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Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 10/22/2008 7:50 PM (GMT -7)   
I started methotrexate today, 25 mg sub-cutaneous. The 6MP settled things down for me, but it didn't seem to be able to get me into complete remission. I took the 6MP for years, but stopped it last fall and went into a flare.

So far so good with the methotrexate. I know that 6MP takes about 3-4 months to work, how about mtx? The nurse today said it takes about the same, but I read on ccfa that mtx works more quickly (didn't say how quickly). I'm not taking the 6MP anymore so I hope that I don't go backwards before the mtx takes effect?

Anyone know how quickly it's supposed to work?
Dx'ed in 1999. No surgeries.

Current meds: 100 mg 6MP. Just finished prednisone taper. Udo's Choice Probiotics (30 billion).
 
Betaine, digestive enzymes, Candicin (oil of oregano capsules), Beta Sitosterol.


ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 10/22/2008 7:56 PM (GMT -7)   
They told me three months.

Yes, it might work sooner, but it can take up to three months.
Co-Moderator Crohn's Forum.


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 10/22/2008 8:05 PM (GMT -7)   
MTX has rocked for me, it has been the only thing that has even remotely worked for me. It really depends on how much your body can absorb, as tot the time it takes. It is not a magic wand, but you will see some results in a couple of months, but I know people who have started feeling better by their 6th injection. Just be aware you might feel worse the first month you are in it. Not usually, but it can happen.
Forum Co-moderator - Crohn's Disease
...I will find a way, or make one. -Philip Sidney 1554-1586
Make sure your suffering has meaning...
All suggestions/options/opinions are caveated with please consult with your local health care provider...


SydneyJo
Veteran Member


Date Joined Mar 2006
Total Posts : 1354
   Posted 10/22/2008 9:35 PM (GMT -7)   
I take 25mg orally and it started to kick in at about the 4 month mark - hang in there though, it might kick in early for you. Good luck and keep us posted.
Jo

78SilvAnniv
Regular Member


Date Joined Apr 2008
Total Posts : 289
   Posted 10/22/2008 10:12 PM (GMT -7)   
I had my 5th shot this past Tuesday. I am on a schedule to have 6 shots and then I switch to pills.

I noticed positive results (more formed stools and less trips to the bathroom) after the very first shot. The shots seem to lose their effectiveness at around 5 days for me, but the two days until my next shot are still better than pre-MTX. I experienced slight nausea. I took only one pill for anti-nausea after my first shot (and I really think that was just a pre-emptive strike on my part) but all other nausea sensations were very mild. I needed only a slight distraction or a snack to get rid of the feeling. This last week, I didn't recall any nausea at all when my nurse questioned me about how I'd been feeling.
heidi
I have the ability of single-minded determination and accurate project focu....Hey, look, a cat!
 
Crohn's and UC are pretty darn crappy, but if you can't laugh at yourself, you'll cry. 
I'd much rather laugh.
2001 Dx'd with UC.  No remission.  5/2008 surgery, removal of 6" of left side colon.  Dx changed to Crohn's.  Remission for 8-9wks after surgery, symptoms returning after resuming 6MP.


Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 10/23/2008 7:51 AM (GMT -7)   
Thanks for the responses everyone. So far I feel not too bad as far as side effects, so that's positive. I'm think I'm going to learn how to do them myself so that I don't have to go to the clinic every week. I feeling fairly optimistic since I did respond to the 6MP, just not quite enough, and I think this mtx is a bit more potent.

I'll keep you guys updated!
Dx'ed in 1999. No surgeries.

Current meds: 25mg Methotrexate. Udo's Choice Probiotics (30 billion).


Betaine, digestive enzymes, Candicin (oil of oregano capsules), Beta Sitosterol.

Tried SCD, didn't work, now avoiding gluten and dairy.


sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 10/23/2008 1:29 PM (GMT -7)   
My rhuemy told me months-like many months but 8 weeks after I started mtx-and I am only on 12.5mgs.
Some advice, drink a ton of water in the 12 hours or so before and after your dose, start folic acid-at least 1mg but maybe more (I take 3) now the folic acid protects your liver and also prevents the tiredness and stomach discomfort that Mtx sometimes causes.
Good luck.
Sj

MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 10/23/2008 1:32 PM (GMT -7)   
Great memory sjkly, you can go up to 5 MG for folic acid. Oh and have your b-12 checked too.
Forum Co-moderator - Crohn's Disease
...I will find a way, or make one. -Philip Sidney 1554-1586
Make sure your suffering has meaning...
All suggestions/options/opinions are caveated with please consult with your local health care provider...


Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 10/23/2008 2:23 PM (GMT -7)   
Yes, I read both of your earlier posts before I started, so I drank lots of water and I started taking 3mg of folic acid a day a few days before my first dose yesterday.

I feeling tired, but nothing horrible, and I have a minor headache. Thanks guys.
Dx'ed in 1999. No surgeries.

