Methotrexate: Myths and Realities

In Australia, Methotrexate is a commonly prescribed medication in Rheumatology. Like any medication, there are pros and cons and our Rheumatologists discuss some of the myths and realities of Methotrexate use in our video. Dr Irwin Lim will explain how Methotrexate is commonly used, some of the potential side effects as well as some of the benefits associated with Methotrexate use.
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[@nanou7314]

I have been on Mtx about 5 years now for PsA. I take 20 mg weekly self- injection, and 3 folic acid 5mg tabs a week (not close to injection date). I love this drug, it has given me my life back in spite of suffering pretty much all side effects at one time or another (thankfully not the lung connected side-effects). I am actually here because I was searching for remedies for Mtx hangover as I'm having a tough after-injection day today, but it doesn't happen every week. I'm just annoyed because I planned on working today and my work requires a clear head: the Mtx hangover gives me a brain-fog that would be better spent Netflix binge-watching 🙂I have had hair loss, headaches, exhaustion, nausea, and the worst... mouth sores. BUT, and it's a big but, I am still on it. These side effects are not every time, and the medication stops me being crippled like an old lady and being unable to work. They're worth it for what I get, and very importantly, they have GREATLY REDUCED by self-injecting instead of taking the weekly tablets. Also greatly reduced by taking 3x 5 mg folic acid weekly (for 20mg Mtx). I posted this for an honest, non-dramatic view of the product from a patient. My bloods are OK. I have a little bit of kidney dysfunction but that was there before and hasn't worsened. My liver is alright. I had to skip some injections because of Covid and vaccines the last year (once for booster, once for actual Covid) and the flares & symptoms of PsA remind me everytime how grateful I am for this drug. It's not all rosy, but it works.

[@bjchealthAU]

Thank you so much for taking the time to share your journey and help others who have these decisions to make. I hope your honesty and genuineness can help many others.

[@e.elsibea1518]

I have been on methotrexate for thirty-three years, since the age of twelve. I was diagnosed at age six. I credit it, and the tireless hard working physicians & clinicians of the time period, to saving my life. Before mtx (methotrexate), considering this was the 1980's & I was diagnosed with JRA, I & my family were essentially at the mercy of my disease. Before mtx, there was thirteen 325 mg aspirin a day, which was swithched to gold salt injections, Tolectin, and Trilisate. All of that, almost destroyed my tiny body. Not to mention, the steroids. However, it has because once again a tireless effort to find the right treatment. I only offer this information because coming into contact with those who experienced mtx early on is difficult. The brand name in America back then, or one of them, was Rheumatrex, which I feel is not quite as cool sounding as Methoblastin. Lol!

[@bjchealthAU]

Thank you for sharing your story. I hope this helps many when they are considering their management collectively with their physicians.

[@HappyCatHappyLife]

Great video. I was just prescribed MTX in addition to Remicade and this video addressed all my concerns - leaving me with hope and a bit more confidence in why I’m being prescribed this. Really grateful for this type of literature being shared so easily with people across the world.

[@bjchealthAU]

Thanks for the feedback. It's nice to hear something positive. I hope it goes well and thanks for sharing your journey.

[@jonnyboi068]

Did mtx work?

[@agaragar21]

That was a wonderful explanation !

[@bjchealthAU]

Thank you for your feedback. Love the support

[@juliehammond5822]

I found this very reassuring. Had some trepidation about starting mtx three weeks ago but feel much better about it now. Thank you.

[@bjchealthAU]

Glad we could help. Good luck with it.

[@todorstoyanov1111]

Start it, nothing wrong with this drug!!!

[@juliehammond5822]

@@todorstoyanov1111 Thanks for the reassurance.

[@todorstoyanov1111]

@@juliehammond5822 I have been taking methotrexate 15mg for 1 year.I hope you don't mind if i advise you to take it on a day followed by an off day. I take it after food together with famotidine(drug lowering stomach acid production). This way i have the least problems with my stomach. Some times i get headache or feel a bit dizzy on the following day. Drink more water , rest, and everything will be fine.Good luck!!

