Hi, flasher, and welcome to this group of nice people. My neuro believed in using one med at a time, so prednisone was the only medication I had to take. I started at 100 mg. daily for a week, and then was lowered to 70 mg. for another week, and then down to 60 mg. daily for awhile. There are others on here who have taken methrotrexate and other meds, so I'm sure someone will be able to answer your questions. I just wanted to welcome you and give you my best wishes for quick improvement.

Hi tlasher. I am sorry you have DM. Most people start on about 60mgs of Prednisone daily and something like MTX is added about a month later. There are other Meds but the MTX works faster and can take 6 weeks to 3 months to kick in and do its job. Do check if you should be using Folic Acid every day, I believe you should be not taking it every day but check with you doctor or Pharmacy., there are no quick solutions to DM or PM. These diseases take time and patience but you will get there. I take Imuran so can't advise about MTX but lots of people here do take it and I am sure they will come on to help. Do avoid sunlight and flourescent lighting and wear at least factor 50 sun cover even on dull days. Your Rheumatologist should be able to tell you what auto antibodies you have. These give information about the disease pathway, work up and treatment. Best wishes, Autumm

Hi tlasher, You will find from most of the posts here that at the beginning of DM, the steroid (Prednisone) is at a high dose. Corticosteroid naturally in the body is a kidney adrenal hormone that kicks out when someone is sick. We need extra help of a high dose of corticosteroid at the beginning of DM to stop the severe muscle weakness caused by elevated CPK, elevated liver enzymes, and other elevated blood scores. Your doctor determines the high dose steroid amount that is appropriate for you based on your body weight.

A corticosteroid is not the same thing as anabolic steroid used by weight lifters.

The Methotrexate and Plaquenil are disease modifying anti-rheumatic drugs (DMARDs) that work over time to slow down disease progress. I took 17.5mg and later up to 20mg of Methotrexate at the beginning of my DM. I also took 60mg Prednisone at the beginning of my DM. I would take Leucovorin which is a high dose folic acid the next day (12 hours after MTX). Some patients will take a 1mg folic acid daily for the entire week, 12 hours after MTX instead of the one pill Leucovorin.

Side effects of medication are usually from long-term use of the DMARDs over several years. You might have some mild side effects like the BLAH feeling after taking Methotrexate. I would take 4 pills of MTX in the morning and 4 pills at dinner to help stop the BLAH feelings. Breaking up the MTX dosage over the day does help.

High doses of Prednisone means check blood sugars since the high doses can cause a spike in blood sugars. I had to avoid breads, candy, corn, potatoes, starches to keep sugars normal. I did eat a lot of leafy green salads, green beans, and spinach to feel well during the high dose of steroid. Eat low sugar foods.

Do see the eye doctor soon for a pressure check of the eyes while on high doses of Prednisone for your eye safety.

The rash will improve over time. Do visit The Myositis Association website. Welcome to the group! There is much to learn over time.

Thank you everyone for your responses. I value your encouragement and information.
trpt1 I have noticed that the doses that the rheumy has me on are quite low. I think she wants to see how I respond and go from there. It would be very nice to avoid a lot of side effects if my DM responds to these doses.

Hi tlasher, I hope that you will respond well to your current dosages. Be prepared that our meds may go up or down over time depending on blood work and symptoms. I know my Prednisone will go up when I have a flare, but it goes back down when the flare gets controlled. I was concerned about medication side effects at the beginning of my DM. Do talk with your doctor about any concerns. I am sure you will gain confidence over time as you adjust to the meds. I hope you feel better soon.

Keep us posted. Best Wishes.

Thanks trpt1, I tolerated my first dose of mtx well. I haven't noticed any side effects or improvement but my symptoms seem to have stopped getting worse, so I will take that as a positive sign. Autumn I appreciate the reassurance that it can take weeks to months to start kicking in. Just have to keep reminding myself to be patient. My next appt with my rheumy is on Monday. It will be nice to check in with her. One symptom that is kind of different is how my arms feel in the morning when I wake up. My upper arms and shoulders feel tingly and weak. It gets better after I'm up and moving for awhile.