nino, methorexate takes a long time to work. some people adjust easily
to the side effects over time, but some don't. i never did adjust. i
felt sick all the time from it, so finally gave it up. my doctor
switched me to enbrel at that time, and that worked wonderfully. your
brother should discuss this with his doctor to see what other options
there are for him. fortunately, there are several more for him to
try.

good luck,

diane

Often MTX will make you feel bad the day after you take it.  Well, right
after you take it, but most of us will inject at bedtime to sleep through
the worst of it.

I'll usually have a headache the first day and feel a bit queasy.  If I
remember to drink a couple of extra glasses of water, that takes care of the
headache right away.  Then I feel good (much better than I do without MTX)
for the rest of the week.  I'm retired so don't have to go to work on Monday
morning.  I take my shot on Sunday night.  Others will take it on Friday
night so they don't have to go to work on the off day.

For me the benefits far outweigh the side effects.

Jo