Methotrexate - How long does it really take to "kick" in?

[Yvonnea]

Have recently been switched to Methotrexate from Imuran.
Am waiting to start RTX next week and still on prednisone.
All in attempt to stop or delay damage to sinus and nose. Doc said MTX takes awhile to kick in. He wants me to reduce my prednisone but I am terrified to do that in case flare will get worse.
Took first lot of MTX on Tuesday with no side effects...but just want to know from people who have taken it, how long did it take to see some good results...if any?

Thanks

[pwc51]

If I recall I was advised it took several weeks to take effect - I am not sure if I could tell the difference between the first and later doses (I hate it with a passion!). In my case I did not initially start on it until after my CTX infusions had completed. After my flare, and CTX did not work the second time round, I moved to RTX (2 infusions). In this case we started the MTX at the same time as the first RTX infusion so it would kick in soon after teh second infusion and have continued since.

[JanW]

I would say that it took maybe only a few weeks for it to kick in with me -- but I have a case, that while moderate/severe, responded really quickly to immunosuppression, and didn't require steroids.

[vdub]

Seems like it only took a week or two, but I was pretty incoherent for two weeks while in ICU after the surgery.

I was started on a relatively light dose of mtx, 6 tabs (15mg) and stayed on that dosage for about 10 months. It seems as if the sinus issue disappeared pretty quickly, but I can't really say if was due to the mtx or the brain surgery (which went through my nose) or the nose surgery to open the sinus channels (good stuff). At any rate, the sinus problems disappeared and so did the boxes of kleenex that I had next to my chair, in the pickup, in the car, next to the bed, in the kitchen, etc. The constantly-availiable-kleenex is no longer a part of my life.

The weekly 15mg dose of mtx was fairly manageable. I didn't feel quite right, but I wasn't constantly uncomfortable. I felt "semi-ok". When I went up to 10 tabs (25mg) of mtx, day-to-day existence was a lot more challenging. Usually, the 2nd and 3rd days after taking the weekly dose were pretty bad. Sometimes the bad days would vary, but I never figured out what caused the variance. With the 25mg dosage, I would have just a couple days a week where I felt wegs-ok.

I'm now tapering off the mtx and I'm back down to 15mg at the moment. I'm feeling good again. I had almost forgotten what "good" felt like. It's a nice feeling.

Good luck on your treatment. There is a light at the end of the tunnel.