how long does methotrexate start to work

Locarno Member Posts: 10
edited 28. Nov 2023, 14:08 in Living with arthritis

I have been on it 9 weeks, still enflamed joints, hand shoulder ankle. There is no support from the NHS I was told thats how it is now. Not helpful. My inflammatory arthritis has not name so not sure where to go for help.


  • Anna
    Anna Moderator Posts: 927
    edited 16. May 2022, 15:32

    Hi @Locarno and welcome to the online community,

    You’ve had a diagnosis of inflammatory arthritis and you don’t feel that the NHS is giving you much support. You’ve been taking methotrexate for eight weeks but you haven’t had any improvement yet and you wonder how long it will take to work.

    Ive checked the Versus Arthritis page on methotrexate and it says that it can take up ton12 weeks before you will notice a difference, so hopefully you’ll soon start to feel a bit better. Here’s the link below where you can read more about the drug:

    I’m not sure how long you’ve been diagnosed, but it’s very natural to feel overwhelmed at first as there’s such a lot to take in. You might also find the page below useful. It talks about how to come to terms with your diagnosis:

    Everyone in the online community has experienced living with arthritis and I’m sure many of our members understand how you’re feeling. Do have a look round the forums and you’ll find other people who have shared their story and also give helpful tips and advice on living with their condition. You could start by browsing the posts on the Living with arthritis forum and do join in any conversations where you feel comfortable.

    Anna (Mod)

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

  • Caleb1981
    Caleb1981 Member Posts: 33

    Hi @Locarno,

    I understand your position, I too am about 10 weeks into my Methotrexate ‘journey’ and not really sure if it’s doing anything, but I’ve set myself a target of 1st September to see how things are, with respect to benefits vs side effects. I also opted for a very slow ramp up to my target dose, so I expect the process to take longer.

    I also understand your position with respect to lack of support, although I only recently started Methotrexate, I’ve had active arthritis for close to 10 years - the lack of support from my local rheumatology department, played a small part in my decision not to go on DMARDs at an earlier stage. Reading through other peoples posts and some of the replies I’ve had, on here, suggest that they have supportive rheumatology departments and helplines.

    I’m not even sure if there is a rheumatologist within my local health board as the last one (a locum), retired about 2 months ago and on the odd occasion that I’ve contacted the nursing helpline, they call back after 3 to 4 days appear annoyed at having to do so, they don’t give to any time to discuss your concerns - they generally dismiss them and can’t wait to get rid of you.

    On a positive note, I have genuinely found that this forum and the Versus Arthritis website to be supportive and informative, the hours I spent reading throughout chats and information pages, helped my settle on, not only trying Methotrexate, but staying with it (when I had doubts in the first couple of weeks).

    I hope it can do the same for you 🤞🏻.

    I am starting to believe that mindset plays a huge part in this process.

    I hope things start to improve for you soon and you get the support that you are looking for.

  • jamieA
    jamieA Member Posts: 661

    Hi @Locarno

    Unfortunately MTX doesn't work for everyone - I've seen medical sites quoting 40-50% of those prescribed for inflammatory arthritis get significant relief. This is a quote from the American Healthline publication on the subject of MTX ;-

    'According to the National Rheumatoid Arthritis Society, more than half of people taking it see a 50 percent improvement in the course of their disease. And more than one-third of people see a 70 percent improvement. Not everyone will find relief with methotrexate, but it works better for more people than other DMARDs.'

    I was prescribed 3gms/day sulfasalazine first for 3 months which didn't work, then MTX was added initially at 10mgs, then 15mgs then 20mgs for 6 months. That didn't work either. I was eventually put on an Adalimumab biosimilar - with 10mgs MTX weekly and 3gms per day sulfasalazine as the medics said they would work in conjunction. That has worked.

    I think you need to keep in contact with whoever prescribed MTX and make them aware if it isn't working. I've learned over the last 18 months that I need to be firm in my dealings with medics I see and make them aware of my condition at that time. Of all the medical texts I've now read the fact that early intervention is crucial really stands out.

    If you don't get a satisfactory response I'd suggest you put your complaint in writing as it's then added to your records.

    I hope things work out for you soon.