I am on the oral dose of MTX and I am considering requesting something for the nauseau AND maybe switching to the injection--I am now taking 25 mg a week and that is a bit much orally, I think.
My nauseau seems to hit a few hours after the dose and then again a day or two later. The fatigue seems to set in about that time as well.
You prob know this already, but just in case, be sure you are taking folic acid with the MTX.
Best of luck and take care!