Hello and advice please

RavenGirl
RavenGirl Member Posts: 4
edited 27. Feb 2025, 08:17 in Living with arthritis

Hi, I was recently diagnosed with rheumatoid arthritis and put on methotrexate. I've only taken one dose so far but feel quite nauseous and have vomited once. Is this normal? I'm also a bit worried about work. I sit in a open plan area with about 18 others. Is this OK with the immune suppressants, or should I request a move to a smaller office space?

Thanks!

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Comments

  • Ponee
    Ponee Member Posts: 14

    Hi @RavenGirl, sorry to hear about your nausea! It's really common with Methotrexate. I've found taking the mtx before I go to sleep instead of in the morning leaves me with no nausea at all, basically sleep through it all. Make sure you take your folic acid too that will help.

    I work in a very small open plan area with about 9 other colleagues, unfortunately I do get the odd cold but if you're sensible and sanitise your hands and avoid getting too close to colleagues with a bug you should be fine. I've always got a mask in my handbag and do crack it out if someones really got the lurg. It's just whatever you're comfortable with :)

  • iwannerbeme
    iwannerbeme Member Posts: 31

    Hi @RavenGirl and @Ponee

    I have literally taken my first dose of methetrexate this morning. (9am) I havent noticed any side affects as yet. How soon do people notice them? I have been prescribed folic acid which I start tomorrow. I have felt a bit jittery today but I think its anxiety about taking it.

  • Ellen
    Ellen Moderator Posts: 1,921

    Hi @RavenGirl I see you've already had some replies to your queries. @Ponee 's experience with open plan working was particularly helpful.

    Many of our members take it at night before bed and some on a Friday so that they can rest more the following day. Have you (like @iwannerbeme ) been prescribed folic acid to take on non-Methotrexate days? It can mitigate some of the side effects.

    Others are moved onto the injectable version if the nausea really doesn't settle down in time in spite of your best efforts.

    My best wishes

    Ellen.

  • Ponee
    Ponee Member Posts: 14
    https://community.versusarthritis.org/discussion/comment/727722#Comment_727722

    Usually I feel nausea if I'm hungry just before lunch or mid afternoon. Eating something really hearty makes it go away (snacks unfortunately don't seem to work). Ginger sweets are great too, morning sickness sweets or queasy drops work a treat if you're struggling between meals.

  • frogmorton
    frogmorton Member Posts: 30,241

    I favour something super unhealthy and carby. Used to be cheese and onion pasties now it's vegan sausage rolls being vegan now.

    Also getting enough sleep has a HUGE impact on how queasy I do/do not feel.

    Best of luck

    Toni x

  • RavenGirl
    RavenGirl Member Posts: 4

    Thanks so much all. I have been given folic acid for the day after the methotrexate. The nausea is reducing now, hopefully next dose on Friday will be OK. I'll try the tip of taking before bed. Good to know that being sensible should mean I don't need to move office, but my work is very good and will help.

    Gosh this diagnosis is a lot to process. I've had bad hips all my life due to hip dysplasia and had first full hip replacement earlier this year and am on waiting list for second. Was really thinking after that my health issues would practically over so a real shock to find the aches and pains I'd been having were RA. I'm not even 50 yet! Still seems from reading up here that early treatment should lead to good results.

  • iwannerbeme
    iwannerbeme Member Posts: 31

    So pleased you are feeling a bit better.

    I agree. It is a lot to process.

    My own diagnosis was a shock in September. I was feeling really well after being a non smoker for 5 years and changing my diet to a much more healthy one . I got covid over Christmas last year, I seemd to recover quickly but then started having a lot of pain in my hips, by March I was in agony in my hands and feet. I saw a pretty useless Dr orignally and so only got reffered to rhuemy in August. I am hoping its still early enough. I ve been through "whats the point in eating right and giving up smoking for this" stage and resigned myself to the new reality, I think. I feel full of hope and will continue with my healthy lifestyle, its certainly not going to harm me and might even help with recovery. I am so glad I found this support group and its good to find people ahead of me as well as in similar situations. Well not good, I wouldnt wish this on anyone, but you know what I mean hopefully.

  • FlowerLady
    FlowerLady Member Posts: 6

    Hi all… if the nausea persists you can also have folic acid the day before methotrexate, & make sure these pills don’t sit in your mouth for too long swallow with milk or yogurt, I’m on Methotrexate & Tocilizumab injections both being immune suppressants personally I think we shouldn’t worry to much about who’s got what…. Good luck!

  • Arthuritis
    Arthuritis Member Posts: 521

    @RavenGirl @Ponee @iwannerbeme Whether or not you will get nausea with MTX depends on the dose and your weight.
    The way MTX works is by competing with folic acid which is needed for rapidly replicating cells ie, your marauding misguided T cell army replicating more soldiers to attack your joints. (Unfortunately they are not the only rapidly dividing cells in your body, your skin and hair, digestive system cells too. Unfortunately interference with digestive system cells produces side effects, noticeably nausea). Over time your body will adjust to shorten the nausea period, and as many have suggested, taking it at night, eg saturday night, let’s you sleep it off with folic acid on Monday to get to normal. You are only really vulnerable if your MTX dose is above 20mg for a weight of 70Kg (adjust up/down accordingly). I am at 25mg, and 70Kg, so can’t even take live vaccines. eg nasal spray types. However I avoid getting sick by using Vicks First Defence exactly as prescribed. It really works, even in a train carriage full of sick coughing people & winter bugs.

    There is also light at the end of the tunnel, I have just had a flare after a 2 year drug & symptom free remission, which let me do weightlifting for 2 years. It was great. I hope I get there again, however I flared on Jan 20 and going through the MTX process all over again, but with a “been there” mind set.

    Stay positive, keep going.

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