Question about methotrexate

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sharky456
Regular Member


Date Joined Sep 2008
Total Posts : 30
   Posted 9/13/2008 4:23 PM (GMT -7)   
I was diagnosed with SLE in 2002. I have tried most typical treatments (cytoxan, cellcept, prednisone etc) and had some significant remissions. To ward off prednisone side effects (including nightmares, sweating, and mood changes) we decided to add methotrexate (IM injections) in order to taper the prednisone... The MTX has been wonderful in getting rid of my symptoms (pleursy, joint pain, etc), however I have noticed two things: First, I am extremely tired- not mentally but physically so much that I can hardly stand up for a few minutes at a time and Two (what I am much more curious about) is that no food seems appealing at all. Not even remotely. I have been on MTX for a few months and this started a few weeks ago. Has anyone else experienced something similar?

Thanks
sharky

AlwaysRosie
Veteran Member


Date Joined Jan 2005
Total Posts : 8616
   Posted 9/13/2008 5:48 PM (GMT -7)   
Hi Sharky!!

Welcome to the forum!!

Do you have your injections once a week? How much MTX per injection?

Lots of us have used the once per week pill form. I was taking 20mg/week . . . so that is a pretty mild dose. I did experience sleepiness for a day or so after each dose . . . but the fatigue actually lifted a bit with the MTX.

You sound like you might be going into a flare . . . but I'm not experienced with the injection form of MTX so I'm hoping some of the others who have used injections will post.

Glad you found us!!

Blessings!

In His Grip

AlwaysRosie           "We can't control the waves, but we can learn how to surf!!"

Psalms 139

Co-Moderator - Lupus Forum

UCTD, Inflammatory Arthritis, Diverticulosis, (recent dx - Sjogrens, Crohn’s 4/08)

Clickable Links:  Lupus Resources    Lupous.Org   Lupus Criteria (4 of 11)   Lupus Chapter Locator


sharky456
Regular Member


Date Joined Sep 2008
Total Posts : 30
   Posted 9/13/2008 5:56 PM (GMT -7)   
I do once weekly injections and take 8mg zofran. I am what would be termed at "pharmaceutical cheap date" (ie a little bit goes a loooong way) so i am maintaining on a 7.5mg dose. We actually think it may be adrenal fatigue so I am scheduled to do the cortisone test next week to see what the deal is...

The mtx has made a WORLD of difference for me, and my cell counts are still good so I am hoping to continue it- possibly with a TINY bit more prednisone...

sharky

AlwaysRosie
Veteran Member


Date Joined Jan 2005
Total Posts : 8616
   Posted 9/13/2008 6:16 PM (GMT -7)   
Ohhhhhhhh . . . I missed the prednisone taper.

I haven't had to use pred except for some quick tapers . . . but here is what I understand about it . . . which may be helpful to you.

Our adrenal glands make cortisol which is equivalent to about 7 mg/day of prednisone. When we take prednisone/steroids for an extended period of time, our adrenals stop (or slow) making our own supply. Once we taper down under 10 or so, our bodies start to push the adrenals back into action. That's why the low end of the taper has to be w-a-y s-l-o-w-e-r. It gives your body a chance to start producing its own again. The end of your taper may take a very long time . . . and you may be stuck at a low dose for a long time.

Ginny and Lynnwood are really helpful with the prednisone info. Hopefully they will see your post.

Its good that the doc is checking your cortisol levels.

Blessings!

In His Grip

AlwaysRosie           "We can't control the waves, but we can learn how to surf!!"

Psalms 139

Co-Moderator - Lupus Forum

UCTD, Inflammatory Arthritis, Diverticulosis, (recent dx - Sjogrens, Crohn’s 4/08)

Clickable Links:  Lupus Resources    Lupous.Org   Lupus Criteria (4 of 11)   Lupus Chapter Locator


sharky456
Regular Member


Date Joined Sep 2008
Total Posts : 30
   Posted 9/13/2008 6:25 PM (GMT -7)   
If it is helpful I have been on prednisone ~7 years... I was tapering ~1/2mg per month

AlwaysRosie
Veteran Member


Date Joined Jan 2005
Total Posts : 8616
   Posted 9/13/2008 9:07 PM (GMT -7)   
What dose right now?

In His Grip

AlwaysRosie           "We can't control the waves, but we can learn how to surf!!"

