Methotrexate side effects - when do they kick in

[DuaneHart]

I've been taking mtx for 6-8 months now. I started taking 25 mgs (8 pills) by mouth once weekly. The day after taking them I was totally knocked out---exhausted, ache, felt like I was run over by a sandpaper truck driven by a bad chicken (ha ha). I started doing the injections about 2 months ago (.8ml once weekly) and wish I would have done that from the beginning. Side effects are much, much milder. No nausea, just am tired for a day or two after--but not "have to lie down" tired. It seems to be more evened out rather than a big wallop, if that makes any sense. Hope you get feeling better Andrew!

[andrew]

Thanks for that

I just had this week's dose tonight so I'll see how I go over the next day or so. I must say though, that the injections look like much more fun!

[Sangye]

The doctor just switched A.J. to the injections. He can't keep the pills down any more. As soon as I take the bottle out, he is looking for the bucket! We are suppose to go this week to get trained on how to give them. The doctor says a lot of it is mental, but its certainly real to him. and to me... I have to clean it up!

It's almost impossible to get past a conditioned response like that. Thank goodness there is the option of injections! They are truly painless, as neither the medication nor the needle hurt. Ask his doc about something called emla cream. It numbs the skin before injections. It's not really necessary with this size needle but just in case. You might consider doing the injections when he's distracted with something he likes-- maybe video games. He won't feel it and it'll condition his brain to relax when it's time.

[JanW]

I continue to be very interested in all of these varied (bad) reactions to mtx. I've never had any of them, and my understanding is that in the RA world it is much beloved just because it's so well tolerated (and works really well to ease their inflammation and pain in a short number of weeks after starting). It definitely seems that I'm unusual in this regard and I'm not sure why.

[andrew]

An update:
My rib seems to be getting a lot better over the last day or so. All of a sudden it's much less painful when I cough and I can move around much easier. Weird. Jack, does this happen to you or is it more of a slow progress?

Chest seems to be clearing up a bit too. I still have the cough but at least this morning it appears to be less productive than previous days.

No fever this morning either.

No painkillers required since about 10pm last night too.

Only real bother for me is of course the coughing but also the rib is restricting how deeply I can breathe. Natural course of events though and it should get better over time.

[ScreaminMeanie]

Andrew, so glad to hear you're improving!

Jan, my side effects with MTX have been minimal as well. Since CTX almost killed me, but did succeed in getting rid of the WG for almost 20 years (w/no maintenance drugs), I worry a bit that lack of side effects = lack of efficacy.

[JanW]

well, I have no side effects but my bloods went to normal and my symptoms disappeared, so that's effective enough for me!

[Sangye]

ScreaminMeanie, I understand your logic, but there is not evidence to support it. If you're feeling better and your labs are improving, then you're improving!

Aren't we Weggies funny? We worry about the nasty side effects of drugs like ctx when we're on them, and we worry if we don't have them! I do the same thing. Hampster on a wheel.

[andrew]

An update:
My rib seems to be getting a lot better over the last day or so. All of a sudden it's much less painful when I cough and I can move around much easier. Weird. Jack, does this happen to you or is it more of a slow progress?

Chest seems to be clearing up a bit too. I still have the cough but at least this morning it appears to be less productive than previous days.

No fever this morning either.

No painkillers required since about 10pm last night too.

Only real bother for me is of course the coughing but also the rib is restricting how deeply I can breathe. Natural course of events though and it should get better over time.

Also very very tired today. I can hardly keep my eyes open. So bad that I had to stay home from work today. Had a four-hour nap in my chair. Might be due to last might's MTX as I haven't felt this way before. I think last week's nausea though was unrelated.

Oh yes, just to add to the list of whinges, chest is very congested today. Gets a bit better as I move around tho. I dunno, I'm an enigma wrapped in a riddle wrapped in a conundrum wrapped in snot.

[drz]

Sounds far worse than mine. I felt my rib starting to go as I put weight on it and stopped! It went pop, but I thought I might have got away with it - no such luck, but I stopped it from being really bad. I cough all the time and it is just a matter of bracing myself, nothing too horrendous.

Jack, what causes the pop sound? Is something tearing or the rib actually breaking. I have been warned that my bones are now brittle from heavy steroid use. Is that part of your problem?