Barb - methotrexate (MTX)

[Guest guest]

Barb, all medications sound very scary when you read the prescribing

information. But there is no doubt that methotrexate is a strong

medication that can be toxic and that you must be monitored carefully

while on it. It is also true that methotrexate has been used in RA for

decades and is the most often prescribed DMARD for RA either alone or in

combination with other DMARDs. At least we know exactly what adverse

reactions to look for.

Most importantly, methotrexate is one of the most effective drugs

available to try to prevent or slow damage that can occur in RA. So,

even though you are worried and may be willing to put up with the pain,

you may be risking permanent joint damage if you aren't on a DMARD that

is working for you.

7.5 mg per week is the typical starting dosage. Doctors sometimes

prescribe as much as 30 mg per week. I think in WA is on 27.5 mg

per week and has been for some time.

According to the American College of Rheumatology (ACR):

" The most common side effects of methotrexate include loss of appetite,

nausea, diarrhea, sores or ulcers in the mouth, hair loss, and decreases

in the platelets, white blood cell or red blood cell counts. "

Source: http://www.rheumatology.org/position/mtx.html

ACR Guidelines for Monitoring Drug Therapy in Rheumatoid Arthritis:

http://www.rheumatology.org/research/guidelines/ra-drug/ra-drug.html

Are you taking folic acid, too? I hope so. Many of the MTX side-effects

can be lessened or eliminated with folic acid supplementation.

Good luck and try not to worry!

[ ] question for and a

> Hi there,

> Well I finally called my rheumi on Friday since the pain in

my feet

> was so bad and i got in this morning to see him. I told him about the

pain in

> my feet, the burning feeling that I've been having, stiffness and

such. He

> asked me if I have been having any other problems lately. I have and

told him

> about them and also how it seems that on part of me will start up, and

then

> I'll get some relief only to have another area start to give me

problems.

> Like my feet are doing now. Anyway he seems to think that my plaquenil

has

> stopped working as well for me as it had been. He put me on

methotrexate. 2.5

> mg 3 pills 1 day a week. I did get them filled and when I read the

insert

> with the warnings listed I have to say that it really scared me. He

told me

> that this is a low dose. I still have to take the plaquenil till I see

him in

> October since he said that it takes a little bit before the mtx starts

to

> work for me and if I stop the plaquenil I will probably be in alot of

pain. I

> did read that it can cause serious problems when used along with

nsaids. I am

> on celebrex also. I was wondering what if any side effects seem to be

most

> common with anyone that has been on this drug, what dose seems to be

the

> usual that most people have been prescribed. It just worries me now

that I

> have read this literature and am wondering I guess if I should put up

with

> the pain rather than worry about these side effects. Thanks in advance

for

> any info. Barb