methotrexate not working yet

salamander

Can anyone tell me how long it took for methotrexate to kick in for them? I've been on it since beg January and had two week break early on when had an infection. Surely it should be working by now? Am getting really fed up with constant pain and swelling.

jaspercat

salamander wrote:

Can anyone tell me how long it took for methotrexate to kick in for them? I've been on it since beg January and had two week break early on when had an infection. Surely it should be working by now? Am getting really fed up with constant pain and swelling.[/quote

Hi, it usually takes up to 12 weeks for it to start to work, although it took longer with me, I suggest talking to your Rheumy nurse if you are worried love Jaspercatxx

dorcas

jaspercat wrote:

Hi, it usually takes up to 12 weeks for it to start to work, although it took longer with me, I suggest talking to your Rheumy nurse if you are worried love Jaspercatxx

Hi Sally!

I agree with jaspercat...chat it over with your rheummy if you're worried or just need a bit more info. sometimes the dose needs adjusting until you get to the optimum effective dose for you as an individual...that's how it was for me. We are all different and what works/ dosage for one doesn't always work for another. keep your chin up! hope it does eventually give you relief from that blighter arther!
Iris x

lizzie7ne

Hi, it took about two months before I felt the slightest benefit, after three months felt a lot better, I started on a small dose and worked up to 25mg a week.

I definately think its worth having a chat with your Rheumy or Rheum nurse, do you have a helpline you can ring. It may be that the dose needs to be increased or it may be the stopping of it for the infection may have slowed things down a bit, also its worth remembering that it can take us longer to get over the effects of an infection, also if you are like me, my RA loves an infection, it goes into full flare a couple of weeks after, then it takes a good while for it to settle. Although Methotrexcate improved my RA a lot I still needed another drug added to bring about better control. So there are lots of different factors involved, which your Rheum department could guide you on.

Lizzie

salamander

hi, good advice from all of you, thanks. I did ring my rheumy nurse on Thurs but her mailbox was full and her bleep 'absent.' I left a message with consultant's sec but nothing from them either. Am still on steroids, though low dose and think that is the only thing keeping me mobile. Every time I drop down (1mg every 2 weeks) I flare up badly. Very difficult to plan anything as feel so tired all the time as well. I will talk to someone next week but it's proving a hard weekend to get through!
xx

colinone

hi
12 to 16 weeks but hey i'm told where all different lol
should kick in for you soon.
Colin

salamander

thanks Colin, sincerely hope you are right! Life is getting very tedious as it is.

fourferrets

I still get fairly frequent flares even being on MTX, maybe you are going through one?

salamander

fourferrets wrote:

I still get fairly frequent flares even being on MTX, maybe you are going through one?

Do you really? Don't they want to increase the dosage? Maybe you are right and I am.

fourferrets

I was supposed to up the dosage to 8 tabs but I feel so sick taking 6 that I cannot face an increase. I've been taking MTX for 2 years, I get less severe flares now than I used to but still get them.

If I take a break for a week or 2 then I soon wish I hadn't!

salamander

8 sounds like a huge dose. I am only taking 7.5 - maybe not enough!! My lovely gp, when she retired, said not to let them put the dose up too much! Those were her parting words.

annie_mial

Sally, I'm on the top dose of 10 tabs.......25mg. But I still have pain and discomfort and I fully expected to - MTX isn't a pain killer or anti-inflammatory, it's intended to slow down and possibly stop the progress of the disease.

Having said that, the pain now is not nearly as bad as 6 months ago when I first started it.

One of the reasons I was put on it was to reduce the steroid dose (and perhaps stop the Pred completely) but when I had the severe chest infection in January I had to put it back up again to 30mg daily.

In spite of the MTX I am struggling badly with reducing the Pred, and still on 17.5, although hoping to get down to 15 soon.

Is it possible that your dose is still too low for you feel any benefit?
I was started at 12.5 in the hope of getting a quick response.

Annie

salamander

hi Annie, I've been led to believe by both consultant and GP that the inflammation and swelling, and hence the pain, should go. I know the drug is not a anti inflammatory, as such, but that should be the effect of it, apart from the occasional flare up. I'm also on steroids, which is suppressing the disease to some degree (on very low dose now.) I am borderline in terms of the 12 weeks - actually my consultant said 10 doses should do it - and am impatient to get a better quality of life as I still can't do very much. I am surprised that you expected to still be in discomfort after 6 months on the drug.

annie_mial

Now that surprises me and shows the difference between consultants!

When I first saw the Rheumy last September it was clear that whatever-I-had (at that point undiagosed) was very aggressive. I know she wanted to slow down the progress first and see if I could get off the Pred second.

It's certainly done the first as far as I am concerned - in spite of the extreme weather and the other problems I had earlier in the year (which caused a massive flare) I am so much better now than last Autumn.

