Kickas.org Forums Rheumatoid Arthritis General Discussion #1 RA Web Support Group Increasing methotrexate dose

Hi mom2many - I think you're probably right about doses lower than 5mg. My symptoms became noticeably worse after a few days on 4mg and worse again on 3mg. My plan was to taper off entirely if the mtx was working so the 3mg was just a step en route and not intended to be a therapeutic level.

I was taking folic acid daily but when I began to suspect that mtx might not be working, I also dropped the folic acid for a few weeks to check that it wasn't interfering. Seemed to make no difference. Now that I'm going to increase the dose again, I will go back to taking folic acid at least to start with. Don't want to risk side effects if at all possible.

Well, at least I've figured out why today has been so bad. I was getting quite worried - both knees are really swollen and my wrists have got so bad, I couldn't even consider playing the piano and typing has been painful. Just discovered I didn't take my celebrex this morning. I've done this before when I dropped it on the floor but this morning it had got jammed in my little pill box. I decant a week's meds into the daily compartments of my pill box because I'm taking so many it's the best way of staying in control. Didn't notice that the celebrex, which is a capsule, so long rather than round, had jammed and when I tipped out the little pile to swallow them this morning, it stayed behind.

Just figured it out when I went to get the evening dose!!!

I'm a bit relieved because now I know I won't be quite as bad as this tomorrow.

That's happened to me, too. I have 2 pillboxes to cover 2 weeks of meds and refill it every 2 weeks.

one morning i found my muscle relaxant in the pocket of my robe the next morning, another time in my pants pocket. doesn't happen often, but explains why i don't feel its effect.

but always good when feeling bad is from not taking the med, rather than from something else. at least its an easy "problem" to fix.

I've heard that mtx can take up to 6 weeks to take effect. Dosage changes also take a few weeks... I only take folic acid on the day before/day after my mtx dose. For me it definitely helps - I had a spate of mouth ulcers at one point making life uncomfortable (which I also used to get pre-mtx, although these were worse) - increasing the folic acid dose fortunately sorted out that problem and I think it's now been over a year since I had one!

I don't know the doses. It has been too long since I took it but my hubby is sticking with 8 pills daily right now. He thinks it is helping him. He had to be off of it during the surgery activities.

I hope you feel better soon Wendy.

You are too sweet to hurt.

Hugs.
Possi

I am going back on Imuran. I took it 9-10 years before and had to go off of it to try the Remicade. Wish I had stayed with it.
I am down to 3 mg. Pred. Next week, I go to 2 mg. My joints are so much worse but I am determined since my intestines are so thin because of them. I have taken steroids for many years lots of times at 60 mg. and even 100 mg. solu-medrol in the hospital. It is tough on a person. I have been told that your body makes 7 mg. Pred. Still it is so tough to get off of it.

Just throwing in my little bit about the Imuran.

Hugs to you all.
Possi

Hi Possi,

When I went to the Doc it was clear that the mtx wasn't working because my ESR and CRP were up so we agreed to increase the mtx. However, I was getting so bad that we decided to up the prednisone again while waiting for the higher dose of mtx to kick in. I'm planning to stay on about 6mg, low but hopefully just enough. To kickstart the improvement I'm doing a taper: 3 days on 10 mg, 3 days on 9 mg, I'm now down to 8 mg. I'll keep going down every three days until I get to 6mg again. I'm not worried about doing it slowly because I haven't been on the higher levels for long enough to worry. So I never got below 3mg.

I have to say, I could sing for joy that my pain levels are back down in the 4-5 range again!

Wendy,
Hi. I hope you are feeling better.
My blood tests were fairly normal, but it showed that my uric acid was "quite high". But He said, You donot have "gout". Never before has my uric acid been high, never in my life. So I am wondering what chang is going on. Any ideas.
I am ready to go on one of the big guns. My best to you and I hope your body is ready to let you have a good Spring and Summer.
agape'
Lon

Hi Lon,

Sorry to hear about the struggles your body is having. No one would guess from the way your mind keeps driving forward with determination!

I don't know much about elevated uric acid but a bit of research suggested a couple of possibilities which could apply - one is a response to medication. I'm not sure what you're taking right now but some medications can cause increased uric acid levels. Another possibility is diabetes - do you have diabetes in your family or any diabetic symptoms. Another possible cause is impaired kidney function which could occur because your kidneys are being affected by inflammation.

Apparantly you can modify your diet to reduce the amount of uric acid in your blood.

Here's a link to a website with a list of foods that are high in purines (that lead to high uric acid). The site talks about gout which is often caused by high uric acid so, even you don't have gout right now, you could develop it.

http://www.goutpal.com/foods-high-in-uric-acid.html

Best to you as well, Lon. Hope things improve soon.