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New to RA and methotrexate. Screwed up dosing and have questions.

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Rheumatoid Arthritis
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Posted 5/26/2014 3:39 AM (GMT 0)
I was diagnosed with RA about a month and a half ago by my family doc and it was confirmed by rhuematologist last week. He started me on 2.5mg methotrexate "6 tablets per week". Instead of taking one weekly dose of 6 tablets I have taken 1 tablet per day for four days.

Not sure why I read and reasoned that would be correct dosing. I have since found that I should have take the one 6 tablet dose once a week. Atleast it seems that my mess up was a lot better than overdosing on accident.

I have a message in with my RA doc to see what I should do but with it being a holiday weekend I'm guessing I don't hear back to Tuesday.

1) please tell me I'm not the only one to have made this error lol.
2) anyone have any idea on how I should proceed? Should I not take any for two days and then hit the six?

RA doc also has me on prednisone till the methotrexate kicks in, tapering down from three days of 40mg to three of 30 then 20 down ultimately to 5mg per day.

Looking for a little reassurance on this as the past six months had been a real hard and frustrating time.

Alittle background on me. I'm a 41 year old police officer from michigan. Realitivly healthy,non smoker/tobacco user, very light drinker.

Thanks in advance for any insight.
J-
Posted 5/26/2014 4:05 AM (GMT 0)
Hi and welcome,
I too have done this years ago and it was fine, my doctor recommended that I simply take my next dosage as recommended and I did and it was fine. I would make sure and speak with your doctor however before proceeding just to be on the safe side. I had problems with MTX in pill form as it upset my stomach really bad. If you experience this ask about injectable. It has been much easier for me than the tablets were.

Also, if you experience fatigue for the next few days afterward make sure to bring it up to the Doctor. It is pretty common with mtx and folic acid can help alleviate it but it should be doctor prescribed and not over the counter since over the counter vitamins and supplements like this are not FDA regulated while Rx are.

I was recently on prednisone as well for he last 2 years. It helped with my flare ups which were really bad at the time. once I was on it for a few months it was very hard to get off of though. I would flare up really bad whenever I started tapering off of the lower doses. It took many months for me to finally get off of it and it was not easy. Hopefully you will not be as sensitive to it it as I seem to be. :) I hope that you are able to find some relief with the medications prescribed. Mtx can take a while to really kick in (6 months for me) so be patient and hang in there. This is a great forum with a lot of people who have been dealing with RA for many years. The combined knowledge and knowing that others have walked in my shoes has been a big help. I hope it is for you as well.

-Don
Posted 5/26/2014 7:55 AM (GMT 0)
Thanks don. He has me on folic acid too.

My understanding with the prednisone was that after the mtx starts working that I was only going to need the prednisone for flair ups. My onset was very fast and aggressive with a lot of swelling and near disability in my right arm from the inflammation and pain. The prednisone has really helped with that. I can make a fist, move my wrist and left my arm above my head now, none of which I could do last week.

Thanks for the reply don you have helped ease me mind.

J-
Posted 5/27/2014 12:29 PM (GMT 0)
I am glad you have gotten some relief :) hang in there!
Posted 5/27/2014 1:18 PM (GMT 0)
Thanks don. Talk to my doc today and he said as long as I had a couple days between I can take the full dose tomorrow. He assured me I was not the first to make this mistake. Lol.

J-
Posted 5/27/2014 4:19 PM (GMT 0)
Just make sure to keep it at a weekly dose, from here on out. and maybe add the vitamin biotin to help with hair and nails. (MTX can cause some hair loss, especially at the beginning...)

mtx can be a scary medicine as it is used to treat cancer, but it's been safe to use for RA and it's a much lower dose for RA than it is for cancer ...

There are older posting on here about mtx, you can go back and read them, but please do not respond to post older than a week...some older posters are not here anymore...

Born and raised in Michigan, but now living in Texas and loving it, even if we do get hot...so far this year has been mild for us...which is nice....Only thing to worry about here is Hurricanes, sure do hate those...
"Howdy"
Posted 5/28/2014 5:08 AM (GMT 0)
There ya go :) I figured he would but Im not a Doctor and although mine suggested the same I hate to give "advise" when I am not qualified to give it. Yeah, there are a bunch of us I am sure who have done the same thing.
Posted 5/28/2014 9:07 AM (GMT 0)
Hi and welcome unfortunately this group is Growing shakehead too many people getting RA it's not fun
all the other advice was what you needed not much else to say just remember don't take the Folic Acid on the Days you take the MTX
and don't be surprised if you get an upset tummy after taking your proper dose
I take Maxalon ( anti Nausea) the morning after MTX as I wake up feeling very sick
so if you take the MTX in evening make sure you have a good meal even a night snack latter on, it helps.
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