Psoriatic arthritis and methotrexate

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janetv
janetv Member Posts: 3
edited 18. May 2025, 08:23 in Living with arthritis

HI everyone. I was diagnosed with PA in January after several years back and forth to my GP. I was put on methotrexate orally but have now switched to subcut due to nausea. I did initially feel better but now don't feel the metho is working at all. The fatigue is overwhelming and pain hasn't improved at all. Does anyone else feel like the fatigue is so hard? What else have people tried? I'm not due to see the consultant until August. Thanks in advance and lively to meet you all x

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  • jamieA
    jamieA Member Posts: 864

    Hi @janetv

    I think quite a few of us on MTX recognise the fatigue that it brings. In my case it's always either the day after or two days after that fatigue kicks in for me. I think the medics suggest that it takes up to 3 months for any of the drugs we take to have an effect. If you've been on MTX longer than that and your symptoms haven't improved I'd suggest you make contact with your clinic and ask to be seen. In my case whilst they were trying to find a drug that worked for me they supplimented the drugs with steroid injections to try to give relief. These normally worked for 4-6 weeks at a time. In my case it took about 11 months from diagnosis to finding a combination that worked for me. I'm on sulfasalazine, MTX and the adalimumab biosimilar Amgevita.

    I hope you get a working solution soon.

  • claudsl
    claudsl Moderator Posts: 214

    Hi @janetv and welcome to our online community.

    I have psoriatic arthritis too and I used to take methotrexate. It made me so sick and fatigued, I tried both the tablets and the injections but in the end I had to stop as I had no quality of life. I moved on to biologics and they are brilliant. I don't get any sickness and they are really effective with pain management. It might be a good idea to discuss this at your next appointment, or if you feel you can't wait that long perhaps give them a call to see if something can be done sooner. I know people who have no problems with methotrexate and it works well for them but it definitely didn't agree with me.

    Good luck and take care

    Claudia x

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  • Arciere
    Arciere Member Posts: 123

    hi @janetv

    I have a similar story to Claudia. So +1 for that.

    I would say do push for an earlier medication review, if you’ve been taking for 3 months already. The rheumatology advice line, if your hospital has one, might be better then a GP route.

    What I’ll also say is try to avoid making decisions about medication yourself. After methotrexate I was moved to sulfasalzine which I complied with for three months but after feeling so poorly and frustrated I took it upon myself to stop taking it and nit renew my prescription. This had an adverse effect because it was doing “something” and I became really quite poorly until I was prescribed a biologic. In the interim period I found oral steroids worked really well.

    Hope this helps and I promise you will find the right mix of medication for you in due course, it’s just the passage of time which frustrating.

    Hope this helps

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