Current meds: 25mg Methotrexate. Udo's Choice Probiotics (30 billion).


Betaine, digestive enzymes, Candicin (oil of oregano capsules), Beta Sitosterol.

Tried SCD, didn't work, now avoiding gluten and dairy.


Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 12/1/2008 9:45 AM (GMT -7)   
So I did my 6th injection last Friday and reduced my pred from 20mg to 15 to try to get rid of my constant jitteriness and the last 2 days haven't been so great, bloating and pain.  I was hoping that maybe the mtx had started to kick in but I guess not.
 
I'm getting concerned that the mtx isn't going to work, but I know I have to give this at least 3 months.  Right now I feel worse than when I was on the 6MP and I'm starting to wonder if I made the right choice by switching.  I was on 6MP for 6 months at 100mg but maybe I should have been more patient.  No point going back to it now though I have to hope the mtx will work.  I had a bleeding episode a few weeks ago and my hemoglobin crashed to 9.9.
 
It's hard to hold on and wait for this to kick in and keep working everyday and stay positive.  I think I'm just having a bad day today....feeling really discouraged.
Dx'ed in 1999. No surgeries.

Current meds: 25mg Methotrexate. Udo's Choice Probiotics (30 billion).


Betaine, digestive enzymes, Candicin (oil of oregano capsules), Beta Sitosterol.

Tried SCD, didn't work, now avoiding gluten and dairy.


CrohnsDaddy
Regular Member


Date Joined Oct 2007
Total Posts : 235
   Posted 12/3/2008 4:51 AM (GMT -7)   
Man, I feel your pain...Waiting for a med to start having an effect just *sucks*. I've been on azathioprine now since February, with a dosage increase to 150 mg just 1.5 months ago. I think I'm *finally* starting to feel the effects of the dosage increase now... 1.5 months later. :/
 
In addition to the mental side effects of the pred (which, quite literally, drive me nuts), I was diagnosed with steroid induced glaucoma. So now I *really* need to come off the pred. Every time I try to get below 20 mg/day, I flare like crazy. I'm starting Cimzia this week, and am hoping that the Azasan/Cimzia/Entocort cocktail will be enough to allow me to elliminate the pred all together. Have you and your GI talked about combining your methotrexate/pred therapy with an Anti TNF biologic like Remicade/Humira/Cimzia/Tysabri? The total percentage of people that obtain  a positive result from biologics isn't really that high (in fact, it's discouragingly low), but for those that it helps, it *really* helps. Cimzia, for example, quotes a 38% response rate.
 
Anyway, I hope things get better for ya, man.
Just trying to be a "Regular Member".
 
Entocort 9 mg/day, Prednisone 20 mg/day, started Humira 1/22/08, started 100 mg of Azasan (Imuran) 2/20/08. Increased Azasan to 150 mg 10/15/08. Discontinued Humira 11/03/08 after extreme fatigue and moderate muscle aches. Hoping to start Cimzia around Thanksgiving. 
 
I'm convinced that Prednisone is the root of all evil, and primarily responsible for global warming.


Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 12/3/2008 9:27 AM (GMT -7)   
That's too bad about your eye. You're right, the next step is probably to combine the mtx with a biologic, but I want to give this mtx a good 3 months to see if it can kick in, if I can.

Thanks for posting and please let me know how the Cimzia works out for you.
Dx'ed in 1999. No surgeries.

Current meds: 25mg Methotrexate. Udo's Choice Probiotics (30 billion).


Betaine, digestive enzymes, Candicin (oil of oregano capsules), Beta Sitosterol.

Tried SCD, didn't work, now avoiding gluten and dairy.


CrohnsPatient
Regular Member


Date Joined Feb 2008
Total Posts : 314
   Posted 12/3/2008 9:33 AM (GMT -7)   
I have never heard that it takes 3 to 4 months, I noticed a differnce literally after my first injection. And I've heard that it worked within a couple doses, which would be a couple weeks.

For me 6mp was very dangerous for me lower my counts to where I had to be isolated. but Methotrexate took me from a very very severe case to not having any activity in my small bowel in over two years, since two aprils ago.
Ive had no side effects, at first I got headaches, so I took fioricet, and it was even the one without codeine and worked great, and I have a huge tolerance for narcotics so to say it worked is pretty good. its like barbituates, tylenol or aspirin and caffiene.

