Hello anybody, I'm currently on 6 , 2.5 milligrams of methotrexate once a week, so far they are not working.

I've been on them 4 months , hands ,wrists knees shoulders and elbows still in pain . How many tablets does it take to work ?



  • Brynmor
    Brynmor Member Posts: 1,755

    Hi Brian and welcome to the Community.

    Methotrexate can take quite a while to start working, so it may be 3 to 12 weeks before you start to notice any difference. However, I would have thought that there would have been some change after 4 months. It may well be worth trying to get an appointment with your doctor to discuss your progress.

    We have a great page of information on methotrexate that you like to take a look at:

    Do join in across the Community, ask questions, call in for a chat and also to let us know how you are getting on.

    All best wishes


  • dreamdaisy
    dreamdaisy Member Posts: 31,520

    That is a very small dose so it may need to be increased. What are your bloods showng and what are you hoping it will do? I've taken meth for years, with other meds too; I currently inject 15ml per week and it is controlling disease activity. DD

    Have you got the despatches? No, I always walk like this. Eddie Braben
  • Brynmor
    Brynmor Member Posts: 1,755

    Hi @dreamdaisy When starting off on the course of medication, Methotrexate tablets come in two strengths: 2.5 mg and 10 mg. To avoid confusion, it’s recommended you only be given one strength, usually 2.5mg.

    Dosage is then reviewed after a period of time depending on the outcome until an optimal level of control is reached. 😃


  • 2151ellis
    2151ellis Member Posts: 2

    Stick with it, my dose is 8 x 2.5 mg once per week, with daily sufazalazine intake.

    It took ages 8 months plus to feel definite improvement. My Consultant was just about to move me on to the next stage which was going to be injections of a drug I can’t remember the name but it was a biologics drug that had to be injected once a week. (Entercept I think).

    Luckily my pain had resided to a level where I no longer needed painkillers. Also my blood tests showed a marked improvement. So just letting you know that sometimes it can be a long time before you get any relief. I realise that it’s not the same for everyone and just go with the advice of your medical team.

    Hope you get relief soon, Vernon

  • chrisb
    chrisb Moderator Posts: 677

    Hi @2151ellis,

    Welcome to the forum. I see that you joined some time ago but this is your first post.

    Please feel free to contribute to any post on Living With Arthritis and other forums. Also, feel free to start a new one there, if you have a question, clearly titled so that others can easily see what you'd like to talk about.

    Best wishes

    ChrisB (Moderator)

    Need more help - call our Helpline on 0800 5200 520 Monday to Friday 9am to 6pm

  • MrDJ
    MrDJ Member Posts: 276

    another one here on 20mg (8) a week as well as 2 sulfasalazine a day and dihydrocodein for the pain also 2 anti inflamatory ibrufroben. to add to that im on 6 weekly anti tnf infusion. been on these for 22 years now.

    after 4 months i would of thought it should be showing some improvement by now. as asked, are you having regular full blood count especially esr and crp. these are the main markers for inflamation. have you also been prescribed folic acid as well?

    ask your doctor or gp for a copy to keep an eye on if the readings are going down. mine started off at 122 and 96. they are both below 10 now but i still have pain. you may need additional pain killers or anti inflamotary drugs as well.

  • TUL50
    TUL50 Member Posts: 19

    I am going to persevere with methotrexate, because I had my first proper dose this weekend. The net result was a fever of 38.7 for a few days. I don't know if the medication caused this, but I am changing the day I take it, so I don't have to take any more time off. It was scary though, because I felt like I did when I had chemo poisoning and that is not a good sign. Anyway, I will try again next week and see if I go without any major side effects. If it happens again and the fever lasts 72hrs, I have to contact medical help.