I started with a low dose of oral MTX and gradually worked up to my current dose which is about the max oral dose. I was on MTX for about 2 years and stopped (long story) and then restarted (straight back to the max dose) about 7 months later. I have been back on for about 6 months. I split the dose - 1/2 in the am and 1/2 in the pm. I have very little nausea the day after, otherwise there is no disruption of activity. I am very careful about sun exposure. The first time around I lost a little more hair than the usual daily loss but it was not noticeable on me since I have a lot of hair. It did come back in curly, which was kinda fun. I did not notice any other hair loss, and really do not think I have had much hair loss this second time on it. (The dose is much, much lower than the dose used in cancer treatment.) I have had no increase in infections, sores or other concerns about my immune system, and I am exposed to sick people every day at work. My immune system is probably stronger than most because of that, but then and again I am also at greater risk for being exposed to unusual infections.
Everyone is different -- some people do not tolerate it at all, or have lots of side effects. Just like our RA symptoms are so varied....our response to the meds is also so varied.
I hope you find the right treatment for you that works and isn't too bad to take.

I was on oral Methotrexate for 3 months. Now on injectable Methotrexate. It can take 3 to 4 months to get a full effect from it. It's taken once a week, I took mine on Friday night before bed because it made me sick to my stomach. It also gave me diarrhea to begin with. I did get some relief of my symptoms within 4 to 5 weeks. I did not have hair loss with the oral tablets but with the injectable noticing hair loss on my head. I was switched to injectable due to mouth sores, nausea and not good control.

BTW I work with someone who has RA and has been contoured on Methotrexate for years. She has no sideeffects no hair loss.

I been on sulfasalazine for about three months and it has been not working well so end of this week I will start methotrexate. With sulfasalazine I notice little more than usual hair loss so I am little worry about that part. Hopefully I will get some pain relief from combination of two drugs.

I started MTX with pills. Made me nauseated, very tired for two days, heightened anxiety. After a year was switched to injections, still some side effects but not nearly as bad. If you take MTX and your home is on a septic system then you need to start feeding the septic system lots of those good thingies (?) to keep it functioning properly because MTX can mess it up and it'll back up.

Ginger can help if you are sick at your stomach but don't take too much or you'll back up! I made that mistake as well.

ok so much thanks for the info. Being a guy the potential hair loss doesnt concern me as much as some folks . To be honest I already have a retreating hair line .yah its in full retreat . To be honest the risk of illness is most concerning to me . I seldom get sick ever. My wife works for a school so constant exposure to germs and is often sick. The world is not made better by this guy getting the flu . I am a whinny , grumpy little brat when i get a cold . Seriously nobody wants that .

NONIGHTSHADES2 what is this septic issue you speak of . 2days ago I spent the entire day dealing with a huge septic backup due to a faulty lift pump. I want never to have to look into that tank ever again.

just found out my dose will be 4 2.5mg once a week does this sound appropriate?

i've been on mtx off and under a decade and i have a septic - i'm not doing any special protocol and for 10 years the septic tank has not blown up. i pump about every 2 years and routine inspections are done then. and nothing else. the septic company advised me against additives. i don't look in the tank wojo. i let the cucker sucka folks do that. i figure it comes with the wonderful payment and besides i don't want to see all the snakes. our dose is so low on RA that it is not equivalent to cancer treatment. oh! in my neck of the woods i have seen folks back up, from not pumping or failure to plan.
depot

unfortunately I had to repair the wiring to the pump so had to work in it. from the top I would move before I did any work inside unreachable from the top. Only additive I have ever used is a packet of yeast every few months . Ok so alcohol is it never ever ever or is ok on occasion.

I started at 4 x 2.5 and am now on that dose twice a day.

Per my rheum -- no alcohol. I know some rheums are ok but just not on the first couple of days after the dose when MTX levels are higher. Ask your rheum. Keep in mind there are many things that can increase your liver enzymes...

No comment on septic systems...we have one, just don't like to talk about it! But I think I will call the guys to come out and clean it after all these comments!

I had a septic the first 9 years on mthx, and now the last 10 months since I restarted it. We have not done anything special.

As for hair loss, prednisone is what made my hair fall out. I think my hair dresser figured I lost 2/3rds of my hair, back years ago. The good news is using Biotin, it has grown back in wonderfully thick. I wish I had known about it 25 years ago!