Rheumatoid Arthritis Support Group

Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...

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MTX and Persistent Nausea

Frazzled
Frazzled

Hey folks...I took my second 10mg weekly dose mf MTX last Thursday. Friday I was fatigued, Saturday was nauseous and throwing up and uncomfortable but but could still play in the church band, Sunday was blah but played to a crowd of about 1,000 at the outdoors festival where my church was having its service, but pretty nauseous all day - and I threw up the fair food I ate after church. It was hard not to eat crappy stuff since in the middle of the sermon the Mini Donuts truck fired up.


Monday comes and I am nauseous and throwing up anything I eat. Tuesday comes (today) and still the same. It doesn't appear to matter what I eat, but my body is craving salty foods. I am drinking (today) vitamin water mixed with seltzer water to get some electrolytes in me. But this is ridiculous.


Anyone ever experience this? I am taking my Folic Acid exactly as prescribed. I take my MTX at night in the hopes of avoiding most of the side effects. I am at a loss...and I guess if I didn't feel so gross all the time, the not eating part would be fine because I could survive several hard winters with the weight I have on me. But I would prefer to be able to go to work instead of dealing with this. Maybe that's just not realistic for me during the first few weeks. 

doodlebug25
doodlebug25
So sorry you are having such awful side effects with MTX. Everyone is different (I take 10mg in the am and pm on my MTX day without much more than a little nausea and very little decrease in my appetite). And there is some gradual "break in" period. But you really have had what I would consider intolerable side effects (assuming there is no other reason for your symptoms). One option to ask about it splitting your dose to morning and night, but even with doing that you are on a pretty low dose and may need a higher dose to control your RA eventually. The other thing to discuss with your rheum is the injectable version. A lot of people on this forum take MTX as an injection and will tell you they had fewer side effects (not to mention better effectiveness). Good luck and hope you feel better.
californialynn
californialynn
People don't generally vomit while on MTX.

I would rule out a digestive issue or bug first.

Of course, some people read the wrong literature (for cancer patients, who take much higher doses) and assume they'll vomit. The mind is a powerful thing.
Frazzled
Frazzled
Lynn, I find your comment to be a bit offensive. In consultation with my Rheumatologist, he agrees this should not be happening, but his instinct is that I am having a bad reaction to the medication and will never likely tolerate MTX, not a thought process issue. Since I am able to precisely correlate the taking of MTX to the adverse reaction, it would appear this is a physical reaction and not psychological. This is also not a stomach bug.

I am being moved off MTX to Arava in the hope this will reduce the symptoms I have.
californialynn
californialynn
Sorry. Didn't mean it personally. I was writing in general terms.
MarleneJ
MarleneJ
I was very sick to my stomach every day for the first 6-8 weeks the first time I took mthx. But I persisted and it went away, never to return. I went off after 9 years, the last 5 years were injectable, which was much easier on the stomach.

Last September I restarted mthx after a 7 year break. I was nauseous for 2 days after the first injection, and 2 hours after the second injection, and never again.

I would certainly try mthx injectable first before giving up. I am also on Arava and for me, it is not nearly as effective as mthx, the gold standard. Even with Orencia, Arava was not enough the first year, which is why my rheumatologist added the mthx back. I am 99% in remission!

Of course, you need to do what works for you, it's just a shame to rule out such an effective drug so early in the game. I don't know, I probably would have scarfed the junk food even if I hadn't been on mthx! LOL
Hellen
Hellen
Nauseated the entire time I was on the pills. Now on injectable and it is much much better.
Frazzled
Frazzled
I was not offered the injectible...I was offered (and now have an Rx ready for me) for Arava at the pharmacy. Going to start that tonight I guess. Nausea was gone today for the most part, though I still have a bit of vomiting this morning.

Every body is different (and ys, I mean that as two words :-) ) and so we have to listen to them and not try to break them while we put the disease in remission. Maybe it was bad timing for me since I had such a reaction to the vaccinations I had, but it seems to me I am fairly sensitive to new medications (might be Fibro-related) so I have to take that into consideration.
doodlebug25
doodlebug25
Good luck with starting the Arava - I imagine with a history of being sensitive to medications and vaccines that it is extra stressful starting another new thing. Hope your residual side effects resolve quickly.
nonightshades2
nonightshades2
Injections are much less discomforting to me than are pills. Yes, I still have some nausea, have the tiredness and weakness (lasts usually 20-36 hours) and also the anxiety that leads to a REALLY PISS-POOR ATTITUDE AND THE bad habit of snapping at people.....as I see others are having to deal with as well.
Frazzled
Frazzled
Yes, I have to watch my tongue. It can be sharp when I am in constant pain. I mowed the lawn last night because I was so sick of just being in the house, and this morning could barely get out of bed. Not a good combo.

Meds went down ok, but I felt very lethargic this morning. I suspect it is all just my body reacting to being under assault with all this new stuff floating through it. I don't mind the pills...and I wouldn't mind injections either. I just don't want the constant sickness and nausea and general "blah".

The fact that it is 1000% humidity is not helping. I need to move to someplace dry.
lowiina
lowiina
Do you take oral MTX or injection? I couldn't do oral MTX, but injections worked well with no nausea,but "tired" for better part of day. Still better than having nausea. Just planned injection for a day to relax.
Frazzled
Frazzled
I was taking MTX orally. I have since been switched over to Arava. What seems to have been the case was that the persistent nausea/vomiting I had was likely a virus - as my wife came down with the exact same set of symptoms a week after I did. SO we will see. I seem to have developed some new issues with Arava - my previously controlled hypertension became an issue again so another BP med was added, and I believe I may have developed panic attacks form the medication. No one seems to think it is the Arava, but I did not take any yesterday and was fine, and took my normal 20mg dose today and am feeling a bit anxious. We will see if the panic attacks come back this weekend and if so, I may have to move to something else. Very frustrating...
californialynn
californialynn
Are you taking methyldopa for hypertension?

I wouldn't think it was the Arava.

http://www.webmd.com/anxiety-panic/medications-that-can-cause-anxiety
Frazzled
Frazzled
No, not methyldopa, nor any of the other medications on that list. I have been on Lisinopril for 15+ years, and when I started the Arava they added Amlodipine to the mix because my numbers got higher than they were before. Now I have not taken the Arava today, and things seem ok, but yesterday they were bad again. I was also up in the middle of the night with anxiety, but not as bad as when I had been on Arava for a few days.

I did find that Arava can cause anxiety here:

https://www.drugs.com/sfx/arava-side-effects.html

That would explain also why I am having such a hard time sleeping despite the medications I take for insomnia.
Trooper45yrs
Trooper45yrs
Hi Frazzled,

I would recommend running fast and far from methotrexate. It caused kidney failure for me. Just saying. I know we are all different.

As for Arava, I also have high BP and that made it worse, as did Prednisone. It's always something. Hope you can get on a biologic if the DMARDS are not working well enough.
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