Side Effects of Methotrexate

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Queenie - 04 Aug 2007 13:29 GMT

I am taking Methotrexate for Psoriatic Arthritis & am experiencing
extreme nausea. I have just swithched to the injectable form and it is
worse. Any ideas remedies for counteracting this unpleasant side
effect?

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Harvey R. Stone - 04 Aug 2007 14:39 GMT

>I am taking Methotrexate for Psoriatic Arthritis & am experiencing
> extreme nausea. I have just swithched to the injectable form and it is
> worse. Any ideas remedies for counteracting this unpleasant side
> effect?

With some people it is something that your body has to get used to. Methx.
is the prime medicine for PA and will give you the best results. The
injectable type is the most effective because with the pill form some of it
lost going through the gut. I took Methx for 7-8 years for RA and usually
a person has to see how your liver is going to react to it.
What dose did your doctor start you out at?

Harv

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Diane - 04 Aug 2007 15:37 GMT

did your doctor also prescribe leukovorin (folic acid)? that should
help. I was on methotrexate for a couple of years (low dose,
injectable) and unfortunately i always had a low level nausea on it.
for most people, that goes away, esepcially with the folic acid. talk
to your doc about it and i hope you can adjust to it.

diane

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nanny - 06 Aug 2007 05:53 GMT

Ditto on the folic acid. When my doctor prescribed MTX, he also prescribed
folic acid, as he said the MTX depletes the folic acid in our bodies. Nanny

> did your doctor also prescribe leukovorin (folic acid)? that should
> help. I was on methotrexate for a couple of years (low dose,
[quoted text clipped - 3 lines]
>
> diane

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jofirey - 04 Aug 2007 15:29 GMT

Maybe. Most of us take the injection right before we go to sleep for the
night, so we can sleep through the initial nausea. First day after can be
queasy stomach and a headache. Drinking extra water will usually kill the
headache.

And you are taking lots of Folic Acid with it right?

Jo

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Alix - 05 Aug 2007 18:12 GMT

I also take mine at night so I don't get the queasy, off kilter feelings so
bad. It seems to work best that way and with the folic acid!!

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Alix

Be humble. Trust always and a great deal in divine Providence; never never
must you let yourselves be discouraged, despite contrary winds. - Saint
Pauline of the Agonizing Heart of Jesus (1865-1942)

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Adelle - 06 Aug 2007 15:22 GMT

>>I am taking Methotrexate for Psoriatic Arthritis & am experiencing
>> extreme nausea. I have just swithched to the injectable form and it is
[quoted text clipped - 7 lines]
>
> And you are taking lots of Folic Acid with it right?

Hi, Jo;

I'll be starting mtx this weekend. RD's starting me on 10 mg. oral dose, to
go up to 14mg after few weeks; 5 mg folic acid 12 hrs later. Any words of
advice, other than taking it before bed? Food in stomach (with reflux, that
means staying up for three hours after food)?

Anyone take mtx and plaquenil? RD wants to keep me on latter until mtx is
on board and working. He also said that most of these meds work better in
combination and I may get better result if I stay on both, than one alone.

Adelle

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Joan Carter - 06 Aug 2007 16:12 GMT

On Mon, 6 Aug 2007 10:22:30 -0400, "Adelle"

>I'll be starting mtx this weekend. RD's starting me on 10 mg. oral dose, to
>go up to 14mg after few weeks; 5 mg folic acid 12 hrs later. Any words of
>advice, other than taking it before bed? Food in stomach (with reflux, that
>means staying up for three hours after food)?

When I started MTX I took it in the morning, with food. Also
started 5 mg. of Folic Acid daily at the same time. Never had
side effects. I now take 20 mg of MTX weekly by injection.

>Anyone take mtx and plaquenil? RD wants to keep me on latter until mtx is
>on board and working. He also said that most of these meds work better in
>combination and I may get better result if I stay on both, than one alone.

I take both, have for quite a while. I see an ophthalmologist
every six months because of the Plaquenil and never had problems
with it either. Hate having those visual field tests though.

Joan

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Adelle - 06 Aug 2007 16:32 GMT

> On Mon, 6 Aug 2007 10:22:30 -0400, "Adelle"
>
[quoted text clipped - 18 lines]
>
> Joan

So glad no side effects. With my pre-existing GERD, am a little
trepidatious.

Interesting - your reaction to the field test. I found it fascinating. The
again, I used to love being a guinea pig for testing during college. Had to
volunteer for a couple of tests a semester as part of psych 101/102. Wasn't
paid - but had fun.

Adelle

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Nann Bell - 11 Aug 2007 22:44 GMT

> On Mon, 6 Aug 2007 10:22:30 -0400, "Adelle"
>> Anyone take mtx and plaquenil? RD wants to keep me on latter until mtx is
>> on board and working. He also said that most of these meds work better in
>> combination and I may get better result if I stay on both, than one alone.

I took both for a while, even along with sulfasalazine. We finally dropped
the plaquenil and SSZ when we added arava. sometiems I feel like I need a
flow chart for my DMARDs! lol

Anyway, aside from fatigue from the mtx and tinnitus from the SSZ, I was fine
with the combo. My immune system saw it as a challenge though, rather than a
control.

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jofirey - 06 Aug 2007 17:45 GMT

>>>I am taking Methotrexate for Psoriatic Arthritis & am experiencing
>>> extreme nausea. I have just swithched to the injectable form and it is
[quoted text clipped - 20 lines]
>
> Adelle

Sorry, GERD is the main reason I take the shots and not the pills. I think
I'd try the pills three hours before bed along with something easy on the
stomach to eat.

Jo

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nanny - 07 Aug 2007 02:11 GMT

Adelle, yes, I take these 3 in combination: MTX, Folic Acid, and Plaquenil.
Nanny

>>>I am taking Methotrexate for Psoriatic Arthritis & am experiencing
>>> extreme nausea. I have just swithched to the injectable form and it is
[quoted text clipped - 20 lines]
>
> Adelle

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Kelly - 04 Aug 2007 23:33 GMT

Make sure your doctor knows for one thing. Others have given you good tips
but I must stress that the water the day before, the day and after is
important for me. Also taking it before bed helps. Folic acid or for me
leucovarin is a must taken 12 hours after in my case. Some doctors will
divide up the dose by a day. What dose are you taking?

The other thing is sometimes the side effects go away after a bit. The
first time I took it I had nausea and horrible headaches. This time he
started me on 2.5 for 4 months, 5 mg for 5 months and now I am on 7.5 mg.
No problems at all. My body just seemed to need to go slowly (we stopped
the time before do to more serious side effects but those have not happened
this time.)

Stick around - hopefully some of this has helped.

Kelly

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jofirey - 05 Aug 2007 02:21 GMT

> Make sure your doctor knows for one thing. Others have given you good tips
> but I must stress that the water the day before, the day and after is
[quoted text clipped - 12 lines]
>
> Kelly

I want to add, this group helps long term not just short term. I can rattle
off the side effects of MTX and ways to prevent some of them.

But more than once I've been sitting at the computer on a Monday, with a
nagging headache. Read something here and DUH! Go drink a glass of water
and headache gone.

Jo

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spodosaurus - 05 Aug 2007 18:31 GMT

> I am taking Methotrexate for Psoriatic Arthritis & am experiencing
> extreme nausea. I have just swithched to the injectable form and it is
> worse. Any ideas remedies for counteracting this unpleasant side
> effect?

Ask your doctor about using Zofran as needed.

Ari

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