Psalms 139

Co-Moderator - Lupus Forum

UCTD, Inflammatory Arthritis, Diverticulosis, (recent dx - Sjogrens, Crohn’s 4/08)

Clickable Links:  Lupus Resources    Lupous.Org   Lupus Criteria (4 of 11)   Lupus Chapter Locator


Trying2BFree
Regular Member


Date Joined Oct 2005
Total Posts : 251
   Posted 9/14/2008 1:37 PM (GMT -7)   
Be sure and take plenty of folic acid with MTX. I hope you feel better soon.
Jeannie 
SLE diagnosis 10/05 now changed to RA 3/06, Endometriosis 5/05, PCOS 1990
Meds: Metformin ER 1500mg (PCOS); Loestrin BCPs (Endo); Methotrexate 15mg (RA); Metanx 5mg (RA); Orencia 750mgs (RA); Lunesta 2mg (as needed); Prevacid


sharky456
Regular Member


Date Joined Sep 2008
Total Posts : 30
   Posted 9/14/2008 3:50 PM (GMT -7)   
I was done to 2 (its a MIRACLE) mg and was doing fine for 6 weeks then all the sudden the bottom dropped out. I am taking the daily 1mg folic acid that is recommended as well.

Trying2BFree
Regular Member


Date Joined Oct 2005
Total Posts : 251
   Posted 9/15/2008 7:07 AM (GMT -7)   
It doesn't sound like the MTX is your problem, but just in case....You can take more than 1mg to help with the side effects. I take 5mgs.
Jeannie 
SLE diagnosis 10/05 now changed to RA 3/06, Endometriosis 5/05, PCOS 1990
Meds: Metformin ER 1500mg (PCOS); Loestrin BCPs (Endo); Methotrexate 15mg (RA); Metanx 5mg (RA); Orencia 750mgs (RA); Lunesta 2mg (as needed); Prevacid


Serina
Regular Member


Date Joined Aug 2008
Total Posts : 431
   Posted 9/23/2008 9:23 AM (GMT -7)   
AlwaysRosie said...
Ohhhhhhhh . . . I missed the prednisone taper.

I haven't had to use pred except for some quick tapers . . . but here is what I understand about it . . . which may be helpful to you.

Our adrenal glands make cortisol which is equivalent to about 7 mg/day of prednisone. When we take prednisone/steroids for an extended period of time, our adrenals stop (or slow) making our own supply. Once we taper down under 10 or so, our bodies start to push the adrenals back into action. That's why the low end of the taper has to be w-a-y s-l-o-w-e-r. It gives your body a chance to start producing its own again. The end of your taper may take a very long time . . . and you may be stuck at a low dose for a long time.

Ginny and Lynnwood are really helpful with the prednisone info. Hopefully they will see your post.

Its good that the doc is checking your cortisol levels.

Blessings!

I am so glad that all of you are willing to reprint or speak about things more than once.  It is easier for me to remember things if I hear them more than one or two times. 
Thank you
Hester

Lupus diagnosed 1996, Heart by-pass 1998, breast cancer 2000, stroke2002, vascular surgery 2005, heart attack in 2007, and had a stint put in, Sjogren's Syndrome 2008
 
******
aspirin daily, multivitamin daily, Arthrotec 50mg twice daily, Meclazine 25 mg, as needed 4x daily, Hydoxychloroquine (plaquinil) 200mg twice a day, Metoclopomide 10 mg, 4x daily, Doxepin 50 mg one cap 4x day, Metoprolol 100 mg daily, Levothyroxine (synthroid) 50 daily, Amlodipine 5mg daily, Crestor 10 mg one tab daily, Lisinopril 40 mg, one tab daily, Omeprazole (prilosec) 40 mg daily, Plavix 75mg daily, promethazine 25mg x4 daily, Restasis one drop in each eye every 12 hours
 


elcamino
Veteran Member


Date Joined Sep 2005
Total Posts : 1744
   Posted 9/23/2008 9:33 AM (GMT -7)   

I've been taking mtx for quite a while now, and I still have mild nausea and fatigue a few days after taking my weekly dose.  I take 15mg/week.  I've noticed that some weeks are much better than others, though, with respect to the nausea.  On a good week, I simply won't have an appetite.  Occassionally, the day after I take it I'm severely nauseated, but can manage light food and plenty of fluid.  The nausea and fatigue, I'm hoping, will disappear in time.  I've been taking mtx for a little over a year now.

Mtx has made a world of difference for me as well.  I hope it does for you too.

 

El


Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Early Lupus
Current Meds: Enbrel, Plaquenil, Methotrexate, nexium, tramadol, nasonex,Tylenol PM
Past Meds: Relafen, Vioxx, Mobic, Voltaren, Sulfasalazine, Entocort, Prednisone, Humira, Reglan, zyrtec, zegerid, aciphex


sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 9/23/2008 4:05 PM (GMT -7)   
I agree that more folic acid may be needed. I take 3mgs per day and the very first day I started doing that the fatigue vanished and I have not had any problems with the mtx since.
Sj
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