Starting methotrexate

[Guest guest]

As I remember, n started out at 5mg and went up by 5mg a week. I think

the max dose is 25mg. You can go with pills or injection. Our ped rheumy

only does injection. I am sure someone will chime in on what they think

regarding pills or injectable. Remember to get a folic acid prescription

with the mtx. Good luck. and n

starting methotrexate

>

>

> Hi all,

>

> Well, the rheumy called back and has suggested that we start Aundrea

> on Methotrexate. She said she would call me tomorrow when she has

> more time so that we can have a conference call and she can answer

> all my questions. I guess we will get some baseline labs and then

> repeat labs every 2 weeks for the first month. She wants to keep

> her on the plaquenil and continue the prednisone.

>

> Could someone let me know how the dosing system works for

> methotrexate.

>

> Thanks,

>

> (Drea 9 systemic)

>

>

>

>

>

>

>

>

[Guest guest]

...

Im so glad you held your ground and finally got to talk to the

doctor. I'm very proud of you for being the BEST advocate for

Aundrea. I know its not easy sometimes, as I always question am i

being too pushy. Im getting better and I also feel more comfortable

calling Nicks doctor now. I think we are very blessed to have a

doctor who always personally calls me back usually within 30 mins.

Im glad they are starting the MTX.. I really hope this is the answer

for her. Remember though that it can take a long time to work, upto

12 weeks, I believe. Usually its helped Nick around 8 weeks into it.

Are you going with the injections or the pills.. I would recommend

the injections, i know they sound scary but i really think they are

the best way to go...liver toxicity wise and also best absorbtion. I

figure if im giving this drug to my child it is best that he get it

the best possible way. Im not sure how they start the dosing.. Nick

started at 10mg....according to Nicks doctor she goes upto a max of

1mg for each kg the child weighs.. Nick is around 20kgs, so his max

MTX is 20mg which is where he is now. The doctor was telling me

though that some rhuemys are now going higher than the 1mg=1kg but i

didnt want to go that route with Nick. Also remember to ask about

the folic acid....

Also you will need to go get labs taken 24 hours after her 1st dose

to check that the MTX has all been absorded.

I know its a big step, but you are doing what you need to help

Aundrea.. if you have any more questions, just ask...Let us know

what the doc says tomorrow...

Hugs Helen and (7,systemic)

>

> Hi all,

>

> Well, the rheumy called back and has suggested that we start

Aundrea

> on Methotrexate. She said she would call me tomorrow when she has

> more time so that we can have a conference call and she can answer

> all my questions. I guess we will get some baseline labs and then

> repeat labs every 2 weeks for the first month. She wants to keep

> her on the plaquenil and continue the prednisone.

>

> Could someone let me know how the dosing system works for

> methotrexate.

>

> Thanks,

>

> (Drea 9 systemic)

[Guest guest]

Hi ,

Congrats on getting the best help for Aundrea. This is one case when being

pushy is a quality! Eliot(systemic) is 10 and was on Plaquenil (200 mg per

day for six months + pred tapering off from 50mg to 10mg) and it worked for a

while but when another flare started six months later my Rheumy at the time

was stumped and during our appointment with Rheumy and Dermatologist I could

tell they just didn't know where to go from there. They had been very nice and

attentive but just didn't have the right attitude to JRA. They wondered

whether to wait it out(!!!) or double the doses of Plaquenil (!!!) all this to

avoid MTX of which they seemed more scared than me. I live in France and this

was one of the South's best Pediatric Rheum. Departments. I ended up flying

Eliot to another hospital in Paris to get a third opinion. Our Doctor said how

important it was in terms not only of pain control but as far as the general

prognosis of the disease to be aggressive in its treatment and to keep the

number of flares down as much as possible. She started him on MTX (he had pulse

steriods first)

0.5mg per kilo per week is the basic prescription (careful not to confuse mg

and ml as I did in another post!!!) and that went on to be a combination of

MTX and ciclosporine (Neoral) that so far is working well (he is still on

pred and we are slowly cutting id down). He is taking 25 mg of oral MTX (he

drinks the liquid) per week.

Do ask others on the list if they have any experience of combining MTX and

plaquenil but I'm sure I remember that for systemics my doctor said that if the

plaquenil wasn't working it would not do any better as a combination drug.

Maybe others have input about this.

Before starting MTX they usually do lab tests to check CBC, AST and ALT.

I wish you both well and again BRAVO for standing up for Drea's rights!

Chloe mom to Eliot 10 - systemic.

[Guest guest]

Helen,

In talking about starting mtx to you mentioned:

> Also you will need to go get labs taken 24 hours after her 1st

>dose

> to check that the MTX has all been absorded.

I have never heard of this???? But I'm no expert and behind on

posts. Maybe as I read on someone will comment on that.

Stacia and Hunter 8 systemic, 8 iriits

[Guest guest]

Hi, anyone and everyone who will listen. PA is a new diagnosis for

me. I've had psoriasis,(which is very mild psoriasis) for over 20

years. Have the flair ups when I'm stressed or in the winter. Just

started having the arthritis symptoms over the past year or so. I saw

a new dermatologist this week and she prescribed MTX. I am not having

alot of pain or have the sausage fingers etc, but want to stop the

disease progresion. The side effects of this medication is very

scary. I just don't know what to do. My insurance will not cover

Enbrel, at this time. I'm a registered nurse, so I am very active and

on my feet 4-5 days a week. I'm not sure how long the fatigue will

last or when you start feeling the fatigue. Does it last for hours or

days?? I need to start this medication either today or next weekend.