Not at any point did she give me the impression that I would ever be pain free - in fact she pointed out more than once that it wasn't a pain killer and that additional help with pain would almost always be necessary. In fact when the weather got a little warmer I was able to go three days with no painkillers at all.

As far as the inflammation goes, I have several different factors all playing a part in this and I think their combined efforts are still winning! But I'm hoping with some more warm weather and the full MTX dose kicking in, that we will win the war!

Annie

salamander

annie_mial wrote:

Now that surprises me and shows the difference between consultants!

When I first saw the Rheumy last September it was clear that whatever-I-had (at that point undiagosed) was very aggressive. I know she wanted to slow down the progress first and see if I could get off the Pred second.

It's certainly done the first as far as I am concerned - in spite of the extreme weather and the other problems I had earlier in the year (which caused a massive flare) I am so much better now than last Autumn.

Not at any point did she give me the impression that I would ever be pain free - in fact she pointed out more than once that it wasn't a pain killer and that additional help with pain would almost always be necessary. In fact when the weather got a little warmer I was able to go three days with no painkillers at all.

As far as the inflammation goes, I have several different factors all playing a part in this and I think their combined efforts are still winning! But I'm hoping with some more warm weather and the full MTX dose kicking in, that we will win the war!

Annie

Yep! With you on that! I don't think mine is as aggressive as yours, even though it struck with a vengeance, but I've never been without pain. My rheumy is leaving to do research so it will be interesting to see what the new one says. I was upset initially that he was leaving but, as someone said to me, you might get somebody better!
xx

joyful164

I have been on MTX for nearly 3 years now. It took about 3 months to properly kick in, but in the meantime, my rheumatologist arranged a steroid injection to help it along.
I have had numerous flare ups since being on it like others, this is not a complete cure. But it does help to stop the disease getting any worse. Everyone is different on the MTX andthese are early days. Try to be patient. Your rheumy nurse and consultant will soon realise whether you are benefitting by your 2 weekly/monthly blood tests.
If you did have an infection and you are antibiotics, you should have been told to curtail your MTX until you are off the anti's. Sometimes, if you are on tablet form, there is a possibility that your stomach is not sending out the MTX efficiently. This happened with me and I had to go on injection form. Very much a trial and error in the first 3 or 4 months.
It sounds like you have problems with contacting your rheumy nurse like I do.

Hope this helps, but do talk it through with your nurse. There is so much to take in at the moment for you and try and get some rest.
I'm a good one to talk, I never rest like I am suppose to.

Joy

skezier

Hi Sally,

Firstly a ((( ))) and the other thing I started mtx recently and the Rumo told me that it can take up to 3 months. I hope you start to get some improvement soon and how are you apart from the bones? Cris x

salamander

Hi Joy, thanks for your very useful post. I guess am just getting impatient now. Just got to hang in there. My bloods have always been reasonably ok, one of those tricky people with good bloods and grotty joints, rheumy said there was quite a lot of swelling on my last visit but said steroids masking inflammation so it doesn't show up. I will bear what you've said in mind when I see someone next - no idea who though!

Thanks for the hugs Cris. Feel a bit better this evening but have been really down in the dumps over the past few days. Trying to be positive and succeeding at times, helped to get out in the garden today but did too much gardening of course!
How are you?xx

skezier

Oh Sally sorry you have been down, another ((((( ))))) and a hope it will all get easier and better for you soon. It can be hard to stay positive flower and none of us can do it all of the time.

Me well I also have been struggling a bit :roll: For me its the eyes and the crohn’s that get to me....... mind the crohn’s goes for the back every time! Hey don't know about you but I really hope the mtx works quickly, in my case its got 3 known things and who knows what else to sort out Sally I think I just fell apart somewhere

You take care and fingers crossed for you and another ((( ))) Cris xx

salamander

skezier wrote:

Oh Sally sorry you have been down, another ((((( ))))) and a hope it will all get easier and better for you soon. It can be hard to stay positive flower and none of us can do it all of the time.

Me well I also have been struggling a bit :roll: For me its the eyes and the crohn’s that get to me....... mind the crohn’s goes for the back every time! Hey don't know about you but I really hope the mtx works quickly, in my case its got 3 known things and who knows what else to sort out Sally I think I just fell apart somewhere

You take care and fingers crossed for you and another ((( ))) Cris xx

Thanks Cris, very kind of you, esp with all the things you've got going yourself. What's the prob with your eyes? I didn't about them.
I've just hit a wall - mostly of frustration and anger about my situation. Bound to have happened. Feel a bit better this morning. I guess the mtx must be working a bit as I am on low dose steroids and, although in pain, not completely incapacitated. I suppose thought it would be more effective. I know one woman who now has no symptoms at all! Also, reassessing life, always a dangerous thing Take care Cris.

thanks everyone for your support.
xx