Methotrexate injections

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Regular Member

Date Joined Mar 2005
Total Posts : 455
   Posted 12/27/2009 11:42 PM (GMT -7)   
So I have been on pretty much every medication or every "class" of medications in the last 15 years that I have had Crohns. Remicade, humira, prednisone, 6mph etc.
My last effort was a Study drug called MLN0002. I didn't notice a change after 2 months so I gave it up. The doctor put me on 60mg of prednisone and told me my only other option is to have my Colon removed. He said if I had that done I would be "pretty much Crohns free". First of all I am very scared to do that. Second I cannot afford all the time off work I would need since I am not near a bathroom often and I am always lifting heavy things.
Anyways I said I can't do that right now so he is putting me on Methotrexate injections, along with the prednisone. I go on Tuesday. I have read a little bit about this and have seen there can be some severe side affects.
If anyone can help me out as far as giving me some of the common side effects, how long it usually takes to start working etc I would appreciate it.

Veteran Member

Date Joined Dec 2008
Total Posts : 947
   Posted 12/28/2009 5:12 AM (GMT -7)   
I'm not on Metho but I would'nt worry about all of the side effects, every drug has to list them even if one person has a reaction. there are several people here that use Metho and they currently don't have any problems. I'm sure someone will come along soon that is on Metho and ease your mind. I did have surgery in Feb 09. It wasn't that bad and i only missed 2 1/2 weeks of work and I do physical work. My boss gave me a job for 2 weeks with very little lifting.
Don't fear the knife!
I hope Metho works for you.
Diagnosed with Crohns in 2001
First and hopefully last Ileocecectomy 2/18/2009

Medications: Asacol, Precription Folic Acid, Multivitamin, 1000mg Calcium, Vitamin D, Probiotics, Pepcid Complete, Questran,  Monthly B-12 injections.

Living a Great life with my Wife and my two Chocolate Labs
Hunter & Hailey.
I love them dearly.

Regular Member

Date Joined Apr 2007
Total Posts : 134
   Posted 12/28/2009 5:30 AM (GMT -7)   
My personal opinion, just get the surgery. The amount of days you will need to recooperate will be less than the amount of days you will periodically take off because you'll flare. Assuming you won't need some sort of ostomy, you're quality of life will increase.

I'm on methotrexate, started it after my surgery when I couldn't tolerate Remicade anymore. The question you should ask yourself is how much and for how long are you willing to be on that Prednisone...those are the side effects that can be devastating.
22 Female, currently on MTX. Previously on Imuran, Remicade, Pentasa, etc. Ileocolic resection in 2006.

Regular Member

Date Joined Dec 2007
Total Posts : 414
   Posted 12/28/2009 5:40 AM (GMT -7)   
Yup this is my 8th year on methotrexate!! Tablets for 7 years then switched to injections.

When I first started on it I got gradually better over around a 3 month period which is about right - it is not an instant fix.

I found the first month taking it (tablet form) I was quite side-effecty but they weren't unbearable side-effects - nausea, light-headedness, visual disturbances and tiredness, these lasted a day maybe a day and a half after taking. But after a month things were much better, I'd take the dose last thing at night before I went to sleep so I'd sleep through the majority of side-effects and Stemetil worked wonders for the nausea - I could still function fine go to work etc and whats one day of nausea/side effects a week compared to a Crohn's flare?

Apparently the injections cause less side-effects like nausea as its not digested, can't say I've noticed a huge difference but the side-effects never bothered me anyway. Methotrexate has kept me in remission for up to three years at a time, my liver functions still perfect and I get to live life almost completely normally. I can't stand when people bash methotrexate I love love love it! The little risks are totally worth it in my opinion for the happy years I've had on it!

