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View Full Version : Methotrexate tablets or injectable?



ticklytoes
12-31-2009, 04:43 PM
My rheumy wants me to try the inj mtx to see if it will cause better results since its absorbed better...anyone have any info about this? Has anyone switched from tabs to injectable form and seen better results? Nicole

jola57
12-31-2009, 04:46 PM
My rheumy gave me the tablet form since it is the easiest, if they wouldn't work then I would have the injections.

deb
01-01-2010, 02:00 AM
I have only taken the injections but have not experienced the nausea and tiredness others have noted. I have not noticed any additional side effects that do not seem to be from the predizone. Does anyone have these issues with the injections or does it seem to be only those taking tablets?

Sangye
01-01-2010, 02:05 AM
I was on the weekly injections for about 2 months--transitioning from cytoxan. I don't remember feeling nauseous or tired. I felt much better on it than the cytoxan. But to be honest, I was in seriously bad shape then--still on oxygen, barely able to stand. I don't know if my reaction is useful. I went off it because I developed pneumonia and lung infiltrates-- side effect of mtx.

Barbara1966
01-02-2010, 12:27 AM
For me the deference is only the convenience of the tablets, for the injection I was in recliner for 5 hours in cancer center.
I don't experienced any side effects.

Sangye
01-02-2010, 02:55 AM
Barbara, I wonder if that was for something else? The mtx injection is a simple shot you give yourself at home, not an IV. I'm not aware of IV mtx being used for Wegs. IV mtx is used as a chemo for cancer, since it's given in much higher doses.

Barbara1966
01-02-2010, 04:53 AM
Sangye,
I'm still new in this, my was cytoxen

Sangye
01-02-2010, 04:56 AM
Oh, IV Cytoxan, that makes sense! It's very easy to get all the drugs mixed up!

Hammy8241
06-12-2010, 05:34 AM
Just wondered if Ticklytoes moved to injections and what if any difference/benefits/contra they noticed as I’ve been informed by my consultant we will be discussing whether to move to injections mtx when we next meet. Anyone else?

Just increased pred from 20 to 30mg after failed reduction and yes, I have stopped running and stopped overdoing it Sangye:)……..and no, I’ve not noticed any great improvement yet and Yes, I still find Tweety cute!! Sad git or what:D

Sangye
06-12-2010, 07:55 AM
LOL-- thanks for answering my question.... :D

Hammy8241
08-18-2010, 09:51 PM
Just back from hospital where i have been taught, assesed and approved to self harm.:w00t:

The injection is painless and once you get over the thought of sticking into yourself simple and quick. This is my second week of inj mtx. No side effects (but I also found tablets easy too)
Too soon to say if it will improve things though.

JanW
08-18-2010, 10:16 PM
Why did you switch to injectibles, Hammy?

Hammy8241
08-18-2010, 10:32 PM
Why did you switch to injectibles, Hammy?

Basically the pills were not working for me. They say that by Inj more of the drug gets into the body. It seems that some peoples metabolism can restrict the dispersal of mtx via the pill method. The dose is actually lower by Inj.

Sean48
08-19-2010, 07:25 AM
Hi Hammy......that is why I went on MX for my RA ... The pills weren't working like my doctor hoped ithey would.

onatreetop
09-28-2010, 09:31 AM
I just switched from cytoxin to methotrate about 6 weeks ago. I felt fine with the cytoxin but the methotrx is kicking me down. So my rhummy told me to take 2 tablets sat am then sat pm then sun am and sun pm. I still feel sick to my stomach but not as tired. He took me off the pred last week and put me on medrol instead. Is anyone else Taking this steriod? It has lesser side effects he says. I have also developed bone cysts in my hands. going to see a surgon friday. right hand looks pretty bad and left is starting. Cant really make it flat anymore. had a resting splint made to wear to bed. The swelling isnt bad in the am but by the end of the day it is. That and the pain that goes with it. I have also noticed ifI use it or dont it doesnt seem to matter so........medrol 20mg .

Sangye
09-28-2010, 09:39 AM
Medrol (methylprednisolone) is basically the same as prednisone. I've never heard that the side effects are less.

What's going on with the bone cysts? What does your Wegs doc at JHU say about that? Especially since it's in both hands...

onatreetop
09-28-2010, 09:47 AM
Havent been back need to go. I think its the weggies acting up but the labs are all ok. We found it first in the arts in my hands but not the joints. the lung nodules 2 of them are tiny but back. waiting for another catscan or 4 before I return to the rhummy next week. The tests said that the cysts where due to an injury? I remember thyper extending a finger or 2 but thats it. tore something or 2 also.

