Re: Methotrexate via injection -

[Guest guest]

, what mg. did your doctor start you out on? Is there

a " normal " dosage, or does it just depend on each situation? Thanks

> >

> > Happy Thanksgiving!

> >

> > Today was my return visit to my rheumatologist, having been

> diagnosed with RA two

> > weeks ago and recently completed a two week course of

Prednisone.

> I told her with four

> > days of using Prednisone, the swelling in my hands went down, my

> pain was reduced and I

> > felt a surge or energy. I relayed that when I tapered the

> Prednisone, most of my

> > symptoms returned.

> >

> > We discussed options and she recommended Methotrexate. Nothing

> surprising there.

> > When we discussed that I have chronic gastritis (from years of

> taking NSAIDS), she offered

> > me the option of injecting the Methotrexate weekly. Bypassing my

> stomach is an

> > attractive option so I learned how to give myself a shot today.

> >

> > I have a couple of questions for those who take this medication.

> >

> > 1. Within several hours of the injection, I felt an almost

> crushing fatigue and pain in my

> > joints. Coincidence? Also, I live in the Northeast and we're

> having nasty cold and wet

> > weather this evening. So...

> >

> > 2. I don't drink, primarily because I'm generally on pain

> medication. I was going to forego

> > the pain meds tomorrow to have a glass of wine with Thanksgiving

> Dinner. Then I read

> > that one should never drink with Methotrexate. Is this a hard

> and fast rule? I didn't ask

> > my doctor because I didn't put the two together.

> >

> > 3. My doctor said that the Methotrexate could take up to a month

> to work. She gave me a

> > script for 5 mg. Prednisone to take daily in the event the pain

> gets really bad again. How

> > long did it take for your Methotrexate to take effect?

> >

> > Many thanks!

> >

> > Paige

> >

>

[Guest guest]

I started on 10 mg per week of Mtx, and eventually worked up to 20

mg per week. I think the goal is to find the lowest dose that is

effective without bad side effects. I've heard of some people on

doses as high as 25 mg per week.

In my case, I don't think the Mtx itself does that much. But it has

been found that the biologics work better, and are likely to work

longer if they are taken along with Mtx. ( posted an article on

why this is so, but I can't reliably remember the details<g>)

At the moment, I'm back down to 15 mg weekly (.6 ml injectable)

because my liver valus were up when I had my last blood work done.

(someone probably has mentioned this to you, but if you are on Mtx,

you need to have bloodwork done every 4-6 weeks)

> > >

> > > Happy Thanksgiving!

> > >

> > > Today was my return visit to my rheumatologist, having been

> > diagnosed with RA two

> > > weeks ago and recently completed a two week course of

> Prednisone.

> > I told her with four

> > > days of using Prednisone, the swelling in my hands went down,

my

> > pain was reduced and I

> > > felt a surge or energy. I relayed that when I tapered the

> > Prednisone, most of my

> > > symptoms returned.

> > >

> > > We discussed options and she recommended Methotrexate.

Nothing

> > surprising there.

> > > When we discussed that I have chronic gastritis (from years of

> > taking NSAIDS), she offered

> > > me the option of injecting the Methotrexate weekly. Bypassing

my

> > stomach is an

> > > attractive option so I learned how to give myself a shot

today.

> > >

> > > I have a couple of questions for those who take this

medication.

> > >

> > > 1. Within several hours of the injection, I felt an almost

> > crushing fatigue and pain in my

> > > joints. Coincidence? Also, I live in the Northeast and we're

> > having nasty cold and wet

> > > weather this evening. So...

> > >

> > > 2. I don't drink, primarily because I'm generally on pain

> > medication. I was going to forego

> > > the pain meds tomorrow to have a glass of wine with

Thanksgiving

> > Dinner. Then I read

> > > that one should never drink with Methotrexate. Is this a

hard

> > and fast rule? I didn't ask

> > > my doctor because I didn't put the two together.

> > >

> > > 3. My doctor said that the Methotrexate could take up to a

month

> > to work. She gave me a

> > > script for 5 mg. Prednisone to take daily in the event the

pain

> > gets really bad again. How

> > > long did it take for your Methotrexate to take effect?

