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Methotrexate for Ankylosing Spondylitis

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Rheumatoid Arthritis
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Posted 5/2/2013 9:28 AM (GMT 0)
Good morning, I was diagnosed a couple days ago with A.S. and given 25mg a week of methotrexate. Could anyone tell me the best time of day to take it to avoid nausea and also what types of side effects that you have experienced. Any insight would help greatly. Thanks so much!

 

Posted 5/2/2013 5:36 PM (GMT 0)
Hi There and Welcome!

I was dxd. with RA not AS, so I'm not sure if this applies since medications can affect patients differently.

I've noticed Patients seem to have a varity of times to take the folic aside to reduce side-effects. It is trial and error for each of us. Methotrexate(MTX) should be taken the same day once a week and around the same time of day. You should be using Folic Acid to reduce toxitity and some side effects of Methotrexate.

I am taking Pantoloc to reduce the risk of stomach ulcers and irritation from NSAIDS(nonsteroidal anti-inflammatory drugs) which you may also be taking and some other medications.

I haven't experienced nausea or vomiting from MTX but I have lost 16 pounds due to loss of appetite, a side effect of MTX.

I used to get ulcers on the sides of my tongue often but that side effect disappeared after being put on Rituxan.

I have had hair loss while being on MTX but noticed that I haven't lost barely any since I took extra Folic Acid weekly. I'll be waiting for my hair to grow back since I was been taken off the MTX yesterday. :)

Drinking alcohol may increase the risk of liver damage while taking MTX.

Improvement of conditions can appear at 6 weeks usage but full benefits may take 3 to 6 months.

Lab tests are usually taken every 8-12 weeks for detection of possible serious side effects.

Hopefully your treatment works well for you as it does for many.
Posted 5/2/2013 9:15 PM (GMT 0)
Thank you so much for the information. I am concerned about taking this medication because I have severe GERD and I am on Dexilant 60mg and Rantitidine 150mg per day and I still have heartburn. I am also really concerned about losing any hair as I have very fine hair as it is. Has anyone found that Humira or Enbrel work better and why? I have been doing a lot of research since I was diagnosed and have read that Enbrel works the best for A.S.
Posted 5/4/2013 5:22 AM (GMT 0)
Hi Kate_M For the hair lose there is folic acid. If you are concerned
should should talk to your rheumy doctor about the MTX. I am using Enbrel for my RA. It helps my RA.
Posted 5/4/2013 9:17 AM (GMT 0)
The biologics work best in combination with MTX so are often prescribed together.
I don't take biologics.
I have been on MTX for years. The side effects went away completely when I started taking 3 mgs per day of folic acid.
I never had hair loss, in fact the RA was causing some hair loss that grew back when I started MTX and got the RA under control.
Posted 5/4/2013 12:27 PM (GMT 0)
Thank you everyone. So far so th old. I'm just really tired and ALL of my joints hurt worse. I'm not sure if that is due to meds or disease though. I've heard that side effects peak between 48-72 hours after taken. Has anyone experienced this?
Posted 5/5/2013 5:24 AM (GMT 0)
I take 5mg of folic acid every day except the day I take the mtx. I used to take my tablets at night with food, this helps with the nausea and any possible effects on the stomach. For a while there I was taking it in combination with Humira and it worked well. Having said that, I have been on mtx injections for a while and they are a lot easier to tolerate than the tablets. The main side effect I have now is extreme fatigue. I now take it in combination with Infliximab. If you're still in pain and unable to tolerate the side effects, I would speak about combining it with a biologic and getting it injected.
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