Methotrexate for Crohn's

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Iram
Regular Member


Date Joined Jul 2003
Total Posts : 145
   Posted 6/5/2009 11:23 AM (GMT -7)   
Dear forumities,

Can any of you share your experience regarding Methotrexate (either oral or injection). One of my GI's wants to try this on me, to try and break my steroid dependence. As always I am concerned about all the side effects of Meth. I am presently pred-dependent.

Thanks

Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 6/5/2009 12:02 PM (GMT -7)   
I have been taking Methotrexate by injection since September. Originally 25mg once a week reduced to 15mg. I have had no obvious side effects and have my blood checked regularly. Colonoscopy in January showed improvement and GI was able to get through the stricture in colon at that time but for other reasons (further test showed deep scar tissue) did have surgery. Previously had some mild Crohn's in terminal ileum but this did not show up in January (?). Have follow-up appointments with GI and surgeon next week and have many questions.
 
Good luck!
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.
Lap assisted sigmoidoscopy done May 11/2009


lilcrohnieUK
Regular Member


Date Joined Dec 2007
Total Posts : 414
   Posted 6/5/2009 12:06 PM (GMT -7)   
I've been on methotrexate for nearly 7 years. 25mg in tablets for 6 1/2 years then switched to injections for last 3 months.
 
I was put on it as steroids didn't do a lot for me and gave me really bad side effects and we didn't have biologics for Crohn's back then, it significantly improved my Crohn's in general got me able to back to school etc but it wasn't complete remission, I had one dose of infliximab when it became available and that boosted me into remission which has been maintained by just methotrexate since (only 3 flare ups in the last 6 years all short lived ones treated with one dose infliximab to kick me back into remission with remission periods of 6 months - 3 years long)
 
I get regular bloods done and liver function has remained absolutely fine even with regular alcohol intake, I do get throat infections fairly regularly but lets face it its a small price to pay! The only side effect I get is I do get nauseous after I take it but I now take it at night so I sleep through the side effects!
 
 


Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 6/5/2009 12:33 PM (GMT -7)   

Thanks lilcrohnie, Find it very interesting that you just have infliximad (that is Remicade is it not?) shots now and then. You did mean that you have had more than one on different occasions? And the fact that you have been on Metho for that long as I'm not sure what the GI is going to recommend for me. Why did you switch to injections?

Thanks


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.
Lap assisted sigmoidoscopy done May 11/2009


lilcrohnieUK
Regular Member


Date Joined Dec 2007
Total Posts : 414
   Posted 6/5/2009 4:07 PM (GMT -7)   
Yup infliximab is remicade, sorry its just in the UK the docs tend to call it infliximab! I have it episodically, thats the way NICE originally approved it (technically the old guidelines still say that, think they're getting changed officially later in the year, but now most doctors won't give it episodically as there is some evidence to say that its better to have it regularly. Methotrexate also makes it less likely that you will develop antibodies to remicade so they're happy for me to have it as and when needed as I am being maintained by another drug and it makes it less risky when I do have the infliximab) so back then you were only given one dose and then they'd only give another when symptoms returned which for me was 2 years, then 3 years, then 6 months, then I had to have 2 doses 8 weeks apart as I needed 2 to get me into remission and its now been over 3 months and so far still in remission.
 
I changed to methotrexate injections when I had my last infliximab as both myself and my doctors felt that one reason I was maintaining remission like I had been was that either I wasn't absorbing the methotrexate tablets anymore or that maybe I needed a slightly more potent dose, 25mg is the highest dose of methotrexate they give so I'm still on 25mg but the injections are more potent and of course if it was due to absorbing issues then injecting it would get round that too, and so far so good! From the information I've read on my NHS trust they've had patients on methotrexate for longer than 10 years without any problems. I was put on the methotrexate as I was allergic to pentasa, steroids were useless and my docs went for methotrexate over azathiaprine (Immuran) as it works better with arthritis which I also have (which again has been in remission along with the Crohn's) though its similar to methotrexate but less dangerous from what I've heard.
 
 
 


ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 6/5/2009 4:09 PM (GMT -7)   
Check out the relevant links in the new meds thread, which you can find in my sig.
Co-Moderator Crohn's Forum.

New meds thread


Iram
Regular Member


Date Joined Jul 2003
Total Posts : 145
   Posted 6/7/2009 7:26 AM (GMT -7)   
Thanks everyone for the responses and update. I will be seeing another GI next week and he will have to prescribe methotrexate for me, my current GI said that does not know how to treat people with methotreaxte. So we will see how things work out. I am not able to drop down below 10 mg of pred. I had dropped to 7.5 mg for a few days, CD mild flare again. So time to try something new to keep the inflammation under control.

sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 6/7/2009 4:25 PM (GMT -7)   
I love my mtx which I take for RA. There is currently a thread about mtx on the front page of the arthritis thread-lots of stories of people taking it for the first time, side effects, concerns about taking it and then results. Even though most of those people are taking it for RA you may find the information very helpful.

SydneyJo
Veteran Member


Date Joined Mar 2006
Total Posts : 1354
   Posted 6/7/2009 6:38 PM (GMT -7)   
I take 25mg MTX orally and am still pred dependent, I cant get below 10mg either. I am currently waiting for approval for Humira - great another toxic med to the list!Hope the MTX works for you though.
Jo

MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 6/7/2009 7:27 PM (GMT -7)   
MTX injections have been the only thing that even half way helped my crohns.
Forum Co-moderator - Crohn's Disease:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


ZenaWP
Veteran Member


Date Joined Aug 2007
Total Posts : 884
   Posted 6/8/2009 9:17 AM (GMT -7)   
Iram, I'm having the same problem but with my arthritis.  Couldn't get below 10 mg of prednisone without being in severe pain and unable to dress myself.  Just started on methotrexate pills about 4 weeks ago but noticed it was hurting my stomach, so we will be switching to injections as soon as the mail order pharmacy gets them here.  Pills seem to be helping, though.  Down to 5 mg prednisone and will be tapering off 1 mg at a time.  I'm a little scared to lose the prednisone, though!  =)
Crohn's Disease, Acid Reflux/Gastritis, Hashimoto's Thyroiditis, Endometriosis, Arthritis, Depression/Anxiety.  Too many meds to list them all.  =) 


Iram
Regular Member


Date Joined Jul 2003
Total Posts : 145
   Posted 6/9/2009 11:19 AM (GMT -7)   
Does the Prednisone come in 1 mg tablets, I could only get them in 5 mg tablets? Yes, I am also scared of losing the pred because it basically keeps me out of the hospital and surgery, but several doctors that I have consulted the last few months have expressed serious concerns about the impact of pred on bone density and adrenal gland functions. So a DEXA scan is in order and maybe a visit with an endocrinologist. I met with my GI yesterday and he is said that I have to go another GI if I wanted to try Methotrexate. So a decision to be made and insurance complexities to be managed...this never ends does it?

ExJohnson
Regular Member


Date Joined Feb 2009
Total Posts : 128
   Posted 6/9/2009 2:17 PM (GMT -7)   
So, are tablets taken every day or just once a week? Sounds like the injections are just once a week, oral too?
I am a pre-30yr. old who has been diagnosed with Crohn's for 14 years.  Symptoms change from cramping and weight loss to severe anemia with fatigue and diarrhea. 
100mg mecaptopurine, 20mg Prednisone, 500mg Metronidazole 3x daily, Darvocet for dessert.

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