Stomach not tolerating methotrexate

[Toni]

I'm surprised that our 12 year old Jaxon is now not tolerating his by mouth methotrexate since he's been on it since last Oct. I suppose side effects could happen at any point. He has gotten very reluctant to take it....takes him several hours to get his pills down and then ends up with a stomach ache and nausea.....guess I'd be hesitant too. These past couple of weeks he has thrown up after his methotrexate dosing. Can anyone give me feedback on subcutaneous methotrexate? He was actually crying tonight...."I want the shots!"
~thanks Toni

[pberggren1]

Is he on any other meds like pred?

[pwc51]

I really hated MTX by mouth. I really struggled to take it. I was switched to the injected version which I found much better. It still makes me feel somewhat ill for a couple of days each week but, for me, is much better than the tablets.

[Alysia]

Hi Toni.
I couldn't take imuran (vomiithing) and in order not to vomit MTX I am taking it differently: 2.5mg per dayX 6 days a week.
good luck with you son and hugs to you both.

[NikkiNicole]

I get pretty "off" and nauseous taking my dose every week. I am only starting my 20mg dose today, in two weeks I will be at 25mg. I feel worse with each higher dose but it only lasts a day or two, three at most. I am hoping that once I hit my 25mg and do that for a few weeks I will start to have a tolerance to the nauseousness.
My doctor had suggested the injection method if the nausea gets too horrible or if there is vomiting involved. I would talk with the doctor. The injection method bypasses the stomach and should alleviate the nausea/vomiting. At least, that is what I was told.

[Toni]

Dear all~ thanks so much for the feedback on the methotrexate nausea/vomiting. Jaxon is not on any steroids at this time. I think once he had a run of nausea and abd pain and then subsequently vomiting....he anticipates the same with each dose now. I foresee us heading to the subq route soon. We were even doubling up on his folic acid the day after his methotrexate to see if that would help. Maybe zofran? Thank you all for the input!
~ Toni

[whatthewhat]

Our rheumys routinely prescribe Omeprazole (Prilosec) to avoid this... and btw, they say the folic acid is fine even on mtx day now, for our daughter's once-weekly 20 mgs.

[carriej22]

I took the injection, as I couldn't handle the pill.

Eventually, I couldn't handle the injection either but it's because I had a reaction to it. However, it just seemed to wipe me out. I used to take it at night, and I was never sick or anything on it and I am sensitive (this girl pukes on antibiotics).

It's not difficult either - it does not hurt and the needle is very short.

[gilders]

Our rheumys routinely prescribe Omeprazole (Prilosec) to avoid this... and btw, they say the folic acid is fine even on mtx day now, for our daughter's once-weekly 20 mgs.
Were you on Pred when Omeprazole was prescribed. As far as I know Omeprazole is used to prevent stomach ulcers (caused by high dose, frequent pred), rather than anti-nausia?
At least that's why I was prescribed it.

[Wegetarian]

Were you on Pred when Omeprazole was prescribed. As far as I know Omeprazole is used to prevent stomach ulcers (caused by high dose, frequent pred), rather than anti-nausia?

That's my understanding too (atlhough wasn't sure which drug(s) cause ulcers as there were so many pills.). Actually my MTX listed it as a drug that could have some synergy effects, so I discussed with my doctor that I wouldn't take it on the morning after taking MTX.

Some people from a local group were prescribed Primperan for nausea caused by MTX, not sure if it goes with the same name elsewhere but google might help.

[annekat]

I guess I'm lucky to get by on 15mg. MTX. But even at 10mg., there was some nausea and an "off" feeling, though never to the point of throwing up, and I did get used to it eventually. I would imagine it would be more of a problem at 20 or 25 mg.

I'm curious, when you get the injected version, do you inject yourself or go have it done at the doc's office?