My shift starts at 5:00 tomorrow morning, which means I need to get up

at 3:00 am. Will I be able to function if I take it today?? I am

trying to get in touch with my brother who is a pharmacist, to ask him

questions about MTX, but he hasn't returned my call. If anyone out

there, has any suggestions, or positive experiences with MTX, please

write back. Thanks, and God Bless You!!

[Guest guest]

Hi ,

MTX is scary stuff, but it has been WONDERFUL for me. I actually

have many days with little or no pain. It took about 5 weeks for

the pain to subside noticably, but the swelling and inflamation was

noticiably better after 3 weeks. I take 6 x 2.5mg once a week. I

haven't noticed the fatigue. I take a healthy dose of folic acid

every day 3 x 1Mg and my Rhuemy raised it from 2 to 3 after I

developed a small sore in my mouth. I've been about 12 weeks on

Methotrexate now and I don't have hardly any knee or foot pain and

in fact have quit taking the Ibuprofen 800 mg to give my stomach

lining a rest. (Had been taking this 3 times or more per day for

over 2 years).

All that said, I did have a new area of involvement recently with my

right hand mirroring the finger/thumb arthritis of my left hand, and

also my left elbow developed a bursitus (sp?) lump (it has been sore

and painful to the touch for months). I pushed hard and my Rhuemy

prescribed Enbrel - 50Mg injectable once a week. My copay on that

is over $250 a month, but at least I have insurance. But my hand

and elbow calmed down after two weeks, and every day I feel better.

My memory issues and foggyness issues are no worse now than before I

started on the MTX and Enbrel.

Hope this information helps. Good luck with your meds and hope your

pain melts soon with no fatigue issues.

Jeff

> Hi, anyone and everyone who will listen. PA is a new diagnosis

for

> me. I've had psoriasis,(which is very mild psoriasis) for over 20

> years. Have the flair ups when I'm stressed or in the winter.

Just

> started having the arthritis symptoms over the past year or so. I

saw

> a new dermatologist this week and she prescribed MTX. I am not

having

> alot of pain or have the sausage fingers etc, but want to stop the

> disease progresion. The side effects of this medication is very

> scary. I just don't know what to do. My insurance will not cover

> Enbrel, at this time. I'm a registered nurse, so I am very active

and

> on my feet 4-5 days a week. I'm not sure how long the fatigue

will

> last or when you start feeling the fatigue. Does it last for

hours or

> days?? I need to start this medication either today or next

weekend.

> My shift starts at 5:00 tomorrow morning, which means I need to

get up

> at 3:00 am. Will I be able to function if I take it today?? I

am

> trying to get in touch with my brother who is a pharmacist, to ask

him

> questions about MTX, but he hasn't returned my call. If anyone out

> there, has any suggestions, or positive experiences with MTX,

please

> write back. Thanks, and God Bless You!!

[Guest guest]

I would also suggest that if possible, you time your weekly dosing of

methotrexate for after dinner just before a day off - that way you can sleep off

most of the fatigue with no consequence at work. For the nausea, there is a

wonderful med callled Zofran that is specifically made to combat nausea and

vomiting from chemo (which metho is in higher doses}. I recommend taking it an

hour before your metho dose and continue taking it around the clock for the

first 24 hours if you need it.

Taking folic acid is a great idea. My doc prescribed me 1 mg folic acid 6

days a week (none for metho day since it stops the action of the metho cold).

If you get mouth sores from the metho the folic acid will help clear them

right up. It will also help keep you from getting anemic and from getting too

tired .

Unfortunately, there are no side effect free drugs to treat the PA, so we,

with the help of the doctor we chose have to judge on our own which meds will

work out best for our needs.

Good luck to you,

S

PA group founder

[Guest guest]

Hi ,

You didn't mention the dosage you would be taking, but I've been taking

10mg per week for over 3 years. I've needed more sleep for the last 5-

6 years even prior to my diagnosis. I'm not convinced that MTX is the

cause of my need for sleep, rather I believe PA is the cause of my

tiredness. MTX isn't a big bad ogre for everyone. For me, It's a

godsend.

Stay Well,

[Guest guest]

In a message dated 9/5/05 2:11:36 AM GMT Daylight Time, queen_castle@...

writes:

My shift starts at 5:00 tomorrow morning, which means I need to get up

at 3:00 am. Will I be able to function if I take it today?? I am

trying to get in touch with my brother who is a pharmacist, to ask him

questions about MTX, but he hasn't returned my call. If anyone out

there, has any suggestions, or positive experiences with MTX, please

write back. Thanks, and God Bless You!!

Hi ,

Welcome to the group. I know, I know, I'm about seven weeks late in

welcoming you but you will get used to me answering mail several weeks behind

everyone else. lol

Did you get any answers to your questions? I hope so. Let us know how you

are getting on if you eventually started the MTX. If you have I hope its working

for you and you are able to lift the patients over your shoulders by now.

lol Seriously though, I hope things are going well for you.

Take care,