Regular Member

Date Joined Jun 2006
Total Posts : 83
   Posted 12/28/2009 6:32 AM (GMT -7)   

I also have been through every med out there and none work for me except Remicade but I built up antibodies to it and had to stop.  6mp was messing up my liver, nothing was working so my doc said lets try Methotrexate.  Like another poster said it's not a quick fix takes about 2 or 3 months to kick in.  But you definitely want to inject it.  The only side affect I get from it is tired. It make me tired and sleepy for about a day and half after my one week injection.  So I take it on Fridays and gives me the weekend to rest. For me, I don't think it's working 100 percent but it does help some so far. I would try everything before surgery.  Good luck, this disease is bad stuff no doult!


Crohn's in the ileum for the last 35 yrs.  3 ressections, numerous attempts at fistulae repairs, a battle with C Diff (that was bad), while recouping from C Diff, I had two PE's. Doing good now.
RX: Methotrexate, Zoloft.

Veteran Member

Date Joined Jul 2008
Total Posts : 674
   Posted 12/28/2009 6:45 AM (GMT -7)   
I've been on Metho for the last 4 months, 1 injection every week. All other meds have failed, and this one hasn't helped my Crohns either...but I haven't had any side effects from it. 
Dianogsed with Crohns: At 16 years old. 23 years old now.
Surgeries:3 Bowel Resections, Gallbladder Removed, 3 Abscess Cleanings, Fistula Repair
Current Meds: Methorexate, Vitamin B12 (injections), Nexium.
Next Surgery: None.

Regular Member

Date Joined Aug 2008
Total Posts : 351
   Posted 12/28/2009 9:01 AM (GMT -7)   
I would go with metho before getting surgery.  I've had surgery and i was left with a temp ileostomy for about three months before i was reversed.  so if you can live with going to the bathroom in a bag for the rest of your life than go for it.  do u know if your crohn's is limited to just your colon or your small intestine as well?  If you remove your colon chances are that you will have a reoccurance in the small intestine.  Totally up to you though.  I'm in the same situation as far as the medications.  Been on everything except metho.  Prob gonna start taking it within the next few weeks.  I'm a little scared but i need somthing that is going to work.  i have crohn's in the small intestine and the colon.  i also have it in my mouth.  ( yea i know, lucky me lol)  So i would suggest trying the drug before doing surgery.  Once you remove your colon there's no going back.  hope this helps and i hope you feel better.

Regular Member

Date Joined Aug 2009
Total Posts : 377
   Posted 12/28/2009 3:12 PM (GMT -7)   
I'm on both Remicade and Methotrexate, so I can't tell you for sure when the Methotrexate kicked in. I'm pretty sure it was the Remicade that helped at first. I do weekly injections, and honestly the only side effect that I've noticed was that I'm losing a bit more hair every day. Thankfully it's not enough that you can tell, since I do have a thick head of hair, but it was a little worrisome at first. That started happening about 3 months after I started, so maybe that's about the time that it would kick in? Good luck, I hope it works for you.

Regular Member

Date Joined Mar 2008
Total Posts : 382
   Posted 12/28/2009 6:22 PM (GMT -7)   

Have been on weekly injections for 15 months with no side effects.  I can't see the side effects any more scary than being on Remicade, Humira or any length of Prednisone.

You will have to have regular bloodwork done so this will detect any harm it could be doing in it's early stage.


57 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

Regular Member

Date Joined Dec 2009
Total Posts : 44
   Posted 12/28/2009 9:22 PM (GMT -7)   
Hi, my 14 year old daughter was on Methotrexate when she was first diagnosed. She took it orally for 6 months and did ok. Then she began to throw up every time she took it. We then switched to injections which was just as bad. She threw up every time and was weak and sick all weekend. We finally stopped it.

Regular Member

Date Joined Mar 2005
Total Posts : 455
   Posted 12/30/2009 9:43 PM (GMT -7)   
Just got my injection yesterday. The nurse taught me how to do it and it was surprisingly easy. Not sure if it was in my head or if it was the Crohns or not, but I felt a little tired after like I wanted to take a nap. Then later in the day I felt a little sick, but nothing I couldn't handle.
I had less bms today, but it could be from the prednisone kicking in.

