I was told to take the mtx at bedtime, to 'sleep' thru the upset tummy. That would be nice - if I slept decently, sleeping 4 hours would be something worth cheering about, normally, 3 hours then I am awake for a while. Anyway....... I have never had the unpleasant side effects. My liver numbers did go up, so my dose was cut back to a total of 10 mg a week, seems to be working for my liver. Also, the Dr told me to take 5 mg one day, 5 mg the next day. Did he give you a prescription for folic acid? If not, you might want to ask him about that. On the days I do not take mtx, I take 2 mg of prescription folic acid.

Plus, what buddhcat said :)

I am currently on 20 mg per week. Take mine on Tuesday morning. Seldomly notice any nausea. I live in the country with a septic tank, so taking it in the morning before work minimizes the amount I excrete in urine at home. Mtx will slow cell division in bacteria too! I killed my tank and it was a plumbing nightmare.

aggie - I had no idea that could happen! good to know!

Yes I'm taking the folic acid too. Almost at the 2 day point now. I had read that the gastro side effects usually happen 24-48 hours after taking methotrexate... so it looks like I'm almost in the clear. haha
Although I guess some have delayed effects.
It's also hard to tell which drugs might be causing what. I'm also on plaquenil and a few other drugs for related and unrelated conditions.

I took MTX for about 3 years. In the beginning I had hair loss for about 6 months. My hairdresser noticed but no one else did.
I did finally have to go off the drug though because I developed bleeding gums. It eventually got so bad even with 8 mg of Folic Acid I had to go off of it. I would be sitting at my desk and I could feel my gums starting to bleed, every time I brushed I would spit blood and not a little "pink in the sink", I had to totally give up flossing.
My dentist said I didn't have gingivitis or gum disease so it had to be the MTX. I switched to ARAVA about 3 months ago. My mouth is healed (even though I still take 2 mg Folic acid for my hair and nails :-). Other than that I was and still am in medically induced remission with Arava and Enbrel. I hope you find relief and congrats on the babies!

Good info on the tank, thank you!
Take your folic acid. If you have stomach upset, if you use ginger to settle it don't use too much. I did and in a couple of days I was at the drug store when they opened to get a bottle of what they referred to as thunder and lighting. Never been so clogged in all my life.

your septic tank? oh for goddess sake...i have been off and on methotrexate for years with a country **it hole in the backyard - i pump about every other year and the system does not seem to have blown up yet from my pee. so I should expect this any day now?

where's blue dogs?

blue can you write a script for me on this so I can call the local septic folks to tell them about my pee and mtx?

aggie
how old was your system, irrespective? anyway this could be linked to like 5 teenagers taking showers one after the other, age of system, do you have a waste disposal, leaching field, too many occupants, or whatever?

goddess. mtx pee. i am going to tell that to my rheumatologist on the next visit.

depot

I was on it for 9 years. In the end, my liver enzymes went up too high, too often and I had to go off of it. In combo with a biologic I went into 100% remission for 4 years. Those were the GOOD old days. I would go back on it if it wasn't for my liver.

In the province I used to live in, they brought all these safety protocols for nurses giving mthx shots. If you had it at home, you had to have a vent installed to draw off the fumes, so most people just went to a doctor's office. Of course, the person giving the shot had to be gloved, draped and masked.

To which I said - what about us - we are injecting it into our bodies!!? But seriously, other than a bit of nausea at the beginning with the pills, and of course my liver not liking it at the end, it didn't give me any problems and helped wonderfully.

I had a septic tank in my last place. And I did not go away to pee! So toxic waste in the dump ponds? I never had a problem with that tank. I have heard serious talk about not letting people pee into city sewage systems who were on mthx. So where were we supposed to pee? An outhouse in the backyard, with toxic waste symbols on it? Talk about overkill on safety.

dear new

go for it.

it has been prescribed for RA persons in the world for over 50 years, it seems to work, including the guy in my town who I talked to last night who has been taking 8 dose for 30 years for his RA (he is age 70)

he is OK and so if his septic.

take your folic.

back track to lower dose if you have to tummy wise or fatigue wise.

don't hesitate to ask for injectable from the rheumie (it's not a big deal)

time your dosing to the most favorable after dose 24 hours that you can think of.

get your liver tests.

don't drink 5 margaritas every week

don't listen to horror stories.

it's the standard dmard for go to when starting.

take pictures of your joints. my swelling goes down with mtx - that's all the hell I want to see or know (along with my good liver tests)

when you get an infection like a rip roaring cold or whatever call your rheumie - i tend to pause the mtx when I have any infection but ask your doctor, not the list. i find it easier for my body to fight one thing at a time.

depot

Been on MTX for 10.5 years and me and my septic tank are all well. I suspect your septic tank person was giving you an inaccurate diagnosis of your leach field/tank problems.

I do mine on Fridays and have my blood work on Wed....best results are when you have the dose 5 days prior to blood work..

My doc and I have worked so long on this I can go up or down by the equivalent of 1 pill(2.5 mgs) without talking to him first. So if I start to flare, I go up and if I doing well, I can drop it to give my liver a break.

My only side effect? I tend to get diarrhea 24-36 hours after my injection so If I can remember and pop an Imodium, then I'm good.

I have tried taking my biologic without MTX and the MTX does make a difference.

Right now, since I am on the waiting list for spine surgery, I am off MTX. The surgeon is far more worried about MTX than the biologics as MTX slows cell division and he actually gives me something to speed up cell division during surgery and doesn't want the 2 to counteract each other. Doesn't make Orencia that effective but I do miss it but it's the only way I can be open to a phone call that says...how fast can you drive to Boston?

MTX was actually developed back in the late 1940's and started as cancer chemo in the 1950's and was approved by the FDA in low doses for RA in 1982. A more studied drug does not exist! Don't be afraid of it.

Jen

I have been on 30 mg once week and was sick to my stomach, ask your dr for script zofrin it does work well with methotrexate
. Good luck

Well, I had a brand new system and there's me and my husband, so no hordes of teenagers showering for hours. The solids were not breaking down in the anaerobic system. Nothing wrong with the drainage except too many solids getting into second tank. Pharmacist agreed that this could cause a new system to fail. Just trying to give a heads up. Glad none of you had problems, esp depot.http://www.septic.umn.edu/factsheets/medicationsandseptics/index.htm

do you have a leaching field?

depot

We call it 'field lines' but the problem was not in the lines. The problem was in the tanks where nothing was breaking down. The third time this happened, the sanitarian asked about medications. We had both tanks pumped, then used bacterial treatment for a few days. I add one-quarter monthly treatment on Wednesday mornings each week and have had zero problems. Water getting to the drain fields works just fine. It's the solids in the tanks that were causing the backup. Tank die off.

My pharmacist confirmed that this is not uncommon with mtx as it slows down cell division. In the body, half life of mtx is 6 to 8 hours and full clearance usually in 24 h. Thus, repopulating the bacteria after 24 hours keeps the tank cooking. http://pharmrev.aspetjournals.org/content/57/2/163.full

I been counting down the days to take my second dose (today) Yay!