Methotrexate

I started methotrexate today, 25 mg sub-cutaneous. The 6MP settled things down for me, but it didn't seem to be able to get me into complete remission. I took the 6MP for years, but stopped it last fall and went into a flare.

So far so good with the methotrexate. I know that 6MP takes about 3-4 months to work, how about mtx? The nurse today said it takes about the same, but I read on ccfa that mtx works more quickly (didn't say how quickly). I'm not taking the 6MP anymore so I hope that I don't go backwards before the mtx takes effect?

Anyone know how quickly it's supposed to work?

MTX has rocked for me, it has been the only thing that has even remotely worked for me. It really depends on how much your body can absorb, as tot the time it takes. It is not a magic wand, but you will see some results in a couple of months, but I know people who have started feeling better by their 6th injection. Just be aware you might feel worse the first month you are in it. Not usually, but it can happen.

I had my 5th shot this past Tuesday. I am on a schedule to have 6 shots and then I switch to pills.

I noticed positive results (more formed stools and less trips to the bathroom) after the very first shot. The shots seem to lose their effectiveness at around 5 days for me, but the two days until my next shot are still better than pre-MTX. I experienced slight nausea. I took only one pill for anti-nausea after my first shot (and I really think that was just a pre-emptive strike on my part) but all other nausea sensations were very mild. I needed only a slight distraction or a snack to get rid of the feeling. This last week, I didn't recall any nausea at all when my nurse questioned me about how I'd been feeling.
heidi

My rhuemy told me months-like many months but 8 weeks after I started mtx-and I am only on 12.5mgs.
Some advice, drink a ton of water in the 12 hours or so before and after your dose, start folic acid-at least 1mg but maybe more (I take 3) now the folic acid protects your liver and also prevents the tiredness and stomach discomfort that Mtx sometimes causes.
Good luck.
Sj

Yes, I read both of your earlier posts before I started, so I drank lots of water and I started taking 3mg of folic acid a day a few days before my first dose yesterday.

I feeling tired, but nothing horrible, and I have a minor headache. Thanks guys.

Man, I feel your pain...Waiting for a med to start having an effect just *sucks*. I've been on azathioprine now since February, with a dosage increase to 150 mg just 1.5 months ago. I think I'm *finally* starting to feel the effects of the dosage increase now... 1.5 months later. :/

In addition to the mental side effects of the pred (which, quite literally, drive me nuts), I was diagnosed with steroid induced glaucoma. So now I *really* need to come off the pred. Every time I try to get below 20 mg/day, I flare like crazy. I'm starting Cimzia this week, and am hoping that the Azasan/Cimzia/Entocort cocktail will be enough to allow me to elliminate the pred all together. Have you and your GI talked about combining your methotrexate/pred therapy with an Anti TNF biologic like Remicade/Humira/Cimzia/Tysabri? The total percentage of people that obtain  a positive result from biologics isn't really that high (in fact, it's discouragingly low), but for those that it helps, it *really* helps. Cimzia, for example, quotes a 38% response rate.

Anyway, I hope things get better for ya, man.

I have never heard that it takes 3 to 4 months, I noticed a differnce literally after my first injection. And I've heard that it worked within a couple doses, which would be a couple weeks.

For me 6mp was very dangerous for me lower my counts to where I had to be isolated. but Methotrexate took me from a very very severe case to not having any activity in my small bowel in over two years, since two aprils ago.
Ive had no side effects, at first I got headaches, so I took fioricet, and it was even the one without codeine and worked great, and I have a huge tolerance for narcotics so to say it worked is pretty good. its like barbituates, tylenol or aspirin and caffiene.

I have had 11 metho injections so far and GI is doing another colonoscopy at 4 month mark (would have been 3 months if not for Christmas) so he must think we should know by then if it is working. I have inflammation at a stricture site which may be a different situation than some of the other replies. I take 5 mg. folic acid daily and my husband gives me the injections. I went from 6-7 bowel movements a day to 1-2 after first injection. I have no diarrhea and no nausea. The real test will be to see if a scope shows inflammation.  If so, next step may be a resection.

Yes thats doing pretty well. I remember When I was in high school and I would go 6-10 times before my 7:30am class...so 1-2 is probably equal to not having crohns disease for a lot of people.

Just wanted to add for those who didnt know, Methotrexate works great for me. Once crohns moved to my small bowel I had to have 29cm of terminal illiuem removed, which was actually a 2am emergency surgery. Since then I've been on Methotrexate, and havent had any small bowel problems, I eventually added Humira on top of this, along with my low dose prednisone and some other things, and I feel as close to normal as I have in years. Me and My drs, both Gi's and Both surgeons agree that Methotrexate, besides Prednisone, has been the single medication that I can use as maintenance with no side effects that works very well for me.

Bummer. Hope it kicks in for you soon.