this at the same? Or have I just

> > become a big wimpie?

> > in CA

I just took my third Methotrexate injection this evening. My Rheumy

told me I could put the dosage in orange juice and drink it (the

injectable) or inject it. I inject Humira every other week and I

have a rare colitis (collageous) so I decided to inject. Are you

guys on the pills? I haven't had any side effects from the

injections. Love this group !!!!

Colleen

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With the wise advice of this group, I started methotrext injections two months

ago. I haven't noticed any side effects. Oh I am on folate daily too.

Noreen

[ ] Re: Methotrexate

, I was on MTX before, and it did cause nausea with me also. You

may also experience fatique, and some other side effects. I have

heard the MTX injections have hardly any side effect. Good luck, and

will be praying for you, Tawny

> Hi all,

> I got put on this because my rate was high and my rheumy decided

> that waiting until September until my insurance came through was

too

> long. Has anyone else had nausea? I am normally a trooper and

work

> through EVERYTHING including fever, etc. This is kicking my butt.

> Maybe it is the heat of CA and this at the same? Or have I just

> become a big wimpie?

> in CA

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, Make sure your on Folic Acid also, while taking MTX.

--- In , " lisaplumeria " <lisamolino@h...>

wrote:

> Hi all,

> I got put on this because my rate was high and my rheumy decided

> that waiting until September until my insurance came through was

too

> long. Has anyone else had nausea? I am normally a trooper and

work

> through EVERYTHING including fever, etc. This is kicking my butt.

> Maybe it is the heat of CA and this at the same? Or have I just

> become a big wimpie?

> in CA

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I am on the injectable - he wanted me to be on that - I am having a

senior moment so I can't remember why....gosh - only 43...and I am

forgetting things...glad to hear that you are not having any side

effects. Did you notice that it helped and how soon?

in CA

> > > Hi all,

> > > I got put on this because my rate was high and my rheumy

decided

> > > that waiting until September until my insurance came through

was

> > too

> > > long. Has anyone else had nausea? I am normally a trooper

and

> > work

> > > through EVERYTHING including fever, etc. This is kicking my

> > butt.

> > > Maybe it is the heat of CA and this at the same? Or have I

just

> > > become a big wimpie?

> > > in CA

>

> I just took my third Methotrexate injection this evening. My

Rheumy

> told me I could put the dosage in orange juice and drink it (the

> injectable) or inject it. I inject Humira every other week and I

> have a rare colitis (collageous) so I decided to inject. Are you

> guys on the pills? I haven't had any side effects from the

> injections. Love this group !!!!

> Colleen

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I don't think that I am under very good care - he said nothing about

taking folic acid. WHy do you take that and how much are you

supposed to take. I am on the injectable and it I was soooo sleepy

today - sicky and sleepy. Came home and took a nap instead of

working - I called my boss and told him that I started this

medication and that I was sick. I got great support.....wow!

Nice....

Thanks all for being here...Tawny you are a love,

in ca

> > Hi all,

> > I got put on this because my rate was high and my rheumy decided

> > that waiting until September until my insurance came through was

> too

> > long. Has anyone else had nausea? I am normally a trooper and

> work

> > through EVERYTHING including fever, etc. This is kicking my

butt.

> > Maybe it is the heat of CA and this at the same? Or have I just

> > become a big wimpie?

> > in CA

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Folic acid helps reduce side effects, T

> > > Hi all,

> > > I got put on this because my rate was high and my rheumy

decided

> > > that waiting until September until my insurance came through

was

> > too

> > > long. Has anyone else had nausea? I am normally a trooper and

> > work

> > > through EVERYTHING including fever, etc. This is kicking my

> butt.

> > > Maybe it is the heat of CA and this at the same? Or have I

just

> > > become a big wimpie?