> > >

> > > Many thanks!

> > >

> > > Paige

> > >

> >

>

[Guest guest]

Hopefully the MTX will work well alone. My insurance won't pay for

any of the biologics until I've tried the older, less expensive stuff

for at least six months, without success. Thanks !

> > > >

> > > > Happy Thanksgiving!

> > > >

> > > > Today was my return visit to my rheumatologist, having been

> > > diagnosed with RA two

> > > > weeks ago and recently completed a two week course of

> > Prednisone.

> > > I told her with four

> > > > days of using Prednisone, the swelling in my hands went down,

> my

> > > pain was reduced and I

> > > > felt a surge or energy. I relayed that when I tapered the

> > > Prednisone, most of my

> > > > symptoms returned.

> > > >

> > > > We discussed options and she recommended Methotrexate.

> Nothing

> > > surprising there.

> > > > When we discussed that I have chronic gastritis (from years

of

> > > taking NSAIDS), she offered

> > > > me the option of injecting the Methotrexate weekly.

Bypassing

> my

> > > stomach is an

> > > > attractive option so I learned how to give myself a shot

> today.

> > > >

> > > > I have a couple of questions for those who take this

> medication.

> > > >

> > > > 1. Within several hours of the injection, I felt an almost

> > > crushing fatigue and pain in my

> > > > joints. Coincidence? Also, I live in the Northeast and

we're

> > > having nasty cold and wet

> > > > weather this evening. So...

> > > >

> > > > 2. I don't drink, primarily because I'm generally on pain

> > > medication. I was going to forego

> > > > the pain meds tomorrow to have a glass of wine with

> Thanksgiving

> > > Dinner. Then I read

> > > > that one should never drink with Methotrexate. Is this a

> hard

> > > and fast rule? I didn't ask

> > > > my doctor because I didn't put the two together.

> > > >

> > > > 3. My doctor said that the Methotrexate could take up to a

> month

> > > to work. She gave me a

> > > > script for 5 mg. Prednisone to take daily in the event the

> pain

> > > gets really bad again. How

> > > > long did it take for your Methotrexate to take effect?

> > > >

> > > > Many thanks!

> > > >

> > > > Paige

> > > >

> > >

> >

>

[Guest guest]

:

My rheumatologist gave me Folic Acid as a prescription vitamin (including

Vitamin . She

started me on 15 mg of Methotrexate and honestly, I only feel better today

(three days

later). Yesterday, I had a whopper headache (borderline migraine). My pain

levels were up

so per her instructions, I started up 5 mg of Prednisone again. What a

difference - today I

feel great!

Paige

[Guest guest]

I hate how insurance companies manage our care for us. That you have to take

something

that doesn't work for six months, meanwhile suffering with pain, is ridiculous!

Paige

>

> Hopefully the MTX will work well alone. My insurance won't pay for

> any of the biologics until I've tried the older, less expensive stuff

> for at least six months, without success. Thanks !

>

>

[Guest guest]

Mtx alone does work for a lot of people, and I sure hope you're one

of them!!! I tried Plaquenil, Mtx alone and Mtx plus Arava before I

finally started on biologics. I was on Mtx plus Enbrel for 4 months

and it worked somewhat, but not enough. Now I'm on Mtx plus Humira,

which seems to be working better, though it's still not perfect...

It can take a long time to find the right mix of meds. Good luck,

and I hope you find the right thing faster than I have!

> > > > >

> > > > > Happy Thanksgiving!

> > > > >

> > > > > Today was my return visit to my rheumatologist, having

been

> > > > diagnosed with RA two

> > > > > weeks ago and recently completed a two week course of

> > > Prednisone.

> > > > I told her with four

> > > > > days of using Prednisone, the swelling in my hands went

down,

> > my

> > > > pain was reduced and I

> > > > > felt a surge or energy. I relayed that when I tapered the

> > > > Prednisone, most of my

> > > > > symptoms returned.

> > > > >

> > > > > We discussed options and she recommended Methotrexate.

> > Nothing

> > > > surprising there.

> > > > > When we discussed that I have chronic gastritis (from

years

> of

> > > > taking NSAIDS), she offered

> > > > > me the option of injecting the Methotrexate weekly.

