I was terrified to try mtx. I was started on enbrel for RA, and it took me almost a year to decide to add mtx. It was the best decision I've made yet. Mtx is a wonderful drug for me, anyway. I could honestly ditch the enbrel, if I had to, and just take mtx. My joint pain would come back full throttle, but the mtx would keep it under control. Enbrel seems to be the icing on the cake. I was started on 7.5 mg/week, but mtx didn't start making a difference until I reached 15 mg/week, which is what I take now. Don't think I need to increase it more, although I do know people who take 25 mg and 30 mg/week--it just depends on how your immune system reacts to it. I wouldn't hesitate to take 3 dmards. I'm also on plaquenil, and I 've been taking it with the enbrel and mtx. I've only started decreasing it gradually to see if I can eliminate it altogether. Rheumy said I certainly don't need to take the plaquenil if I'm taking enbrel and mtx, but it won't harm me either--it's up to me.
One thing, when I started taking the mtx, for a day or two after I would have a slight stomach upset. I usually resolved itself within 48 hours and after a few months, that side effect disappeared altogether for me. I also used to experience fatigue for a day or two after my weekly dose. Again, that doesn't seem to bother me anymore. My body is pretty used to it now. Other than those two things, I've had no problem with mtx at all. Just be sure to take your folic acid and go in for your regular bloodwork.
Best of luck to you,
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