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oral methotrexate nausea - unbearable??

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Posted 8/28/2011 2:57 AM (GMT 0)
Hi,

Friday, was my second oral methotrexate dose. I take 2.5 mg/ 8hrs (7.5 mg/day). I think this is a very low dose but my stomach doesn't like it. The first dose went on fine but with some nasty fatigue that lasted till day 3. This time, things changed. I took an 8mg Zofran injection to combat nausea and vomiting. The next day, nausea and vomiting recurred, so I took another injection. Now, it's the beginning of day 3 and I can't sleep because of nausea, reflux and excessive saliva. I've had GERD and gastritis for more than 13 years now. Is this nausea normal? How long does it last? Till the next dose? I'm supposed to up the dose to 15 mg. Will I be able to make it?

Thank you

_____________________________________

Current meds: Pred (tapered to 7.5 mg - faliure of tapering is the reason for taking methotrexate, Pentasa tablets 2 g, Pentasa Enema, Nexuim 80 mg, mutivitamins.

Posted 8/28/2011 5:23 AM (GMT 0)
Yeah, it's tough. Methotrexate can hit you hard, especially when you're having the first few doses. And yes, it's not unusual (at least in my experience) for the side-effects to last days and days. They generally did for me.

Tell me, have you discussed switching to an mtx injection with your doctor? Some patients find that the side effects are easier to cope with when the drug is injected: after all, it's not hitting your poor stomach when it's injected.

Hang in there.

Ivy.
Posted 8/28/2011 9:51 AM (GMT 0)
Hi minnie

Sorry to hear that you´re feeling so nauseus. Unfortunally I´va had the same experience but for me it didn´t start untill I had taken it for severel years. I agree with the others, try mtxinjections. In my case it made no difference if I took it as a tablett or as an injection but it´s worth a try. The nausea was so horrible that even today, severel years after I stoped having MTX i can hardly speak of MTX without feeling the nausea come back, like with pavlovs dogs you know .
rolleyes

Hope you find a medication that works för you.

"abroad"
Posted 8/28/2011 10:46 AM (GMT 0)
I was on oral methotrexate for about 6 years - I can remember the first couple of months was when I got the worst of the side effects, it took trying several different Anti nausea/sickness meds until I found one that provided some relief (for me that was stemetil) so might be worth trying a few til u find one that works better.
After 6 years I was switched to methotrexate injections because of absorption issues and oh my word what a difference that made! I still took the stemetil in a pre emotive strike, but the nausea/sickness/fatigue improved so much with the injections! Definitely might be worth switching to see if it makes a difference.
Posted 8/28/2011 1:54 PM (GMT 0)
I agree with Ivy in that you should talk to your doc about switching to the injections. I have heard that the oral is horrible becuz of the nausea etc.
Posted 8/29/2011 4:01 PM (GMT 0)
Dear all,
Thank you very much. It seems I have to switch to injectible mtx. Today, it is day 4 and nausea is still horrible. I contacted my doc and he prescribed another kind of antiemetics. He told me that I have to take these new anti-vomiting injections every/12 hrs and added that if nausea doesn't become better before next dose, I won't take it.
Tsitodawg, my doc hasn't prescribed any folic acid supplements yet, it seems he is waiting till I complain. I'll discuss it with him after two weeks when I see him.
Thank you all again. Take care!
Posted 8/31/2011 12:13 AM (GMT 0)
Folic acid should help with the nausia. I'm surprised it hasn't been suggested by your doc yet. If you're still having problems I would just call the doc right away and ask about it. I haven't seen any reason to not take folic acid when on MTX for Crohn's.
Posted 8/31/2011 12:32 AM (GMT 0)
I am on 15 mg of oral methotrexate (for my lupus).  I was perscribed 1 mg of folic acid to take every day to help with the side effects.  I see that you switched to the injectable mtx but it still is not helping with the nausea.  I know that you were planning on waiting to discuss the folic acid with your doctor in two weeks but I would encourage you to call your doctor sooner to see if he would perscribe the folic acid for you.  At least you would be able to have a couple of weeks on the folic acid to see if it helps with the nausea before you meet again.  I am sorry you aren't feeling well! 
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