Methotrexate Side Effects

Hello all

I have read many articles and comments about the side effects of this medication, but I can't find anything regarding my query and wondered if anyone on here can help ...

I started on Methotrexate 15mg for the first 2 weeks - then up to 20mg - in total I have been taking the medication for 6 weeks now and just started with the side effects - nausea, tummy upset.

I thought the side effects were supposed to calm down after your body adjusts rather than start-up. Has anyone else suffered from no side effects for the first 6 weeks and then appear after this time?


  • pisica
    pisica Member Posts: 19

    I had a little nausea to start with, which went away for a while but then came back with a vengeance after about 10 weeks. Around that time, I also had a pretty bad flare, and my GP and Rheumatologist thought I probably wasn't absorbing the methotrexate properly. I was switched to injections, which has reduced the nausea a lot, and put on Ondansetron that I take three days per week. It's not ideal, but the nausea is now a background thing I can mostly ignore for 2-3 days, rather than a constant presence for about 5 days a week.

    Long story short, it's worth mentioning to your Rheumy. They might be able to offer anti-emetics or a switch to a different formulation.

  • stickywicket
    stickywicket Member Posts: 26,619

    it might be the increased dóse. Take it with food. Some find taking it at night helps. But, in the final analysis, ring your rheumatology team.

  • frogmorton
    frogmorton Member Posts: 27,386

    Definitely try taking it with food I agree with Stickywicket. Some of us take it before bed so some of the worst side effects are 'slept off' and I remember someone was it @lindalegs ? saying fish and chips helped her!

    How many days a week are you taking your folic acid?

    I hope it settles but if it doesn't maybe you will need achat with rheumatology?

    Take care

  • ElsieBoo
    ElsieBoo Member Posts: 3

    I have a consultation coming up and will discuss it with my consultant, but thank you all for your recomendations.

    I take my folic acid tablets 6 days a week. I just thought it strange that I had gone 6 weeks with no side effects and then in the middle of the night it took me by surprise.😕

  • lindalegs
    lindalegs Member Posts: 5,425

    Hi ElsieBoo,

    It's a long time since I was on Methrexate but I know it helped me a lot initially. My problem was sickness and I found it wiped a day out for me with spending it in bed every Friday! If I remember I took my weekly dose on a Monday. This didn't subside over time for me so I was taken off it and then, as I'd failed two Dmards, my rheumy put me on Enbrel (now Benepali) and I have had no noticeable side effects from this. I do think taking it at night might be worth a try as @stickywicket suggested but discuss it with your rheumy anyway.

    Toni ( @frogmorton ) I could well have suggested the fish n chips as they are my favourite meal forever!


  • frogmorton
    frogmorton Member Posts: 27,386

    I thought it was you @lindalegs 😂

    @ElsieBoo taking folic acid 6 days? Apart from taking it before bed and eating savoury, getting plenty of rest the following day I don't have any other suggestions.

    Might have to be a chat with rheumatology if it doesn't settle ((()))

  • cola
    cola Member Posts: 6

    Hi, yes I found the same, after a few months I had bad sickness. So much so that I lost a few weekly doses down the toilet! I tried spreading out the pills across the day but just felt awful all day and taking at night. I started to get a real phobia about taking any pils....

    My doctors wanted to give anti sickness pills which obviously wouldn't of worked (just another pill) but Rheumatology changed me to injections and within a couple of weeks the sickness stopped. Defo speak to the hospital. Good luck

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