I was on Methotrexate for 8 months. This is very often the first drug a lot of rheumys will prescribe for newly diagnosed rheumatoid arthritis patient. It's actually a chemotherapy medicine but the prescribed dosage is really low compared to what one would take for example cancer treatment. I think the maximum dose for ra patients is 10 pills once a week. I was started on 6. Most of the time the Dr will prescribe the folic acid along with the Mtx to help combat the side effects, and yes the folic acid does help. The most notable side effect for me was diarrhea and fatigue. The fatigue seemed to subside some a day or two later. I would sometimes have a touch of nausea but nothing to bad, or to the point of vomiting. She can not really expect to see any improvement for a couple months since this drug is slow acting just like most other dmards.

They are boatloads of people here that take methotrexate and I'm sure you will get some good advice. A lot of people that have a hard time tolerating stomach problems with the mtx switch over to the injections instead of taking the pills, and have had better success. Just curious of what size dose they are starting her on and if she is on or tried any other drugs for ra. Good luck and I hope that she does well with it.

It took about 4 months for Methotrexate to do some good for me, and only after I switched to the injectable form. The pills had more side effectssome nausea and occasional bad headaches in the middle of the night. No issues with the injections of MTX. I've been on Folic Acid since the beginning and maybe that's been why but its primary purpose is to reduce the more serious possible side effects of liver or kidney damage from MTX, I think.

MTX only gave partial relief from the joint pain for me though. After 5 months I added a biologic and together they've been doing the job pretty well. Still get the occasional headache maybe once a month but it goes away after a couple of acetaminophen.

Sorry your mom is having to deal with this "stuff". 'ole blue was on the pills for about a year - pretty difficult for me - fog for 2 days, queasy stomach, fatigue a plenty and very little return as far as control that I was expecting - went on the shots and got a whole bunch of improvement - no fog, fatigue was trimmed down to just a few hours, an improvement for me. Still take the folic daily - I have had no problems with the folic as near as I can tell

Again, sorry that your mom is having to deal with this and you are a wonderful person seeking help / information for your mom

Peace
Bluedogs2

If your mother has trouble tolerating the oral dose with folic acid, then she should ask her doctor about switching to the injections. Lots of people here have had better luck with those and less side effects.

Linda

I've often had a somewhat sensitive stomach, especially where medications are concerned, but I have to say, I've done well with methotrexate. I do take injections and not pills.

Folic acid is, as far as I know, mandatory with mtx. If she doesn't have a prescription for folic acid along with it, ask her to check with her doctor. And yes, it should be prescription and not OTC.

Your mom needs to take folic acid daily, and I would recommend taking the methotrexate at bedtime. I have only gotten super nauseous one time when I took it am. Trish

I also applaud you for researching for your mother. I'm another one with a sensitivity to meds and a sensitive stomach. So I took it at night with a meal, and at first I started with half the dose to work up to the full amount. The first week I took half, then added another pill each week. I didn't have any problems. Good luck to your mother.

They started her on 4 pills per week. She didn't take them yet because she wants to get the folic acid and maybe take that for a week before the Methotrexate. Her doctor didn't prescribe any so we're trying to find some at CVS or Walgreens.

You will want to contact her doctor for a prescription for folic acid. I would not advise over the counter on that. The doctor should provide that to you with no problem.

Linda

Although I have a prescription for 1mg of Folic Acid, the one time I filled it at a Kaiser Pharmacy, they gave me the same bottle they stock on the shelf of the over the counter section, at the same price.

I suspect there is some difference in quality with different brands since like most vitamins and "natural" products, Folic Acid manufacture is not FDA regulated, but this probably is true whether it is prescribed or over the counter. A large retailer such as a major pharmacy is more likely to be careful about its suppliers than small stores or "dollar" stores I think. Also, having worked in China since about 1989, I avoid buying any drug, vitamin, herbal product or even most food items made therenot even for my dog.

Otherwise, Folic Acid is Folic Acid.

I took 6 methotrexate a week. I never was nauseous but i would get tired and headaches. I then split my doses. I took 3 in the morning and 3 later that same day in the evening and that seemed to ease the side effects a great deal. Good luck.