Methotrexate - Failure to tolerate?

March 19, 2008

My Mom is 80-years-old. For the past 2 1/2 yrs, one of the drugs used

to treat her RA has been Methotrexate. She is now at an injectible

dose of .3cc/wk. She has always had fatigue for 2 days after the

shot, but is now experiencing other side effects, which seem to be

getting worse and are now lasting for the entire week - nausea, GI

symptoms, headache, fatigue, chills, etc. She is taking folic acid at

3 mg/day. Her blood work (at least from 7 wks ago doesn't seem to

indicate any liver problems). The Rheumy has talked about the

possibility of changing to Arava. Arava scares her because of the

warnings re liver damage. She has tried Enbrel and Humira (She became

allergic after 3 mths of treatment with both of those drugs.). Her

Rheumy has even suggested treating her with Medrol alone! Her Rheumy

seems to be hesitant to attribute these symptoms to MTX, even though

when she holds it, she feels better. However, when it was held too

long, she flared. They tell her that they are running out of options!

My question is this: Could she be developing an allergic reaction to

the drug even though she has been taking it for 2 years? I know that

some people can't take MTX for many different reasons, but doesn't

that normally show itself at the beginning of treatment? Are there

any reports of this out there, ? And what are others' feelings

about Arava?

March 19, 2008

I took Arava for about 4 months, and it worked wonderfully, but had to stop as

it caused severe diahrea in me. Perhaps she will be fine on it though, we all

respond differently to meds. I've been on methotrexate for 15 yrs. now, and have

never had any problems with it, no side effects at all.

Jill in Michigan

" When I can't ride anymore, I shall keep horses as long as I can hobble along

with a bucket and a wheelbarrow. When I can't hobble, I shall roll my wheelchair

out by the fence of the field where my horses graze, and watch them. " ~

Dickens

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March 26, 2008

,

It would probably be unusual for an " allergic " reaction to occur after two

years of use, but adverse events can happen at any time during treatment

(and they don't always involve the liver).

Something to consider is that it might not be the MTX itself, but another

issue that has developed. For example, if your mother's kidneys are not

functioning normally, that could impact the way the MTX is metabolized. Or

there could be an infection present.