Re: mtx question - for Steph

August 29, 2008

Hi Steph

I'm still on mtx (10 mg) and sulphasalazine: I've been on them 3 years now

and am in a 'drug-induced' remission. That means, my joint swelling has

disappeared, along with the other symptoms such as fatigue, joint pain,

rosacea etc. (Everyone seems to have their own unique set of symptoms!)

The only side-effects I've had from mtx are initial nausea (for the first

few weeks while my body adjusted). That went away but I still often feel

tired the day after I take it. I get mild mouth ulcers/sore mouth sometimes

and take 'oracort' mouth ointment when required. Now and then my monthly

blood tests show a decrease in white blood count so I am told to decrease my

dosage until it returns to normal and then we increase it back again. I need

10 mg mtx (a low dose) to function well but others take up to 25mg (high

dose). Dosage is a very individual thing, but they try and give you the

lowest dose that is effective for you.

You are closely monitored (monthly blood tests) and take folic acid to

prevent nausea etc. The benefits of being able to function are well worth

it!!! And yes, I have a glass of wine if I feel like it

Having said all that, mtx won't suit everyone or work for everyone, but it

is the 'gold standard' treatment - rheumatologists like to try it before

resorting to the 'big gun' biologics, or will use mtx in conjunction with

some of the biologics. Mtx has been used for over 50 years so they know

everything about it - that gives me comfort

Re. remission, I said I am in a 'drug-induced remission'. That means without

my drugs my symptoms would flare up - they are just being suppressed at

present. (In fact, they flare up if I reduce my mtx to 7.5mg!)

I have had 2 proper remissions before though, where I was slowly weaned off

the mtx and then stayed symptom-free for several years. I hope this will

happen again of course, but for now I am grateful to be well enough to run

for buses again (with my artificial hip)!

Email me privately any time Steph,

in NZ

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