Regular Member

Date Joined Dec 2007
Total Posts : 414
   Posted 12/31/2009 3:02 AM (GMT -7)   
Thats great! I remember being so nervous before I first injected but like you said - nothing to it really! Just find it stings a little bit.

Regular Member

Date Joined Aug 2008
Total Posts : 351
   Posted 12/31/2009 8:33 AM (GMT -7)   
i'm a bit scared of metho. my doc insists that i do not get pregnant while on it and i have to be off of it at least six months before even trying. same thing for men. they also have to be off of it for that long as well. the injection part doesn't bother me. i inject two cimzia every two weeks. i'm just afraid i guess of feeling sick and my liver failing basically.

Veteran Member

Date Joined Mar 2005
Total Posts : 589
   Posted 12/31/2009 6:14 PM (GMT -7)   
I have been doing MTX Injections weekly since July'09 - I take my inection right before I go to bed - at first it made me nauseated, would get a headache for a few days, and just felt generally crappy for a few days after taking it.
(I also have Lupus so my rheumy and GI both agreed on this). 
After speaking with my Rheumy about the side effects I was having after starting the MTX she gave me some wonderful tips that have done WONDERS on feeling so much better are as follows:
- Drink plenty of water/fluids the day before and day of taking your dosage.  Hydration is extremely important (I have learned the hard way when having a "bad bathroom" day the day I take the shot, that when not hydrated - my symptons of nausea and vomiting will show up within a few hours of taking the shot)  The reason being the hydration seems to move the medicine flowing through your liver & kidneys to help disperse it and keeps the side effects away.  If I am feeling dehydrated I drink some gatorade that day to make sure I am hydrated.
- Take FOLIC Acid on a daily basis - I take Folinc Acid 1600mg/day, and the day of the shot I take a DOUBLE DOSE of folic acid.  It makes a HUGE difference of how I feel overnight and the next morning.  Methotrexate depletes your body of Folic Acid which is needed for your brain, etc.  Honestly if I have a quesy feeling in my stomach, taking my dose of Folic acid is enough to settle it.  My GI never mentioned the folic acid to me - my Rheumy said it is necessary for anyone taking MTX - ask your GI if you have questions - do research and you will find how highly it is recommended for those who take MTX, espeically those who have RA or Lupus.
- Take the shot and then go to bed ASAP. 
- if you are going to have a drink of alchohol, do NOT do it the same day taking the injection/pills. 
- I also NOW take the Preservative Free MTX - which made a big difference also in how I felt - I am extremely sensitive to Preservatives and Fillers - I can't take a lot of generic's due to the fillers.
My side effects have pretty much disappeared as long as I follow all of the above tips.  I was loosing a lot of hair, and now after 6 months on it, I have definitely slowed down in the amount that I was loosing. 
It took me about 6 weeks to notice the difference it was making on my Lupus symptoms (i.e. joint pain, swelling of my joints, exhaustion and sun sensitivity) and about 3 months before it kicked in for the Crohn's Disease (bathroom trips, bleeding, etc.)
But I really LOVE, LOVE my MTX, yeah It has allowed me to have the freedom of actually going up and down the steps again - where for the past 3 years I couldn't do any type of stairs - had to move to a ranch house @ 32 years old, not having swollen joints and just actually able to function like what feels like a normal person. 
I was deathly afraid of taking it at first and it still really bothers me to put it into my body, but that is just my personal issue - getting better at being at peace with myself over it. tongue  

Diagnosed with Lupus - April 2002
Diagnosed with Crohn's Disease (and all the lovely things that come with it) - January 2003 (problems since early 1990)
Fibromyalgia 2005 
Normal Meds:  Ambian 10mg, Flexeril 10mg as needed, Plaquenil 400mg, MTX 25mg Injection weekly, 1000mg Canasa Supp. as needed, Probiotics

Post Edited (karasmommy) : 12/31/2009 6:25:48 PM (GMT-7)

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