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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debRAinOC 08/05/2009

When I picked up my MTX prescription this week, the pharmacist went through his usual warnings (drink lots of water, be sure to take my folic acid except on the day I take MTX), but this time he added a new caution: take the pills in the morning. I said that my doctor recommended taking half the dose in the morning and half in the evening. The pharmacist responded that it's not good for MTX to sit in the bladder overnight; I should take it in the morning so the toxins don't build up in my body.

Has anyone else been told this? I don't recall reading about this in any of the literature about MTX. Is my pharmacist just being overzealous about his job to inform customers?

deleted_user 08/05/2009

No, never heard that, but would be interested to find out if that is true. Wonder if this is something new that popped up? I take my mtx mid-day so I guess that would give it enough time to get out of my bladder.

deleted_user 08/05/2009

I always took mine at night to sleep through the initial nausea - my Rheumy was okay with that.

deleted_user 08/05/2009

I once walked into my rheumatologist's office and told her "my pharmacist said...." My RD told me to come to her when I have worries or questions about my medications. I do believe pharmacists know a lot more about meds than doctors, but MTX has been around forever. Call your doctor's office and explain what you were told by your pharmacist. I am sure you will get the answers that can put you at ease! Good luck, marcia

bigiblue 08/05/2009

My book says to drink plenty of Water the day I take it so it can flush out of your body quickly and not hurt my Kidneys. So that makes sense since you don't drink anything while you sleep. I take mine in the am during the week incase something should happen I can call my Dr. He doesn't usually work on the weekends.

deleted_user 08/05/2009

I can take MTX at any time but I was taught to take it at night with my biggest meal. The You Tube video on MTX says to take it at night. http://www.youtube.com/watch?v=1PyX5b3tBqY

JillyT 08/06/2009

I'm with Bigiblue, I was told to take it on a day when I could stay home and relax and to drink tons of water. I figured you can't drink water at night while your sleeping so I always took it in the morning. Hope this helps...hugs jilly

wrenchead 08/06/2009

I have not heard the morning thing either. The idea of taking it in the morning is just a nasty thought for me. Like alot of other memebers here it has nasty nasty side effects. I take mine the nite before so that I sleep through most of it. It still gets me though. This is simply my opinion but i dont think drinking water is going to help flush this nasty thing out of you kidneys. The side effect of hurting the kindneys are the least of my worries with MTX, the liver,bone marrow are much higher on my list of concerns than the kidneys. Anyways, I take mine at night to help with the ugly that follows.

debRAinOC 08/06/2009

Thanks for the responses. Seems like nobody else has actually been cautioned by a doctor or pharmacist to take their MTX in the morning, but I'll ask my doc about it at my next appointment in a few weeks. I'm not overly concerned about it - I usually drink so much water on my MTX day that I have to get up once during the night to go to the bathroom anyway. LOL

deleted_user 08/06/2009

I've not heard about taking MTX in the morning either, but it makes sense. I also have not heard that I should not be taking folic acid on the days that I take MTX. Do others skip the FA on MTX days? Guess I need to call my doc.

deleted_user 08/06/2009

I do take my folic acid everyday but not at the same time as MTX. Since I am not in any pain, and have never had side effects, I will keep doing what I am doing.

I don't listen to much to my pharmacist since he told my husband it was ok for me to drink wine on MTX.

Caspiana 08/06/2009

Hi. I was told to take half in the morning and half before bed. So far no problems.

cindy50 08/06/2009

I never heard that, and I never heard not to take folic acid on the mtx day!

KiddoGal 08/06/2009

I just started on MTX two days ago. My doctor said to take it after dinner because I might get goofy from it or I might get nauseated. I didn't feel any side effects from the first dose. my folic acid prescription says to take it every day. my doctor did not say anything about it being hard on my kidneys or to drink a lot of water....maybe i better though!

Rosemo 08/06/2009

My doctor didn't give me any advice about when to take it, just take all 6 pills once a week. I followed the advice of others on this site to take it at night to sleep through some hours of the side effects. I thought that made sense, but I still feel like crap all day on Monday. I also drink tons of water on Monday because I feel so dehydrated! My Dr. also didn't think taking folic acid was a big deal, but I got some over the counter anyway as most of you use it. What is the reasons you all have been given to not take it on MTX day??

debRAinOC 08/07/2009

The pharmacist said to skip folic acid on my MTX day so the MTX could do its thing better. The folic acid would tend to counteract some of the effects of the MTX.

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