[@juliehammond5822]

@@todorstoyanov1111 Many thanks.

[@roxannestento173]

Great info!!!

[@bjchealthAU]

Thanks for the positive feedback. Appreciate it

[@dianehardy9136]

Just started MTX

[@vernwrites]

I have recurring pyoderma gangreneosum and take methotrexate with the latest occurrence. It has helped and may be headed to remission again. I also have taken a diminishing amount of prednisone as a combo. Any success with PG will be welcome.

[@MICHAELCAMPBELL69]

Have been prescribed it

[@MrSteamDragon]

Am 64, diagnosed with RA 5 years ago. Mainly in knees and hands. Been on MTX 20mg/wk with Leflunomide 10mg/day. Folic acid 10mg a week ( 1 day before the MTX) Blood tests every 6-8 weeks - all good. No side effects - apart from some minor fatigue later on in the day. Although this might be due to the RA itself, can't really say. Very good results indeed, changed my life around. AM getting close to retirement so it was important to me that I maintain my ability to continue my hobbies/interests without the crippling effects of RA later in life. It's definitely a drug where you need to weigh up any possible side effects against the benefits (as with all drugs/treatments). Also I think, where you are able, is to find a Rheumatologist who you can trust so that you can really trust the advice being given to you. Of course MTX may not be suitable for everyone, but please don't simply dismiss it because someone else had a less than favourable experience. Finally, a lot of the Dr Googles out there don't have a clue what they are on about 🙂 Good luck.

[@ericyou11]

@mrsteamdragon I’m on methotrexate the past year I’m hearing n reading horror story’s about it I’m only 30 I’m on it for arthritis and on cosentyx for my skin psoriasis how are u doing on methotrexate now

[@MrSteamDragon]

@@ericyou11 Hi there...well I have yet to have any adverse side effects from either the MTX or the leflunomide - but I am aware a lot of people do have mixed results. Right now the treatment is working very well for me. Personally, I would suggest that if you have not had any unfavourable side effects to date then don't dwell on it. I don't see the point of worrying about things that may not happen. However, you do need to be aware of any possible long term side effects, as you say you are only 30. So my suggestion there is to maintain a dialogue with your Rheumatologist and raise any concerns/questions with them. Initially I saw mine every 3 months to discuss blood work results and progress, now I see him every 9 months. And remember, there are no silly questions 🙂. Good luck.

[@mikecheatwood713]

chk out mtx methotrexate called chemo drug bad on mind, changing red blood cells from circular to oblong, effects folic acid in cells that is what takes oxygen to all parts of body. wife took it for 6 months 26 mg caused bed dementia symptoms kills good and bad cells in body wicked drug for esp. women over 60 also kill babies in the w. of women with mtx, did not know or never touched it.

[@cainrusputin348]

Helpful video, can I take a 20mg of Tadalafil when taking 20mg of methotrexate once a week orally ? Thanks.

[@jmanuelforero3850]

if you are a man planing to start a family, what's the alternative to MTX? thanks

[@zitasolidum3850]

Currently used MTX

[@patkeating8421]

My sister has been diagnosed Fibromyalgia . Will this drug help her. She also has Ulcerative Colotis which is well controlled. Hoping this new drug doest make her Colotis flare up ??

[@dianehardy9136]

I have sarcoidosis n some arthritis and MTX was given for that

[@jaimeehinojosa716]

im afraid to use methotrexate any immunosuppressive drug, steroids, & biologics with mctd overlap syndrome im at loss ..soo many goods and bads...so divided

[@omgediter1292]

currently on mtx

[@trevorjessen8310]

I don't like the drug but it's the only one that really gives relief

[@bjchealthAU]

Thanks for sharing.

[@mckenna9489]

Why?