Sangye
09-28-2010, 09:49 AM
I hope you can get back there soon. I don't like the sound of all that. If it's Wegs and they catch it early on, you have a better chance to avoid the nasty drugs and high-dose pred.

onatreetop
09-28-2010, 09:52 AM
hope so too. never did get below 40mg of pred before the switch. I am taking 20 mgs of methotrx now too. Is that average?

elephant
09-28-2010, 09:54 AM
Onatreetop so glad to hear from you. Yes, I agree ...you need to go to JHU. Whatever is attacking sounds like it is not being controlled. I myself have a cyst on my liver and thyroid. I am being carfully watched to make sure they don't grow any bigger. I think you right Onatreetop,"weggies acting up."

Sangye
09-28-2010, 10:01 AM
hope so too. never did get below 40mg of pred before the switch. I am taking 20 mgs of methotrx now too. Is that average?
Eeech-- that's a high dose of pred to stay on for long.... I have no idea about the mtx dose, though. I was only on 25 mg injections for a couple months.

onatreetop
09-28-2010, 10:02 AM
Been really busy kids back at school cut back on work. doc appts. were far and few but now we are back to a few a week. The other lovely thing a havent mentioned is that I have so many small kidney stones they cant count them. They arent obstruting but are there. None of the docs think its related to the wegs. so that is another mystery in the works. I am wondering if the methotrx is working for me or not.

elephant
09-28-2010, 10:06 AM
That is interesting about the kidney stones. Are you prone to kidney stones?

Sangye
09-28-2010, 10:12 AM
What's their plan about the kidney stones? I can tell you from personal experience you really don't want to pass several of them at once. One is enough to make you want to die.

onatreetop
09-28-2010, 10:14 AM
I have had 3 total. 2 lythotrips to blast them cause they were to big to pass. the 3rd one passed about 7 weeks ago? Holy moly !! Not fun ! was in the er for a bit. But passed it at home. Now I take 1000mgs of vit. C and drink almost nothing but water. Did more lab work and 2 wonderful 24 hour collections of pee. oh joy! nothing bad from the labs yet.

elephant
09-28-2010, 11:22 AM
I remember my grandpa having kidney stones and the doctors back then..about 30 years ago had him drink cranberry juice.

Sangye
09-28-2010, 12:07 PM
I don't know if the cranberry juice helps with the stones, but it definitely helps prevent a UTI that often occurs after stones.

jola57
09-28-2010, 12:25 PM
I was told that cranberry juice was hard on the kidneys but excellent for UTI so tread carefully. I passed the stones with bloody urine(or sand) a couple of times, not fun not fun at all) I spend most of 2 days in a hot bath and with a towel you know where, and I never went to a doc just cured myself with ha ha, cranberry juice and hot salvia and camomile sitz baths. I have not had an episode in 5 years.
Onatreetop, I was given 15mg but with liver enzymes going up I was quickly lowered to 10mg mtx. I have been on it now for a year and it seems to be working for me just fine. I think 15 to 25mg is standard depending on where you are at with your blood workup.

JanW
09-28-2010, 10:16 PM
Jola's right. 15-25 mg is standard but what isn't standard Onatreetop is your dosing. I've never heard of mtx being split up like that -- the point is that it's a once a week dosing. If you are having side effects that are so bad, what is your dose of folic acid. FA seems to work really well in controlling mtx side effects (for some anyway) and docs at the symposium said that you can go up to even 2 or 3 mg a day (standard dose is one). Really important that you take the FA every day, including your mtx dose day, I was told. I've been on 15 mg since diagnosis and no problems with side effects at all.

And I second Sangye on that pred dose. Seems quite high.

Lightwarrior
10-03-2010, 04:27 PM
Been really busy kids back at school cut back on work. doc appts. were far and few but now we are back to a few a week. The other lovely thing a havent mentioned is that I have so many small kidney stones they cant count them. They arent obstruting but are there. None of the docs think its related to the wegs. so that is another mystery in the works. I am wondering if the methotrx is working for me or not.

I so sympathize with you about the Ikidney stones, I have been down for almost three weeks due to infection of unknown origin which they finally decided was most likely a kidney stone from all the stones I have been passing in last few months. I take urocrit which is potassium citrate to help prevent, doesn't seem to work very well. My rheumy thinks that maybe an unknow side effect of cytoxan is kidney stones?? I'm not sure if he is crazy or not.

