Starting Methotrexate

[MINDYB77]

I am finally starting treatment in about 2 weeks. Dr. Villa Forte wants to start with Mtx and Prednisone. I have a couple of questions. What is the time frame for remission with this treatment regimen (I know people are different, but would love to hear other's experience). The Mtx will be once a week. Do you see any fatigue following the dose? I get to pick what day I start it and would like to have an idea for work if I need to try to push it towards the weekend, or if it doesn't really make a difference.

Thanks for any info!

[Pete]

I’m not sure how quickly mtx induces remission. It’s probably faster than rituximab and slower than cytoxan. Mtx replaced cytoxan in my treatment regimen. My mtx dosage ranged from 20-25 mg/week. I was down to about 20 mg/day of pred when I was on mtx.

As time went by, I noticed increasing fatigue the day after my dose. After about two years on mtx (and dealing with too much fatigue), Dr Villa Forte put me on rituximab. I was in remission shortly after starting mtx. I started rituximab in 2013. I’ve been in a stable remission since 2014 and off prednisone since June 2018.

[MINDYB77]

I’m not sure how quickly mtx induces remission. It’s probably faster than rituximab and slower than cytoxan. Mtx replaced cytoxan in my treatment regimen. My mtx dosage ranged from 20-25 mg/week. I was down to about 20 mg/day of pred when I was on mtx.

As time went by, I noticed increasing fatigue the day after my dose. After about two years on mtx (and dealing with too much fatigue), Dr Villa Forte put me on rituximab. I was in remission shortly after starting mtx. I started rituximab in 2013. I’ve been in a stable remission since 2014 and off prednisone since June 2018.


She is not comfortable with using rituximab at this point because I have had several lung infections over the last several months. I was bummed to hear this, but I understand her reasoning. I can be taken off the Mtx and it be out of my system in 2 weeks, rather than 6 months with rituximab if I had a serious infection. Hoping that it will help and that my lung infections will clear up with treatment.

[Dirty Don]

I started treatment with MTX and pred. MTX took approximately 4-6 weeks for full effects. Side effects were nausea, so doc had me take 2 half doses within 24 hours, it worked well. Best to you.

[JBee]

I had MTX and pred and felt better fairly quickly. Remission probably took 6 months or so, it's hard to be exact. I was lucky and have no side effects from the MTX. Occasionally tired the next day but sometimes I have more energy. Good luck and be kind to yourself as you get used to dealing with this.