> > > in CA

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it took me six weeks to work thru the side effects. i am not on any folic

acid. i am now working part time. so hang in there. kathy in il

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I started on folic acid same time as mtx. I was good for a year, no

side effects. Then a month ago my hair started falling out, a side

effect of mtx. My rheumy doubled the folic acid I take daily and I

hope that helps. I think I'm on 2mgs now daily.

> > > Hi all,

> > > I got put on this because my rate was high and my rheumy

decided

> > > that waiting until September until my insurance came through

was

> > too

> > > long. Has anyone else had nausea? I am normally a trooper

and

> > work

> > > through EVERYTHING including fever, etc. This is kicking my

> butt.

> > > Maybe it is the heat of CA and this at the same? Or have I

just

> > > become a big wimpie?

> > > in CA

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--- In , " lisaplumeria " <lisamolino@h...>

wrote:

> I don't think that I am under very good care - he said nothing

about

> taking folic acid. WHy do you take that and how much are you

> supposed to take.

It is vital to replace the folic acid that MTX

depletes from your body. Do a search on methotrexate+folic acid.

I would question your care also, because folic acid with MTX seems to

be standard practice these days. My rheumy teaches at a University

and she put me on both. I take 1 mg. (prescription--paid for by

insurance)

S

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> it took me six weeks to work thru the side effects. i am not on any

folic

> acid.

I would encourage you to do some research about MTX and folic acid or

get a second opinion...I really think it's vital.

s

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I've been on this since Sept and found that if i drink lots of water

the day before, the day of and the day after it seems to help with

the stomach discomfort. usually the day after was the worst for me.

Hope this helps.

Diane

--- In , " lisaplumeria " <lisamolino@h...>

wrote:

> Hi all,

> I got put on this because my rate was high and my rheumy decided

> that waiting until September until my insurance came through was

too

> long. Has anyone else had nausea? I am normally a trooper and

work

> through EVERYTHING including fever, etc. This is kicking my

butt.

> Maybe it is the heat of CA and this at the same? Or have I just

> become a big wimpie?

> in CA

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> Colleen,

> I could not take oral mtx because of the GI side effects, but the injections

> didnĀ¹t bother my stomach. I still had to discontinue it due to elevated liver

> enzymes. Glad you love this group. It is very informative!

> a

>

>

> I just took my third Methotrexate injection this evening. My Rheumy

> told me I could put the dosage in orange juice and drink it (the

> injectable) or inject it. I inject Humira every other week and I

> have a rare colitis (collageous) so I decided to inject. Are you

> guys on the pills? I haven't had any side effects from the

> injections. Love this group !!!!

> Colleen

>

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Diane,

It is the weirdest thing but I have become crazed for water - I was

always a water drinker, but have been drinking it like crazy! I get

up all stinking night because I drink so much! I figure it is good

for me to flush my body. Funny how your body knows what you need,

isn't it? Thanks for the letter...

in ca

> > Hi all,

> > I got put on this because my rate was high and my rheumy decided

> > that waiting until September until my insurance came through was

> too

> > long. Has anyone else had nausea? I am normally a trooper and

> work

> > through EVERYTHING including fever, etc. This is kicking my

> butt.

> > Maybe it is the heat of CA and this at the same? Or have I just

> > become a big wimpie?

> > in CA

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Is he taking folic acid? Most rheumy's prescribe 1mg folic acid

daily to help with the side effects of methotrexate. It is

important to let his rheumy know the side effects he is

experiencing. If he is on folic acid already, the rheumy may want

to increase the dose and see if that helps. If the side effects

continue, another option is injectible mtx. Another thought, did he

take it with food? I just looked and my mtx bottle does not say to,

but I seem to remember being told to take all my meds with food to

avoid stomach problems.

Jennie

> My husband has RA & just started taking Methotrexate (once weekly)

> three days ago. Now he has headaches, nausea & a slight fever.

Has

> anyone else out there had this reaction to this drug & if so, did

it

> go away after awhile?..........he's miserable. He's also just

> started a low dose of Prednisone, but from everything I'm reading,

> it's probably the Methotrexate that's causing the grief.

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