Chronicallyill
Regular Member


Date Joined Apr 2008
Total Posts : 195
   Posted 12/3/2008 1:08 PM (GMT -7)   
Thats funny that these doctors are saying that it takes up to 3 to 4 months. When I was in the hospital the doc told me that it would help immediately and it did.
Age:22/6"1'/138lb - Diagnosed: 2001 @ age 15 now 22
First time mom as of March 8th 2008
Past drugs: Pentasa, Flagyl, Budesonide, Prednisone, tons of Antibiotics, Didrocal
Past herbal remedies and vitamins:Probiotics, Omega 3&6, Prenatal vitamins, B12, Calcium, iron, vit C, vit D, vit E, Selenium, mineral drops
Current drugs: Valtrex, Warfarin, Prednisone :(, 6mp :( NOT WORKING
Problems:Fissure and Tags on rectum, blood clots, ChronicUTI's, Osteopenia, Ulcers in my decending Colon
No surgeries....yet. Gone through 5 G.I.'s
Procedures: 3 colonoscopies, 1 upper endoscopy, 2 barium swallows, 1 biopsy of the fissure and tag (chron's affected)


Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 12/3/2008 10:49 PM (GMT -7)   

I have had 11 metho injections so far and GI is doing another colonoscopy at 4 month mark (would have been 3 months if not for Christmas) so he must think we should know by then if it is working. I have inflammation at a stricture site which may be a different situation than some of the other replies. I take 5 mg. folic acid daily and my husband gives me the injections. I went from 6-7 bowel movements a day to 1-2 after first injection. I have no diarrhea and no nausea. The real test will be to see if a scope shows inflammation.  If so, next step may be a resection.

 


55 yr. old F dx. CD 07/07
Was on prednisone for three months but no medication for next 11 months.
 Started weekly methotrexate injections 09/22/08.


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 12/4/2008 6:13 AM (GMT -7)   
I have to say that I would consider 1-2 movements a day pretty much remission.
Forum Co-moderator - Crohn's Disease
...I will find a way, or make one. -Philip Sidney 1554-1586
Make sure your suffering has meaning...
All suggestions/options/opinions are caveated with please consult with your local health care provider...


CrohnsPatient
Regular Member


Date Joined Feb 2008
Total Posts : 314
   Posted 12/5/2008 11:36 AM (GMT -7)   
Yes thats doing pretty well. I remember When I was in high school and I would go 6-10 times before my 7:30am class...so 1-2 is probably equal to not having crohns disease for a lot of people.

CrohnsDaddy
Regular Member


Date Joined Oct 2007
Total Posts : 235
   Posted 12/5/2008 12:30 PM (GMT -7)   
The following quote is from: http://www.ccfa.org/info/treatment/immunomodulators
 
"Methotrexate (MTX®, Rheumatrex®, Mexate®) works more rapidly than azathioprine or 6-MP, and is given by weekly injections. It is an effective option for people with Crohn's disease who have not responded to other treatments and cannot tolerate other immunosuppressants."
 
Any luck/response with the Methotrexate yet, RiderFan?



Just trying to be a "Regular Member".
 
Entocort 9 mg/day, Prednisone 20 mg/day, started Humira 1/22/08, started 100 mg of Azasan (Imuran) 2/20/08. Increased Azasan to 150 mg 10/15/08. Discontinued Humira 11/03/08 after extreme fatigue and moderate muscle aches. Started Cimzia 12/4/08. 
 
I'm convinced that Prednisone is the root of all evil, and primarily responsible for global warming.


CrohnsPatient
Regular Member


Date Joined Feb 2008
Total Posts : 314
   Posted 12/5/2008 4:17 PM (GMT -7)   
Just wanted to add for those who didnt know, Methotrexate works great for me. Once crohns moved to my small bowel I had to have 29cm of terminal illiuem removed, which was actually a 2am emergency surgery. Since then I've been on Methotrexate, and havent had any small bowel problems, I eventually added Humira on top of this, along with my low dose prednisone and some other things, and I feel as close to normal as I have in years. Me and My drs, both Gi's and Both surgeons agree that Methotrexate, besides Prednisone, has been the single medication that I can use as maintenance with no side effects that works very well for me.

Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 12/5/2008 7:12 PM (GMT -7)   
I'm doing my 7th injection tonight. Not much response so far. Everything I read and what my GI told me is that it can take 12-16 weeks to start working....
Dx'ed in 1999. No surgeries.

Current meds: 25mg Methotrexate. Udo's Choice Probiotics (30 billion).


Betaine, digestive enzymes, Candicin (oil of oregano capsules), Beta Sitosterol.

Tried SCD, didn't work, now avoiding gluten and dairy.


CrohnsDaddy
Regular Member


Date Joined Oct 2007
Total Posts : 235
   Posted Yesterday 12:45 PM (GMT -7)   
Bummer. Hope it kicks in for you soon.
Just trying to be a "Regular Member".
 
Entocort 9 mg/day, Prednisone 20 mg/day, started Humira 1/22/08, started 100 mg of Azasan (Imuran) 2/20/08. Increased Azasan to 150 mg 10/15/08. Discontinued Humira 11/03/08 after extreme fatigue and moderate muscle aches. Started Cimzia 12/4/08. 
 
I'm convinced that Prednisone is the root of all evil, and primarily responsible for global warming.

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