> Bypassing

> > my

> > > > stomach is an

> > > > > attractive option so I learned how to give myself a shot

> > today.

> > > > >

> > > > > I have a couple of questions for those who take this

> > medication.

> > > > >

> > > > > 1. Within several hours of the injection, I felt an

almost

> > > > crushing fatigue and pain in my

> > > > > joints. Coincidence? Also, I live in the Northeast and

> we're

> > > > having nasty cold and wet

> > > > > weather this evening. So...

> > > > >

> > > > > 2. I don't drink, primarily because I'm generally on pain

> > > > medication. I was going to forego

> > > > > the pain meds tomorrow to have a glass of wine with

> > Thanksgiving

> > > > Dinner. Then I read

> > > > > that one should never drink with Methotrexate. Is this a

> > hard

> > > > and fast rule? I didn't ask

> > > > > my doctor because I didn't put the two together.

> > > > >

> > > > > 3. My doctor said that the Methotrexate could take up to

a

> > month

> > > > to work. She gave me a

> > > > > script for 5 mg. Prednisone to take daily in the event the

> > pain

> > > > gets really bad again. How

> > > > > long did it take for your Methotrexate to take effect?

> > > > >

> > > > > Many thanks!

> > > > >

> > > > > Paige

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Well, there are certainly lots of things about insurance companies

that I don't like, but the fact of the matter is that for most of

these drugs, you need to be on them for a substantial amount of time

(usually at least 3 months) before you know whether they are going

to work for you or not. Obviously, if you have an adverse reaction,

they will take you off faster, and I think most insurance companies

will accept that.

But there are two reasons to give Mtx a good try before moving on to

biologics. First, Mtx has the longest track record and the least

severe side effect profile of any of the RA drugs now in use other

than Plaquenil (which is the first drug prescribed for many, if not

most people) Second, it is MUCH less expensive. A month's worth of

Mtx is cheaper than a co-pay on my insurance, while Enbrel and

Humira are both around $1600 per month. It would make everyone's

insurance premiums even higher if people who could be successfully

treated with a very inexpensive, safer drug were automatically put

on a terribly expensive drug whether they really needed it or not.

Believe me, I KNOW how frustrating it can be wading through drug

after drug, waiting to see whether it will work or not. I've been

doing it for 11 months now, and I'm still holding my breath and

praying that Humira is going to be the answer for me. But I've read

enough on this BB to realize that which drugs are going to work for

any one person is very idiosyncratic. You can mention any drug on

this board and you will receive lots of responses saying, " it works

great for me " and lots of others saying " it didn't do a thing " ,

or " I had XXX horrible reaction to it " .

I really hoped that when I started on Enbrel, that would be

the " magic bullet " . It wasn't. It helped some, just like several

other drugs I had tried. But I was still miserable half the time,

and not really back to my " old normal " even when it WAS working.

For other people, Enbrel works great. Now I've been on Humira for a

little more than a month. I'm not back to my old self, but I am

_MUCH_ better on a day-to-day basis than on anything else I've tried

so far, and I've only had one flare since I started on it. So I

really am crossing my fingers.<g>

As frustrating and depressing as it seems while you're going through

it, I don't think there is any other alternative, whether the

insurance company gets involved or not.

> >

> > Hopefully the MTX will work well alone. My insurance won't pay

for

> > any of the biologics until I've tried the older, less expensive

stuff

> > for at least six months, without success. Thanks !

> >

> >

>

[Guest guest]

I would definitely ask her about the possibility of adding Leucovorin

after you take the Mtx. I haven't been off prednisone yet since this

all started last Jan. My doc has always waited to see if the new

DMARD was working before starting to reduce the prednisone slowly.

The lowest I've gotten the prednisone is where I am now, at 9 mg per

day.

>

> :

>

> My rheumatologist gave me Folic Acid as a prescription vitamin

(including Vitamin . She

> started me on 15 mg of Methotrexate and honestly, I only feel better

today (three days

> later). Yesterday, I had a whopper headache (borderline migraine).

My pain levels were up

> so per her instructions, I started up 5 mg of Prednisone again.

What a difference - today I

> feel great!

>

> Paige

>