Sangye
10-04-2010, 12:10 AM
I've never heard of ctx linked to kidney stones. Maybe a remote side effect. I think they'd be a lot more common among Weggies if it were true.

The two main causes are low phosphorus and low vitamin D (which prevents absorption of phosphorus). And yes, even though you live in Tucson you can still be vitamin D-deficient! All of our docs should be checking vitamin D levels routinely. Do you know if yours is in range?

elephant
10-04-2010, 12:45 AM
Good to hear from you lightwarrior. Your doc could be right, we all react differently to meds....it is probably a very rare side effect. That is too bad, how are you feeling otherwise?

Sangye
10-04-2010, 01:04 AM
Well, I was wrong. I looked up ctx and kidney stones and found that ctx can increase levels of uric acid causing kidney stones. Cytoxan consumer information from Drugs.com (http://www.drugs.com/cons/cytoxan.html)

I still tend to think it's not a common side effect, since we don't hear of it much. I've had kidney stones but not related to taking ctx.

Lightwarrior
10-04-2010, 04:31 AM
Well, I was wrong. I looked up ctx and kidney stones and found that ctx can increase levels of uric acid causing kidney stones. Cytoxan consumer information from Drugs.com (http://www.drugs.com/cons/cytoxan.html)

I still tend to think it's not a common side effect, since we don't hear of it much. I've had kidney stones but not related to taking ctx.

My Vitamin D is within range, well blow me over...I thought he was smelling his own socks too long, maybe since I'm off Cytoxan the stone factory will ease up.

pwc51
10-04-2010, 07:51 AM
Jola's right. 15-25 mg is standard but what isn't standard Onatreetop is your dosing. I've never heard of mtx being split up like that -- the point is that it's a once a week dosing. If you are having side effects that are so bad, what is your dose of folic acid. FA seems to work really well in controlling mtx side effects (for some anyway) and docs at the symposium said that you can go up to even 2 or 3 mg a day (standard dose is one). Really important that you take the FA every day, including your mtx dose day, I was told. I've been on 15 mg since diagnosis and no problems with side effects at all.

And I second Sangye on that pred dose. Seems quite high.

For what it is worth, my Rheumy is adamant about 2 things - firstly mtx is once per week (the fact sheet with the tablets stresses that too - I am on 25mg) and secondly that the folic acid is once per week, 3 days after the mtx and NEVER on the same day as the mtx!

Jack
10-04-2010, 08:06 AM
I have no first hand experience of Methotrexate and Folic Acid, but a quick Google seems to indicate that the evidence does not yet exist to support any particular dose or dosing regimen and there is a lot of disagreement between practitioners. One thing that they do seem to agree on is that FA does reduce side effects.

pwc51
10-04-2010, 09:35 AM
Hi Jack - I am sure you are right, I sometimes sense there is more art than science in some of the medciation regimes as we continually piggy back on the back of meds for other, non-Wegs, conditions.

Lightwarrior
10-05-2010, 08:18 AM
For what it is worth, my Rheumy is adamant about 2 things - firstly mtx is once per week (the fact sheet with the tablets stresses that too - I am on 25mg) and secondly that the folic acid is once per week, 3 days after the mtx and NEVER on the same day as the mtx!


I take 25mg once a week, but I take 1mg folic acid every day including the day of mtx. I am supposed to take it 1 to 3 hours prior to mtx on Saturday (the 1 day a week I take mtx).

Hammy8241
10-05-2010, 10:46 AM
For what it is worth, my Rheumy is adamant about 2 things - firstly mtx is once per week (the fact sheet with the tablets stresses that too - I am on 25mg) and secondly that the folic acid is once per week, 3 days after the mtx and NEVER on the same day as the mtx!

Im as above except my FA is two days after the Mtx.

pberggren1
10-05-2010, 03:16 PM
Im as above except my FA is two days after the Mtx.

So if we look up we will see you?

jola57
10-05-2010, 03:18 PM
Oj I have been taking mtx once a week 10mg but folic acid 7 days.

Hammy8241
10-05-2010, 06:58 PM
So if we look up we will see you?

If you look up at me from below Phil, all you will see is my stomach as that is all i see when i look down. lol

elephant
10-05-2010, 09:20 PM
Too funny Hammy and Phil.

Doug
10-06-2010, 06:29 AM
If you look up at me from below Phil, all you will see is my stomach as that is all i see when i look down. lol

How I identify with that! My biggest fear about falling outside is some well-meaning person will try to repatriate me to Sea World for their trained whale act! I have no problem with that except I have an aversion to sushi.