Kickas.org Forums Treatments, Drugs and Alternatives AS Pharmacy Should i start MTX?

I was just wondering if any of you guys have much experience with methotrexate? My Rheumy wants to start me on it and i'm really not sure if i'm up for it with all the possible side effects and hassle of bloodtests no booze etc. I think i'd rather just be on the nsaids and paracetamol! Thanks

I suppose it depends on how the nsaids and paracematol and booze works for you now. If you take anything harsher than that, then blood tests are needed and booze may need to be reduced.

Hi Rob,

I've been on methotrexate for a year now. I've been lucky to have minimal side effects. I started on a VERY low dose and increased it very slowly because I was really nervous about side effects.

Since reaching my max dose (25mg once per week) I think I've been slightly more fatigued (although I'm not sure that's the reason - it may be coincidence or another cause) and I've had mild hair loss (just a bit thinner than it was).

I have monthly blood tests to monitor my liver function. I don't drink any alcohol but I do continue to take celebrex.

I don't know if that's helpful but that's my experience.

i don't know how true this is, and certainly people here are on it, but my new rheumy said MTX isn't really helpful for the spondys. i was curious about that statement, so came back and googled it. found some papers that supported that statement. so just not sure? but thought i'd report what he said.

I've been on it for 7 months. It's helped me, but hasn't done all that I'd hoped it would. Rheumy now has me on Remicade in addition to the MTX (15mg/week) and my 2nd infusion is tomorrow.

I was paranoid about taking MTX, because of the risks involved...mostly of infection. I didn't get any sicker over last winter (a lot of sinus issues) than usual.

Tiredness lasted a couple of weeks or a month, but it doesn't bother me now.

When rheumy was bumping dose up to see if it helped, my hair started falling out. Since I wasn't getting any good benefit from the increase, I told him I was going back to the original dose.

Zero liver issues. Numbers were good before I started and haven't budged from that. I drink ETOH 1-2 times a month, and this isn't an issue for me.

If what you are doing isn't working, maybe this would be a good thing to try. With my insurance, I had to go through different treatments and have them fail or not be totally effective to be able to try biologics. I went through several NSAIDS, SSZ and MTX. So if this is the case with your insurance, you would probably have to try it, unless rheumy feels it would be a risk to your health. Good luck.

Hi Rob, just a question for you, hope you don't mind: do you think you NEED to add something more? Sometimes, and I'm not saying it happens all the time, but sometimes doctors can be more aggressive than we like at treating you (although sometimes it's justified), but if you don't feel that you need to add a DMARD and you're happy where you're at, perhaps put the mtx on hold for a bit? Just a suggestion. You can always add it in later if you feel you need it.

On the flip side, if you start it and you feel it's not working or has too many side effects, at least it's easy to come off it right quick.

Maybe have a chat with your doc and see if he thinks if it's absolutely necessary.

Good luck with it

i have AS and tried in for 5-6 mos. my blood numbers went to normal but i continued to feel like crap and got worse as the dose increased. good luck whatever you decide. everyone is diff.

Methotrexate is the DEVIL. I was on it for 5 months, 4 years ago, and still have dental damage and an ulcer. I lost half my hair (the new stuff grew in a different color;) lost my healthy teeth (six cavities and advanced periodontal disease;) they made me promise to HAVE AN ABORTION if I got pregnant while taking it, because it damages babies so severely - the stuff is EVIL, and it wouldn't be so bad if all the side-effects ended when you stop taking it, but the ulcer and tooth issues are still here, 4 years later. I say, run like hell, the docs want to put everyone on it because it's cheap and insurance LOVES cheap+toxic.
I just can't not pipe up about MTX. It's pretty much my arch enemy.
hugs,
Bridget

Thanks everyone for your feedback much appreciated. Megan yes I think i need something more as far as treatment goes as the nsaids don't seem to be doing anything much these days. I also was allergic to both enbrel and humira so going for a dmard is kind of my rheumy's last option. I just don't want to feel sick from the drugs. I struggle enough with my health to have to deal with side effects etc. Anyways i have decided to give it six weeks and see how it goes and if anything odd comes up i'll can it. Thank you all for your support and wisdom... I think i forgot how great this place is.!

I was having weekly MTX injections for 3 full months and didn't notice one bit of improvement but that certainly doesn't mean you won't. The monthly blood tests were no big deal and I even had 2 beers every Friday when we went out for lunch.
My doc and I decided to just stop the injections due to that no improvement.