Methotrexate side effects.

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Regular Member

Date Joined Aug 2008
Total Posts : 351
   Posted 2/28/2010 10:23 PM (GMT -7)   
I've been on methotrexate for a little over a month now.  The first 2 injections I got a low grade fever, body ache, and extremely tired to the point where I would fall asleep for hours.  Also I was getting a horrible headache.  This would last all day and the next day i would just be extremely tired and have a headache.  The second 2 injections I felt a lot better.  Only symptons were the tiredness and the headache.  Now last thursday i went in for my 5th injection and again i had low grade fever and the like.  What is up with this?  Is this normal?  Has anyone else experienced these side effects on this medication?  Thank you for all your help.

Elite Member

Date Joined Apr 2005
Total Posts : 14995
   Posted 3/1/2010 9:27 AM (GMT -7)   
Bumped up so you can get more responses. Hugs!
Gail*Nanners* Co-Moderator for Crohns Disease & Anxiety/Panic
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Regular Member

Date Joined Dec 2007
Total Posts : 414
   Posted 3/1/2010 11:01 AM (GMT -7)   
You say went in for, does this mean you don't do them yourself? I'm going to assume also that this means your having the injection during the day time, the best trick for methotrexate is to have it last thing at night so you sleep through the majority of side-effects but unless you're doing them yourself that would be tricky - is that something you're going to be doing in the future? I still feel dodgy for at least 6 hours after the injection so I do it right before I sleep when I have an easy day the next day as I get tired easily the day after.
When I first started out on it the side-effects were horrific for the first month and then gradually got easier - it may take time. Another thing is its hard on your liver, a nurse once said to me it basically induces the hangover from hell as your liver processes it kind of like in someone who's had a huge amount to drink. Hydration is absolutely key, not just extra water the day before and after but making sure you're properly hydrated all the time. That might explain the headaches.

Regular Member

Date Joined Jan 2010
Total Posts : 448
   Posted 3/1/2010 11:18 AM (GMT -7)   
My appointment is in a few hrs and we probably are going to start methotrexate.

Im concerned because I really dont want to feel hangover-ISH or nauseated.

Does everyone feel like this after injection?

Regular Member

Date Joined Dec 2007
Total Posts : 414
   Posted 3/1/2010 11:24 AM (GMT -7)   
It'll be different for everyone, not every person will. And it could be different each time maybe. All you can do is see what happens if you go on it you may not get any at all but generally the side-effects are worse to begin with and get better. There are ways to deal with them though such as the take at night thing and hydrating etc. I use prochloperazine (Stemetil) for nausea and it works brilliantly - completely gets rid of it though I hardly have to use it anymore as I sleep through the effects.

Regular Member

Date Joined Feb 2010
Total Posts : 29
   Posted 3/1/2010 3:50 PM (GMT -7)   
I was on Methotrexate in November 09 for 6 weeks. It worsened my fistula, resulted in the induction of another fistula, and it dropped my WBC count massively (normal is WBCs dropped to 0.6). I had elevated liver enzymes aka liver damage, and I developed neutropenic fever, resulting in another admission into the hospital for 10 days....better than the 3 months I spent in the summer!

So, in conclusion, don't be scared of methotrexate, but DEFINITELY be weary of it. I was taking injections once a week. I took the shot at night before sleeping, and, yes, it made me feel very tired and flu-like for two or three days in a week. Make sure that you're having weekly blood tests done to check your CBC (complete blood count) and liver enzymes, tho methotrexate is known also to cause a whole bunch of other issues --- lung injury, liver injury, pancytopenia (dropping of all blood counts - white and red), rashes, and other stuff I can't really remember right now ---but DO NOT TAKE ANY ILL HEALTH LIGHTLY WHILE ON METHOTREXATE. not even a cold. I had a fever of 99.1 and ended up in the hospital after a nurse told me that that wasn't right.
A survivor of CAPS - Catastrophic Antiphospholipid Syndrome with infarcts in one kidney, spleen, liver, and intestines in July '09

Surgeries: cholecystectomy, partial enterectomy x 2 with surgical complication of EC fistula
Meds: Lovenox daily subQ injections, Metoprolol for hi BP
Previous Meds: Ritoxan, Methotrexate, Plasmapheresis, innumerable blood transfusions, and antibiotics galore.

