First Methotrexatre problem

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rootsmith
Veteran Member


Date Joined Jan 2004
Total Posts : 598
   Posted 8/22/2008 1:50 PM (GMT -7)   
I've been taking MTX for 8 weeks and was supposed to take the 9th dose last night.  However, the day before I noticed I was freezing cold, headache and my joints hurt.  This is not unusual for me but since I have never taken an immune suppressant before I decided to take my temp.  It was 100 degrees which would be considered a low grade fever.  I rarely get any fevers, even when I have these symptoms and I've also never taken MTX before so called the doc and spoke to his nurse. As soon as she heard "temp of 100 degrees" she said don't take your MTX.  My temp is still 100 degrees today.  I'm puzzled because this is unusual for me, which makes me worry that the MTX is going to be a problem. No respiratory sx, no unusual gi, no urinary sx, just chills, headache and joint pain.              
10 years, many tests, 3 gi doctors, Pentasa 1000mg 3x day
diovan, simvastatin,levothyroxine, sertraline, lyrica, methotrexate, down to 2.5mg prednisone and miserable.     


sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 8/22/2008 1:59 PM (GMT -7)   
rootsmith-one of the problems with the immune suppresent drugs is they supress the symptoms of infections.
I decided to ignore the minor symptoms I had last thursday since they seemed insignificant and take the mtx anyway and ended up with fever and chills all week-just went to my pcps office today and had to convince a PA that it is possible to have a sinus infection without the classic symptoms of facial pain and headaches if you are immune suppressed.
Then had to convince him that no mtx and penicilian drugs do not go well together. You have an infection somewhere so you should get it treated before you take more mtx.
I hope you feel better soon.
Sj

Dave D
Regular Member


Date Joined Aug 2005
Total Posts : 404
   Posted 8/22/2008 3:00 PM (GMT -7)   

This may not apply to you at all but I was in my 3rd week of Methotrexate and I developed a low grade fever, shivers and sweats. I was busy at work so while I did see my Dr., I had more important things to do.

After about a week I developed severe cramping. My family Dr thought I was having a bad reaction to the Methotrexate and kept me in the local small town hospital on a regular diet, taking Tylonol Codenes every two hours for the pain. After three days he sent me 350 miles by car to Omaha where my Reumy was just coming off vacation.

I made it 300 miles and became violently ill and finished the trip by ambulance. After several hours in the hospital, I went into shock and my wife got a surgeon to look at me. I had ruptured my colon. They did emergency surgery to clean up the Gangreine and Peritonitis and took out an 8" section of gut. I had an out of body experience and watched the surgery from above. After two weeks in the ICU and another 4 weeks in the hospital, I went home.

If that were to happen again, I would beg for Cipro or Flagyl from the getgo and would have been well in the first week. The Methotrexate and Prednisone had masked the real problem.

Don't make the same mistake I did.

Dave D

 
Retired male in late 60's. Perforated Colon in 92. Diagnosed as Ulcerative Colitis in 93. Uncontrolled flareup in 97 dictated J-pouch surgery. 04 Capsule endoscopy diagnosed as Crohns not UC. Emergency surgery in 05 to remove lodged camera capsule. Biopsies positively diagnosed Crohns at that time. 12/06 Unsucessfully tried Naltrexone(LDN). 2/07 developed scleritis of the eye, tearing and detaching the retina. Treated with high doses of Prednisone. 6/07 Thought eye was healing and started taking Entocort counting on the residual (non-systemic portion) as treating the eye. Wrong. In October eye was not stabilized. 11/07 Started Remicade to try and reduce the ocular inflamation of the Scleritis since I had been requiring more and more Prednisone to keep the eye quiet. 12/07, retina tares and detaches again. Started Remicade every 4 weeks plus 20mg of Prednisone per day. Six months and seven infusions later, good eye is back to 20/14. Bad eye is 20/70. Had cataract surgery on June 05 on bad eye. Eye returned to a correctable visionary level of 20/40. Life looks good (literally) today.
Married with 4 grandkids.


rootsmith
Veteran Member


Date Joined Jan 2004
Total Posts : 598
   Posted 8/23/2008 5:16 AM (GMT -7)   
Hmmm, I knew that immunosuppressive drugs make you susceptible to infections but I didn't realize they also masked the symptoms of those infections.  I know being neutropenic does. My WBC was 3.8 last month (which is pretty good for me as a low WBC is part of my problem)  I'm going on Monday to get my monthly blood check.  I will definitely check in with the rheumatology office if I am not better by then. She did say do not take the MTX "until you feel better"  I am allergic to cipro but guess ok with flagyl.  I wonder what they'd use in place of cipro.
10 years, many tests, 3 gi doctors, Pentasa 1000mg 3x day
diovan, simvastatin,levothyroxine, sertraline, lyrica, methotrexate, down to 2.5mg prednisone and miserable.     


