Had to copay for the biologicals. For your mouth, did you try sage leave tea? Like drink or rinse.

Simi thank you!

All depends on your insurance. Call them. I have Medicare Advantage which is a BC/BS product and it covers my infusions in FULL.

I hope those mouth sores get better soon!

I found this online:

In RA, patients can experience mouth ulcers, but normal ulcer medication can help. If it becomes a problem, ask your rheumatology team about this. A lack of folic acid supplementation or interaction with other medicines (which can cause methotrexate levels to increase in the body) can also cause mouth ulcers.

What are you on other than meth? maybe time to try something else altogether. Zeljanz is supposed to work without meth.

I take 2 mg of folic acid per day to help with this.

I am hesitant to call Rheum as I am trying to give methotrexate a good chance as I know it only gets more expensive from here.
I did ask her about increasing the folic acid but she will not do it as she says ir decreases effect of Methotrexate. It's a fragile balance, while my pain is better I am still having joint pain, fatigue, occasionally not sleeping and some days that feeling like you have the flu.

Have you tried biotene? It is a mouthwash for dry mouth. I find it to be very helpful with the sores.

Folic acid supplement helps tremendously.....or at least it did me. I dont take it on injection day though. Look it up and ask your docs opinion.

Yes, I have used Biotene but it does not help. I did buy and try Thera breath and it really soothed them. My Rheum has refused in the past to increase folic acid because it decreases the effectiveness of the Methotrexate. That being said I am taking the 1mg she prescribed and bout OTC folic acid and have added 800 mcg. The sores are fin ally subsiding but it's been a bad couple of weeks really dropped weight cause it hurt to eat. Thank you everyone for the advice.

I think salt rinse used to help mine heal faster. But then maybe it was in my head. Haven't had then in a long while. If course now I prob jinxed myself.

Hi Helen, hope I'm not too late with this. Methotrexate gave me the most horrible sores on upper and lower lips, and the fluid spread into my nostrils and I had breakouts there as well. Seems the doctor forgot to prescribe folic acid for me to take at the same time. Jeepers! Anyway, you can get it over the counter, I forget the normal strength, but a pharmacist can help you with that. It is supposed to be given with Mtx in all forms and dosages. Also, talk to your doctor about getting you on Acyclovir! It is a drug that controls the outbreaks of those sores. The sores are the same virus as causes cold sores/fever blisters. My eye doctor insisted that my PCP prescribe it for me because those sores can actually spread to your eyes easily, and you would end up being blind. So I have to take the Acyclovir the rest of my life so that it doesn't happen. Just one more blasted permanent side effect from the terrible drugs we have to take to try to control out RA. Good luck with it and hope you can get it under control. There are also otc creams that will help the sores to heal fast, Acyclovir is available in a cream, but any salve for cold sores will help, like Abreva, which is really good. Again, all the best!

I had bad mouth sores, the first time I was on mthx. But the mouth sores are only a symptom that the liver is not doing well. Have you done monthly blood tests for your liver? That helps diagnose whether your liver is too stressed from the mthx. My first rheumatologist did absolutely nothing about this, although my liver enzymes just kept going up and up. In the end, I went to a liver specialist, swho took me off mthx permanently. My liver recovered quite well, and all the tests show no long term damage. Although mthx can cause permanent damage.

So you may need to go off. The good news is 7 years later, I was able to go back on a lower dose of mthx, with Arava and Orencia, and I only had one blip in the enzymes! I'm glad to be on mthx, and grateful to be back on it, as it works so well for me.,p

I'm on Orencia. my insurance would not pay for me to self inject but they pay for me to get infusions. never been on mtx. ; but they sell OTC things for mouth ulcers , wonder if it would help you? like little oral patches to cover them while they heal.

Dr increased folic acid and i rinse with peroxly mouthwash by colgate

I had some cancer sores a while back, which my doc and dentist both said were cold sores. They were wrong, but the drug my doc prescribed (acyclivar?) actually worked. Check it out.