If you are hesitant about Methotrexate, have you considered Minocycline? I hated MTX it made me lose so much hair and never really kicked in. Mino is working well for me.

I have been on MTX for almost 2 years and it is helping. I have had no side effects or problems and I take the maximum dose of 25mg orally. I have had severe reactions to several other RA drugs and was dreading Methotrexate. Everyone reacts differently I know but this has been my personal experience.
Good luck

I take mtx and it is working for me. , too, was hesitant to take it, but now I'm glad I did. It's also affordable (especially for a student !) If you search this forum, there are lots of discussion on mtx. Good luck.

I've had good luck with MTX, initially took 20mg (injections) a week + plaquenil. I've been on it for 18 mths, As of this month we are dropping the dose to 15mg. I've been fortunate with side effects - the only one that bothers me is the fact I can't have anything to drink anymore!

I did lose a good amt of hair about 2 mths in (noticiable only to me, my hairdresser and close friends), but switched from folic acid to leucovorin (folinic acid) and that seemd to fix the hair problem.

I understand your doubts, we all do. MTX was helping me but I had to go off because of side effects --- but that's been true for almost every drug I've been put on.

Seriously, some people have no side effects from MTX. Others have ones that are manageable (make sure to take folic acid). RAwarrior.com has a lot of great info on MTX and how to manage side effects.

One good thing is that if you get side effects and go off of it, then you're done with it. As far as I know, the vast majority of side effects are not permanent. So I don't see the harm in trying. I found taking it on a Friday night helped -- that way if you're feeling cruddy you won't miss classes or work the next day.

I think it's worth a try, and there's also Rachel's suggestion of the Minocycline antibiotic, but I don't know much about that.

Good luck!

Tina

I despise methotrexate - FOR ME. I went into methotrexate induced liver hepatitis...BUT, I would do it again if I were starting out since it's one of the most tried and true meds out there for RA. *REPEAT, I WOULD DO IT AGAIN - just differently*

One thing that I've been discussing with my Rheumatologist is a different approach to measure patients on MTX by. Methotrexate takes 3-6mos for the full effect. You don't really know you are getting better except for the blood work on CreactiveProtein, Sed, and RH factor. Standard treatment is to start out with something like 4-5 pills then move up after a few months based on acceptable liver enzymes in the normal range. Well, my enzymes were normal still, but they trended UP from the beginning. Had the standard been to keep MTX low if trending up occurs, I might not have ended up with hepatitis.
I would do it - but I would be involved in reading my liver enzymes. If, after 3 blood draws, my liver enzymes were still trending higher (within normal range though), I would discontinue. If they were stable, I'd keep going with a low dose, staying under 20mg per week. *Methotrexate builds up in the liver, so even if you stay low, one day it could rise, so the lower the better*

If you plan to drink (I see you close to that right of passage), I would not take MTX. Even if you only plan to have one or two drinks a week. It's just contraindicated.

You are very smart to be concerned - but you are also young and your body is a good fighter against side effects. Trying MTX with PROPER blood work to ensure your liver is ok is a good plan. Just be mentally involved in your disease.

Best of luck!

I really hated it at first, the pill form kills my stomach and made me hurt all over for days. My doctor told me to switch to injectable, and now it's smooth sailing. I do feel joint pain the next day, but it goes away.
I know it helps me, I've tried many, and the methotrexate is the one that finally worked.
My doctor said it was safe to have a drink once a week, when I'm out with the girls.
Take with full stomach, and if it kills your stomach, break the dose in half, and take in morn and evening. That's what my doctor told me to do. I took 8 now I'm up to 10.
You only take it once a week, start on the weekend, that way you can see how your body reacts to it, and by Monday your back to normal.
Good luck!

MTX seemed to work some for me, but then added enbrel. Both worked well together instead liver numbers went up because of mtx and had discontinue taking it and I was on a small dose of it. It also made me very tired for a few days. I took folic acid supplements so the nausea would not be so bad.

My rheumatologist said that insurance companies want you to stay on mtx for three months before you go on biologic if you have to.