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Methotrexate - Side effects?

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Posted 7/24/2012 11:59 PM (GMT 0)
Good evening all,

I had a question and hope it's okay to start another thread on Methotrexate and side effects. If not, please let me know and I'll roll it into another thread.

I was just diagnosed with seronegative r.a. on 7/13 (Friday the 13th eyes) My primary care physician started me on prednisone 30mg a day for 2 weeks and then start to decrease down to 20mg see how I do and hopefully on down to none. He also put me on 5mg of Methotrexate on Sunday - take 2.5 at 8am and 2.5 at 8pm. I did mention folic acid to him after reading on the forum here and he said "no need at this time, you are on a very low dose and should be fine". Okay, he's the doctor.

I took it the first Sunday and I didn't get sick but was very tired. Well then this Sunday I took my prescribed dose and at about 3am Sunday into Monday I woke up with stomach pain and I was sweating. It reminded me of the kind of pain I had 25 years ago when I had a gallbladder attack. (the gallbladder is gone as of then too) So I took some tylenol, had some crackers and went back to bed.

I didn't go into work and took a 1/2 sick day to see if I could sleep but then mid morning I got those same pains again with the sweating. I took some chewable maalox anti gas antacid and it seemed to help a bit. Burping. Plus this pain is all upper g.i. not lower. But I called the doctor to find out if they wanted to put me on anything stronger i..e prilosec / nexium. I spoke with the nurse gave her the symptoms and she called me back at 5pm saying the doctor wanted me to come in tomorrow for a work up, could be kidney stones. KIDNEY STONES??? Hello? No, I am not having back pain, no problems passing water, no. (I know I'm not a physician but that was not even close) So I told her I would come in and see them but this was crazy and maybe I just needed folic acid ?

So my question is, can I ask to be put on folic acid to try it and has anyone ever been told no? I read a lot online and so far everything points that way. And, has anyone had this kind of pain from the mtx?

My stomach feels better when I put food in it which makes me think it's irritate
and and I wonder if that could be the prednisone and mtx ??

Thanks for reading !!
Posted 7/25/2012 1:01 AM (GMT 0)
I just popped my 25mg's of mtx an hour ago. I'll get some gas from it in another hour or two, but that is about it. I take 1mg RX folic acid every day. As long as I am not dehydrated I don't get any further intestinal issues, if I'm dehydrated I can feel awful. The first few doses had me so exhausted I wasn't sure I could keep taking the MTX. The third one was good. I would push for the folic acid, it won't hurt and would seem that it can only help. My Rhuem handed me the MTX and Folic acid presciptions explaining that it would help eliminate or minimize most side effects and that was at 7.5mgs.
Posted 7/25/2012 1:17 AM (GMT 0)
They sell folic acid over the counter at any place that sells vitamins. They also sell fully reduced folinic acid at some vitamin stores-like GNC. (MTX prevents folic acid from being reduced to folinic acid which is the usable form). It does not effect the efficacy of MTX for use in RA but if you are taking it for cancer then you aren't supposed to take folic acid.
Posted 7/26/2012 7:21 PM (GMT 0)
Thanks for the replies. turn

I am going to try the folic acid. I spoke to the nurse practitioner at my physician's office and she said there is 400 mcg in women's daily vitamins and that isn't going to hurt anything. But I'd like to try the 1 mg so I will go to GNC to see what I can find. I did already visit GNC and picked up some Calcium - D 3 vitamins. My doctor had asked me to start taking the D 3 - 2,000 a day even before I was diagnosed with r.a.

I am pretty sure the stomach pain I was having is from the mtx. By late Tuesday, the pain was gone and yesterday I felt fine. I am thinking I might also take some maalox the day I take the mtx to see if coating my stomach helps to prevent the gastric distress.
Posted 7/26/2012 8:03 PM (GMT 0)
My daughter takes MTX and also folic acid, her doc will not let her take the mtx without the folic acid...She is on 3 1mg pills of folic acid...He has increasingly moved her up based on her side effects. He has told her to take her mtx on saturday nights so that her sick day is on sunday and then she doesn't work on sundays... It works out well most of the time but sometimes her work calls her in on sundays and doesn't understand why she says no....She sleeps just about the whole day every week...Without the folic acid she was developing sores in her mouth and everything...
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