methotrexate side effect

**Jeff vinc** · 01-28-2012, 10:42 AM

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** · 01-28-2012, 10:46 AM

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** · 01-28-2012, 10:57 AM

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** · 01-28-2012, 10:59 AM

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

**Jeff vinc** · 01-28-2012, 11:14 AM

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** · 01-28-2012, 11:25 AM

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** · 01-28-2012, 01:49 PM

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** · 01-29-2012, 02:17 AM

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** · 01-29-2012, 03:02 AM

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.