Goodbye Cytoxan! First dose of methotrexate is tonight. Any tips?

[SpaceflightAddict]

Hello everyone!

It has been far too long since I posted here... I started feeling better, and life resumed a somewhat normal pattern.

Anyways, the decision to switch to methotrexate came at my rhuemy appointment earlier this week. I have done plenty of reading about it here and elsewhere, so I pretty much know what to expect, but I am still a little nervous about the first time

The doc put me on 15mg of methotrexate once a week, and 1mg of Folic Acid every day.

I picked Wednesday night as my night to take it since I always have Thursday off of work. I am expecting to get some nausea, and maybe being a bit more tired than usual.

Is there anything else I should expect or worry about?

I would also love to hear any tips or tricks y'all have for dealing with the side effects of methotrexate.

Thanks so much!

-Andy

[Dirty Don]

Hey Andy, I've been on mtx for 2+ years now. I use the same dose you are starting on, hasn't changed. The folic is to counteract the mtx in the kidneys...but, as I found out, I lost hair at first, so doc tripled my dose of folic and it worked. I also experienced the nausea and ill feelings for a couple of days after, so doc split my dose in half, 12 hours apart...it worked, nausea went away...still feel a bit lethargic after my Saturday dose, but much better than at first. Best to you.

[renidrag]

Glad things are working out for You Andy, hope it continues.
Dale

[annekat]

Andy, I'm on the same dose as you and Don. Splitting the dose is definitely recommended. You can split it in half, or do as I do, take 4 pills at night, sleep through them, get up and take 2 more pills. I tried 3 and 3 for less nausea at night, and have gone back to 4 and 2 for less nausea the next day. I was recently complaining about the nausea after getting it from a new pharmacy that uses a different maker of the generic. But that seems to have worked itself out, and the last couple weeks, I really haven't noticed anything. 15mg. is a smaller dose than many take, and you will likely get used to it, or even be a lucky one who doesn't get the nausea at all. In retrospect, the side effects of the CTX were worse, for me, until I got used to it; of course I was a lot sicker then, so everything was awful! Congrats on getting off the CTX and moving to the next phase of recovery.

[SpaceflightAddict]

Thanks Don, Dale, and Anne!

I took the full dose at around 9pm last night.

So far I am not feeling any side effects at all!

I might get lucky on this one.

-Andy

[annekat]

Andy, I think you were smart, if you were going to take the full dose, to take it at night. I've also heard to take it with food, so maybe hve a little snack before bed.

[Pete]

Andy, I have a question for you: How long have you been off ctx? When I made the transition, I was off all immunosuppressants for about two weeks to allow the ctx to clear my system. Things went smoothly.

I take 25 mg/wk mtx and split into half doses on Wednesday morning and evening. I am a little tired on Thursdays, but nothing debilitating. I also take 1 mg/day of folic acid.

[SpaceflightAddict]

Andy, I have a question for you: How long have you been off ctx? When I made the transition, I was off all immunosuppressants for about two weeks to allow the ctx to clear my system. Things went smoothly.

I take 25 mg/wk mtx and split into half doses on Wednesday morning and evening. I am a little tired on Thursdays, but nothing debilitating. I also take 1 mg/day of folic acid.

Pete,

I specifically asked my doctor when I should start the MTX, she told me to start the MTX the day after I stopped the CTX, so there was no delay at all.

[annekat]

Pete, my doc lowered my CTX from 100mg. to 50mg. for a couple of weeks, I guess, while starting me on the MTX. That was his idea of making the transition while waiting for the MTX to begin to work. He is not a WG specialist, but in any case, it worked out OK for me. Some months later, the MTX dose was found to be too low, as I flared, so it was increased, and has remained the same since.

[NikkiNicole]

I started my MTX doses in pill form and was very nauseous. It would have been OK if I was off work, but I work in a high stress environment that requires my full attention and ... the nausea was making that difficult. So, I switched to injections.
I'm not real happy with those either. I do it once a week and for two and a half days, I feel awful, I can't even describe it. I'm lethargic and just feel "fuzzy" but ... I am better able to function than with the nausea.

Good luck. We are all different even with our similar disease!