Veteran Member

Date Joined Aug 2007
Total Posts : 1202
   Posted 3/1/2010 3:54 PM (GMT -7)   
I just did my 6th MTX shot this morning. I don't notice any side effects at all from it. I worry that after I've been on it for a while my hair will thin (more). But i'm taking folic acid hoping that helps. I get low grade temps with my Crohn's all the time, but they only come in the evening and I had them prior to mtx, so I don't associate the two. So, debilitated, don't worry. You may be like me and not feel anything from it... Now if only it will help... ;-)

BTW - I had blood work done at weeks 2 and 4 then every 4 weeks...
1 fistula, crohn's colitis, limited to large intestine
Compounded budesonide 3mg/daily, Cimzia, MTX . Dx Osteoporosis 10/08 started Forteo 1/27/09

Regular Member

Date Joined Dec 2007
Total Posts : 414
   Posted 3/1/2010 3:57 PM (GMT -7)   
Oh dear sounds like you had a rough time on it! In 6 weeks as well. Just goes to show how different drugs are for different people, I been on it 8 years and all good so far (touch wood), occasional colds and throat infections but thats pretty much it. I don't have many options left so am very grateful the methotrexate has worked so well for me.

Regular Member

Date Joined Aug 2008
Total Posts : 351
   Posted 3/1/2010 4:54 PM (GMT -7)   
thank you guys for all your responses and nanners thanks for bumping up my post. i really should be drinking more but i do not hydrate at all before or after the injection. and i also go once a week to have my injection done my gi doc. i am totally paranoid and scared out of my mind to inject myself with ANYTHING. i'm alright getting injected so idk...go figure. anyway i know medications effect everybody differently and i know the methotrexate takes a while to kick in. i have read up on all the possible side effects that this drug can do to your body but when faced with no other option what is there to do? i just quite honestly feel like completer crap and i hate the side effects. i do get the injection during the day b/c my doc does give it to me so i guess you reap what you sow. lol. anyway i would like to thank everyone for their responses and i hope everyone has had a good day. :)

Veteran Member

Date Joined Jul 2006
Total Posts : 6927
   Posted 3/1/2010 10:08 PM (GMT -7)   
Bella unfortunately it can take a bit to stablize on MTX, but I will say that I have tried humira and remi and MTX injections worked far better then either one of those did.
Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_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.

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Make sure your suffering has meaning…

Veteran Member

Date Joined Feb 2004
Total Posts : 6518
   Posted 3/2/2010 5:37 AM (GMT -7)   
well if it induces the hangover from H--- I must have a good tolerance and I dont drink. I take four tabs every monday and I have not felt any dif. Maybe the pills are not as bad as the shot ? Still think you should talk to your doc. Keep us up to date ...
If we would read the secret history of our enemies,we would find in each mans life sorrow and suffering enough to disarm all hostility.

Veteran Member

Date Joined Mar 2005
Total Posts : 589
   Posted 3/2/2010 8:49 AM (GMT -7)   
I also do the MTX weekly injection - when I first started I had the "hangover feeling" the next day and a few days following.

My Rheumy told me to take Folic Acid daily (I take 2mg daily and a double dose the day that I inject) and drink TON's of water the day of, also to take the injection right before going to bed so that you sleep off most of the feeling of nausea, headache, etc.

After taking Folic Acid and making sure that I am drinking alot of water/fluids I definitely don't have any issues anymore.
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

Regular Member

Date Joined Dec 2007
Total Posts : 414
   Posted 3/3/2010 6:03 AM (GMT -7)   
I think the nurse used the hangover thing to help me to understand what it does in the body, I don't get that anymore and since I moved from tablets to injections I get even less side-effects (just tiredness) with the tablets nausea was more of an issue for me.

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