methotrexate side effect

[Jeff vinc]

Hi,

I've been on mtx 20mg/week for over a year now and i take it on saturday night but lately i am experiencing extreme tiredness the following day (sunday) and a little tired on monday. My blood works looks good (actually went this week and i had normal results). So i was told 3 different things that i could try. I can split my 20mg into 2 dose of 10mg withing 24h and see if that work. Apparently that dextromethorphan (DM like robitussin DM without acetaminophen or ibuprofen) can help to reduced the side effects of mtx (extreme tiredness in my case). taking this dextromethorphan before taking mtx can significantly reduce those side effect. I've seen some comments about this on internet and seems like it works for some people.
I was told to take more vitamin A as well.

any thoughts?

[pberggren1]

I was on mtx back in 2003 and 2004 and 2005 but do not remember any bad side effects from it. And I thought I took it every day.

[Jeff vinc]

Thanks for reply Phil.
I hate mtx because i have no life those "mtx days" i feel extremely tired when i take it. My kids want to play with me and i just don't have the power at all after taking this crap. But i feel super good the rest of the week....

any idea or comments or thoughts about what i mentioned in the first thread?

Thanks for your attention

[pberggren1]

I think I would try the DM to see if it makes a difference.

[Jeff vinc]

like you said, i think i will try this DM first. I consider the splitting of 20mg ( 2x 10mg in a 24h) as my last option because i don't want to feel tired every weekend saturday and sunday.
Hopefully DM can help.
But i can't find anything about vit A that could help this side effect. weird

[Chris G]

When I was taking mtx, I noticed that extra folic acid helped a little bit. You should already be taking it already. You could safely double your folic acid dose on Saturdays and Sundays, and see if that helps.

I'd be surprised if dextromethorphan could help with mtx side effects - a couple of the side effects of dexromethorphan are drowsiness and dizziness. Sounds like it could make it worse. If you do try it, don't over do it - I think it's dangerous at high doses.

[Jeff vinc]

I do take folic acid. Not sure if its a good idea to double doses on mtx day. Folic acid is more for mouth sores which i don't have.
From what i've seen dextromethorphan seems to work for some people.

[Chris G]

Mtx leaches the folic acid from our bodies. That's why we need the suppliment. It does help prevent irritation and sores in the mouth and gastrointestinal system. I checked with my doc before taking higher doses of folic acid. She said it's not a problem and if it helps then great.

It's a water soluable vitamin so there's no concern about overdosing it. It helped me for a while.....although I still had to stop taking mtx in the end. It also helped another weggie here in the forum.

Sadly though, there's not going to be a perfect solution to the fatigue the mtx causes. Splitting the dose might be your best bet.

[Sangye]

Also ask your doctor about taking the mtx via injection (it's a tiny needle once a week). I was on mtx injections for 2-3 months and didn't notice that I felt worse on mtx days.

[freakyschizogirl]

My mum is back on MTX for her arthritis and she seems really teary - crying a lot. Is this a side effect of the MTX??

[Dirty Don]

mtx days/doses were making me nauseous & very tired for about 48 hours. Doc had me split the dosage in 2 on THE day...12 hours apart, seems to have helped along w/ increase in folic.

[Jeff vinc]

WOW! thanks all for all those comments and suggestions! I will try to split it 12h apart and i will increase the folic acid as well. Hopefully that will work.
Thank you so much! and i will try and let you know if it work.

[Jeff vinc]

one question, if i take 10mg of my mtx at 9am and i take 10mg at 9pm, when should i take my 2mg (double dose) of folic acid?

[Dirty Don]

one question, if i take 10mg of my mtx at 9am and i take 10mg at 9pm, when should i take my 2mg (double dose) of folic acid?

I take it w/ morning doses. Seems to work OK. I'm on triple dose of folic...lol...doc felt sorry for me cuz the mtx has caused some acute hair loss!! I told her I'm going to shave my head, she said try this first!! Ha! Still may shave it anyway! Take care & best of luck!

[delorisdoe]

Folic helps with the hair loss??? I still loose hair from my cytoxan days. would this help that?

[maria garcia]

I just started a thread then Isaw this one. My daughter takes Folic Acid every day including the day she takes MTX and so far no side effect. I read an article that mentioned that Folic Acid is not taken on the same day as the MTX. What is the correct way to take the Folic Acid?

[Yvonnea]

On mtx since July. take it every tuesday. No side effect except being a little tired on the Wednesday. Take folic acid every day except for the day I take mtx. I was told it affects the absorbtion of the mtx. So far no side effects so all good.

[maria garcia]

Ivonnea that is what ive just learned but other say to take it. What to do?

[Jeff vinc]

apparently it is better to avoid taking it same day as mtx but i get so tired when i take mtx so i take it the same day.
I splitted my mtx dose today to avoid tiredness (first time i try that). I took 2mg of folic acid early this morning and took 10mg of mtx at 9am. I will take my other 10mg tonight.
So far i am not tired at all. Normally if i take 20mg in one shot i get extremely tired so this is good, hopefully it way stay that way.

Thanks to Dirty Don and Chris G for your suggestion, I tried it and so far it work.
Thanks to everyone else as well :)

[Dirty Don]

Folic helps with the hair loss??? I still loose hair from my cytoxan days. would this help that?

That's what the doc said...tripled my dose over the regular w/mtx. I don't know the chemical makeup or effects of it yet, you'd have to ask some of the more educated personas in here...but folic does have 'something' to do with hair...hehe...who knows...I'm still vacuuming hair all over the place, but it could just be, as Al might say, an old man's plight!! LOL

[Dirty Don]

What is the correct way to take the Folic Acid?

Not being a chemical compound expert in the least, I do know and feel that in this case, as with some other drugs, you have to 'feel' your way as to what's good for you in dosaging. Just cuz the doc says so or someone else, doesn't mean that's what works for you. After all, early on in treatment, the docs are doing what you're questioning, 'feeling' their way around your body reactions to find the right drugs and doses. Be patient, keep looking upward and forward...that, above all, works best!! Take care.

[gurinbasra]

I take the injection Mtx of 20mg/week, then 1mg folic acid every day except Mtx day as it interfere's with the Mtx absorbtion - there's another thread on this. I used to take tablet form of Mtx when I was really sick, but can't say it was worse as I was not well anyway, but I don't have any side effects from the injections on that day or any other day, other than working up the nerve to stick the needle in my belly fat every week.