Starting on methotrexate

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Deb123
Deb123 Member Posts: 19
edited 28. Nov 2013, 03:59 in Living with Arthritis archive
Evening all !!!

Am starting on meth hopefully next Monday. What is the starting dose? I know probably different for everybody but wondered what to expect.
I was taken off sulpha due to increased coldsores and mouth ulcers, from what I've read on here you still get them on meth. Should I be asking for folic acid from the start?

Would also like to share (as hubby not supportive with my Arthur and fibro) that after having a steroid injection on Wednesday I can now straighten my left arm pain free for the first time in 5 months !

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  • purpleowl
    purpleowl Member Posts: 231
    edited 30. Nov -1, 00:00
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    Hi Deb,

    so pleased that you have some relief from a steroid injection! :D
    I am on 10mg methx but it's for Psoriasis so probably not a lot of help but was started on 5mg.

    Hope it works for you,

    take care,

    Trish xx
  • As5567
    As5567 Member Posts: 665
    edited 30. Nov -1, 00:00
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    Everyone starts of meth differently.

    I have always started off on a small dose and built it up week by week, I don't remember the exact dose but I think it was 7.5mg?

    Side effect from meth are different for everyone, to begin with I did get some mouth ulcers but they settled down after a few weeks. I sometimes feel tired the day after taking the meth so I try to take it on a day where I'm not so busy the day after. I also find taking it at night helps with the tiredness. Also regarding the folic acid you would be best off asking your doctor about that.

    Great news on being able to straighten your arm pain free for the first time in 5 months!
  • dibdab
    dibdab Member Posts: 1,498
    edited 30. Nov -1, 00:00
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    Fantastic news about the arm-hooray for steroids :D

    I started meth on 7.5mg, which I split through the day with meals to lesson tummy upsets. You will probably be offered folic acid as standard-my rheumy nurse said it's recommended for everyone taking meth.

    Hope it works for you.

    Deb x
  • stickywicket
    stickywicket Member Posts: 27,710
    edited 30. Nov -1, 00:00
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    I don't think there is a 'normal' starting dose. I know I was rapidly onto 20mgs and a bit miffed when he wanted to shove it up to 22.5 as I felt rather good on 20. Many years later, I'm now down to 12.5.

    They should offer folic acid but, if not, make sure you get some.

    I hope it works for you :)
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
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    With tablet meth I began on 7.5, increased after a while to 10, then 12.5. I had to stop due to developing a rash on my forearms; I wasn't bothered by it (I had chronic eczema as a child and this was mild in comparison) but my rheumatologist thought otherwise. I am now on the injected form which is set at 15mg. Good luck, I hope it helps you as much as it does others on here. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • Mat48
    Mat48 Member Posts: 1,075
    edited 30. Nov -1, 00:00
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    Folic Acid is a must with Meth. I started at 7.5 with weekly monitoring for a the first month and then moved up the doses very slowly. My liver played up a lot so they took it slowly. I tried Sulfa first too but got very ill and had to stop it. I had 19 months on Methotrexate and never got ill in that way on it - they are completely different DMARDs and just because one gives you mouth ulcers it doesn't mean the next one will. I switched to injections which were much better for me. I hope it works wonders for you. Mat x
    If you get lemons, make lemonade
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
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    Everybody is different in how they react to the meds. I have been on sulph for eleven years and have very little trouble with it, the same with the injected meth. I am prescribed FA (5mgs per week) but often forget to take it because I am not struggling with the drugs in any noteable way.

    It takes time for each of us to establish how we react and cope with the drugs we are given, so please ensure you have your bloods taken on a very regular basis (mine were done fortnightly for years) because they will give a regular feedback on what is going on with you. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • DebraKelly
    DebraKelly Member Posts: 398
    edited 30. Nov -1, 00:00
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    I have been on Meth for 4 years now (currently off it at the moment).

    You should be given folic acid as a matter of course with Meth, please make sure you get some.

    You will feel very tired at the start of taking Meth, but this will go away over time.

    Meth takes about 6-8 weeks to get into your system properly so don't panic if nothing happens straight away.

    You also have the option to switch to Meth injections, which is what I did, and they do work better than the tablets.

    If you have questions about Meth please send me a PM.

    PS - also have mints on standby this will reduce you feeling sick.
  • dippydoodah
    dippydoodah Member Posts: 350
    edited 30. Nov -1, 00:00
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    i was put on meth, on 10mg to start with but it was increased to 20. unfortunately it didnt work for me and after a year, they had to stop it and try me on sulfa but that didnt work for me either. i didnt feel ill on the meth it just didnt have any affect/effect (?) on me and there was considerable change in my xrays over the year. they should put you on folic acid straight away and monitor you with bloods, as others have said. i had mine done every 2 weeks for a year.

    brilliant news about the injection though. 'pain free' are such wonderful words to hear :)

    good luck on the mtx x
  • gemmarh100
    gemmarh100 Member Posts: 73
    edited 30. Nov -1, 00:00
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    Hello, glad to hear the steroid injection helped....I had one today too - "snap" haha :lol:

    Like everyone has said, MTX is different for everyone, I was started on 5mg then gradually upped the dose. You should be well monitored whilst on MTX, and you will probably be offered Folic Acid at some point.

    I have now been transferred to MTX injections, as I was getting bad nausea at the higher doses of MTX (but this only happens to some, and usually subsides).

    Let us know how you get on :)

    Gem X
  • maria09
    maria09 Member Posts: 1,905
    edited 30. Nov -1, 00:00
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    Hi
    I was put straight on 20 mgs with folic acid daily except on methotrexate day
    It can take up to 3-4 months to work
    It didn't work for me so was change to Metoject at end of August and by middle of October it had kicked in and although I still have pain but its much improved and I'm cutting down on my tramadol
    As we are all individuals what works for one may not work for another and it's really trial and error until the right dose and right drug is found for us.
    I hope it works for you and you start to feel some benefit soon
    Maria