Dave D
Regular Member


Date Joined Aug 2005
Total Posts : 404
   Posted 8/23/2008 10:13 AM (GMT -7)   
My problem may not have been the same as yours at all. My best advice is to not let it go if you think it's an infection. Xfaxin (sp) is the new replacement for Flagyl. There are several others that would replace Cipro.
Dave D
Retired male in late 60's. Perforated Colon in 92. Diagnosed as Ulcerative Colitis in 93. Uncontrolled flareup in 97 dictated J-pouch surgery. 04 Capsule endoscopy diagnosed as Crohns not UC. Emergency surgery in 05 to remove lodged camera capsule. Biopsies positively diagnosed Crohns at that time. 12/06 Unsucessfully tried Naltrexone(LDN). 2/07 developed scleritis of the eye, tearing and detaching the retina. Treated with high doses of Prednisone. 6/07 Thought eye was healing and started taking Entocort counting on the residual (non-systemic portion) as treating the eye. Wrong. In October eye was not stabilized. 11/07 Started Remicade to try and reduce the ocular inflamation of the Scleritis since I had been requiring more and more Prednisone to keep the eye quiet. 12/07, retina tares and detaches again. Started Remicade every 4 weeks plus 20mg of Prednisone per day. Six months and seven infusions later, good eye is back to 20/14. Bad eye is 20/70. Had cataract surgery on June 05 on bad eye. Eye returned to a correctable visionary level of 20/40. Life looks good (literally) today.
Married with 4 grandkids.


LBJ
Veteran Member


Date Joined May 2005
Total Posts : 511
   Posted 8/23/2008 10:23 AM (GMT -7)   

OH wow I hope you find out what is wrong and that everything is ok!!! 

I haven't had issues like that yet on the Methotrexate. (knock on wood)   I just get really tired and usually don't feel well the next day after injections.  The side effects though are getting much better for me.


Living with Crohn's Disease since Jan./2000 but had a few years prior
I'm a true Crohnie with IBS and Arthrities too
 
Meds I have tried:  Too many to list- LOL
Meds currently on:  Prednisone 10mg this week
                           Methotrexate injections once a week 25mg
                           Folic Acid 5mg once a week
                           Wellbutrin twice a day
                           Cipro
No Surgeries
 


rootsmith
Veteran Member


Date Joined Jan 2004
Total Posts : 598
   Posted 8/25/2008 8:55 AM (GMT -7)   
I have had a fever since last Wednesday. It started out low grade but on Sat it was 101, yesterday 102.8, and today 101. So, I called the rheumatology office thinking that if he prescribed a drug to me that is known to decrease your ability to fight and infection (and fever is a sign of infection) then he would be the one to treat it. Apparently not, the message I got was "check with your primary care provider" What is really puzzling is that last time I saw the rheumy he made a big deal out of asking me about symptoms of methotrexate induced pneumonitis. So here I call them up telling them I have a high fever and he doesn't seem to care. Oh well, I have an appt with my pcp this afternoon but it was puzzling.

I'm feeling a little overwhelmed managing the gazillion doctors I see. I don't know who is supposed to do what. I think I'm pretty good at accessing the health care system.

LBJ, I don't seem to get tired after my MTX dose (I take the tabs) All I get is nauseous. Its better now that he increased folic acid to 3 mg/day. Not gone, but better.

Dave, sounds like you had quite a time of it. I'm glad things have improved for you I want to go visit my daughter and GrandCats (and recent new addition of a Granddog) in November but it scares me in this condition. Plus I also have the threat of a gall bladder attack. I see the surgeon next week.
10 years, many tests, 3 gi doctors, Pentasa 1000mg 3x day
diovan, simvastatin,levothyroxine, sertraline, lyrica, methotrexate, down to 2.5mg prednisone and miserable.     


rootsmith
Veteran Member


Date Joined Jan 2004
Total Posts : 598
   Posted 8/26/2008 5:17 AM (GMT -7)   
I saw my pcp yesterday and she prescribed a 3 day course of azithromycin. Last night I had drenching night sweats, my pj's were sodden so I thought the fever "broke". But it was back up to 102 this morning. I'm kind of concerned, doesn't look like I'll be taking the mtx this Thursday either
10 years, many tests, 3 gi doctors, Pentasa 1000mg 3x day
diovan, simvastatin,levothyroxine, sertraline, lyrica, methotrexate, down to 2.5mg prednisone and miserable.     

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