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Methotrexate mouth ulcers

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Crohn's Disease
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Posted 9/16/2011 4:18 PM (GMT 0)
Hi, 

Six or seven hours  after I had had my second methotrexate shot on wednesday, I felt severe pain in my mouth and gums. At the beginning, I thought it was because of a decayed tooth. Then, I discovered that the cause was a deep, long, whitish sore in the inside of the lining of my cheek. I have always had one in the roof of my mouth but it has never been that painful. The pain is horrible and lasts for some long time. Is this normal? In the medicine insert, it is mentioned that one third of the patients get stomatitis (mouth sores) and I always get the exceptional side effects. Does getting these mouth sores necessitate stopping the medicine? In a previous post, a fellow Crohnie, Linn, thankfully gave me hope by mentioning that she felt better after her fifth shot and sypmtoms subsided. What should I do? I don't want to stop the medicine, it's my last resort. (failed taking Azathioprine and Imuran - severe side effects).

Thank you.

________________________________

Current meds: Pred (tapering 7.5 mg), Pentasa Enema (before bedtime), Pentasa tablets 2g, Methotrexate 25 mg im/week, Nexuim 80, 2 multivitamins. 

Posted 9/17/2011 6:12 PM (GMT 0)
Hi! I'm pretty sure getting the mouth sores doesn't mean you HAVE to stop....but it certainly made me WANT to stop. I know, mouth sores suck. But hopefully the mtx will help you like its helping me. give it time, and in the mean time, have you tried some orajel? I use orajel and chloroseptic spray, both have numbing agents which can gimp you through the next couple of weeks until the pain subsides. If you slap that on and then eat right after you might be able to get most of your food down without wanting to scream.

I was on night float this week (i'm a med student on my surgery rotation right now) so I had to put off my injection until last night. Thankfully I woke up this morning to no sores in my mouth. I really think there is an adjustment period. Now if only my hair would get adjusted to this stuff.... :-/
Posted 9/17/2011 11:07 PM (GMT 0)
I just had my 3rd shot last night and it gave me a sore, dry mouth and like sores in the corners of my mouth. Have you had any problems with severe fatigue, and horrible headaches with mtx?? Thats my main issue and Im only taking 12.5 mg/ week until I see the GI on the 6th then we are supposed to bump it up to 25 mg/ week. Makes me really nervous if I feel this bad from half the dose!
Posted 9/18/2011 1:49 PM (GMT 0)
Hi Linn and Lovemyboys90,
Thank you very much for your support you two sufferers. Well, I started to reflect on other problems and found that they match MTX, especially, sore throat.
Linn, I'm happy that it went fine with your shot. What's wrong with your hair? Is it falling out? This is a normal side effect of MTX, Imuran and Pentasa. Unfortunately, we have to live up with it (:
Lovemyboys90, yes, I do have severe fatigue that reaches its peak days 2 and 3 after taking the injection. Many of this forum's members thankfully mentioned that taking folic acid daily combats faltigue. I'll see my doc this week and ask him to increase my folic acid supplement. I'll let you know of what I agree upon with him. Actually, the leap from 12.5 to 25mg is not that drastic as I started with 7.5 mg tablets and then jumped to 25 mg injections. The severest side effect that you willl feel are these horrible mouth sores which you already have but as I mentioned above I've always had mouth sores but not these painful ones. These are really annoying.
Take care!
Bye for now.
Posted 9/18/2011 4:11 PM (GMT 0)
Have you tried seeing a dentist/doctor for a prescription that could help with the pain from the sores? Usually, something called "Magic Mouthwash" can help with the pain/healing since it's a prescription for Lidocaine in solution, topical steroids, and topical Benadryl. It helps speed up the healing of the ulcers and decrease pain...I think a PCP should be able to write it for you. It's helped a TON of my patients!
Posted 9/18/2011 6:53 PM (GMT 0)
I always use Oracort for mouth sores/ulcers.
Sometimes I swoosh around a little of warm water & salt with a drop of oil of oregano, too.
Posted 9/18/2011 7:19 PM (GMT 0)
Tooth and Roni,
Thank you very much. Is Oracort an over the counter medicine? I'll ask my GI doc about mouth washes. If not, I'll follow your advice, Tooth, and see a dentist.
Take care!
Posted 9/18/2011 9:50 PM (GMT 0)
No, you'll need a script for it. A dentist can prescribe it as well.
Posted 9/20/2011 8:41 PM (GMT 0)
Hi,
Thank you Roni.
Lovemoyboys90, as promised, I saw my doc, he presribed a dose of 2mg folic acid and decided to switch me to Entocort tablets instead of pred as it seems that MTX hasn't kicked in yet and the symptoms are the same except for the severe pain.
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