[@trevorjessen8310]

​@@mckenna9489 because it makes feel sickly and tired for a few days and also brain fog

[@visichinappa8531]

Sore stiffness in hands and body

[@mohansinhjhala9754]

I've been taking MTX for over 16 years. Important benefit is prevention of deformities of fingers. Side effects are problem of overthinking,skin infections,cartilage degeneration of Right Shoulder.Perpheral Neuropathy of feet , Prostrate problem and so on. Is doze of 15 mg /week optimum at the age of 83 ?

[@visichinappa8531]

Polymyalgea is much better lately so taking 3 to 4 mtx tabs once per week. Question ...is what dosage do I take of folic acid and directions of taking this?

[@anastasiajarrell9006]

What are the side effects, if any, for a caregiver for someone on lose dose (long term) methotrexate?

[@bjchealthAU]

Maybe this video can help - kzbin.info/www/bejne/i5vMoIuqm959fMU

[@tricia-leewairau4229]

I have been on this medicine for 22 years, this was the best explanation I have ever had. Why do some specialist only recommend 1 does of folic acid a week, I have been told to have once a week, 3 times a week and now 6 days a week? Why is this.

[@utahnick]

I just started last night. The Dr has me taking folic acid every day. Are you taking MTX still?

[@mohansinhjhala9754]

I've been on MTX for 16 yrs.For 2 yrs 2018&19 the doze was 7.5 /wk, then for next 2 yrs 15mg and now in 2022 it's 20 mg per week. I'm 83 yrs of age.Isnt it too high?

[@utahnick]

@@mohansinhjhala9754 I feel like that is what they'll do with me as well

[@mohansinhjhala9754]

MTX causes no. Of side effects namely skin infections, overthinking, disturbed sleep etc. Got peripheral neuropathy 2 yrs back.Neourologist says it is due to RA.And lots of other problems.The only advantage of RA is prevention of deformities.

[@odetemartins1103]

Methotrexaate taking for lupus and fibromy For 10 Years and all ready lost my colon now kidneys now lungs take 6 tablets a day🌹💜

[@sonyagair1219]

I was diagnosed with RA, Lupus and Fibro in 2013. RA was apparently advanced as some of the bones in my hands had already holes in them. Dr's never picked any of this up. I was actually diagnosed with OA and thought...hey maybe I should see a Rheumatologist and not just go on what my GP said. He was hundred percent correct on the OA, but I wanted a Specialist in that field. I have been on MT since then. Combined with folic acid. Plus biologics" Actemra". So once a week I take both injections on a Friday and I am literally man down for the weekend. I know it helps but man it's getting to me! I get all the side effects. 😢 There must be other options out there...

[@cassandralangton185]

Methotrexate is poison to me. They say that everybody is different. However it affected me the same way. I was sick as a dog for 2 days straight from the MTX. No way to live. Nasty drug

[@Bichonfrise369]

I was also diagnosed 2013 fibromyalgia lupus RA.

[@gwensimpson4448]

I use Methotrexate

[@visichinappa8531]

Currently on methotrexate

[@jonnyboi068]

Did it work?

[@maidamasoud776]

I have RA and I was prescribed with MTX only 25mg. I've been using it for 3 years now. I take 5mg folic acid everyday. MTX makes nauseous for 2 days. 😢

[@e.elsibea1518]

That much folic acid, in my experience, makes me nauseated. I take 2 mg a day and, sometimes, it can be almost as if I took a prenatal vitamin on an empty stomach. I was taught that 2mg/day was a decently high dose. I might ask your doctor if that is absolutely necessary 🤔. It can help with methotrexate induced nausea, but too much could induce it. Again, from my own personal experience.

[@ranveerranveer6557]

I have been using mtx with hydroxycloroqunane past 4 month , so how long I have to use this medicine plz tell me

[@bjchealthAU]

Sorry this is difficult to answer. It is best to approach whomever prescribed the medication as they should know you the best and your specifics. It would not be appropriate for us to comment.

[@utahnick]

I'm taking both now myself. Are you feeling relief from it? I feel like crap today

[@trevorjessen8310]

I have been on it for 7 years

[@etcwhatever]

Sulphasalazine almost killed me. My liver failed. Im on injectable mtx waiting for the biological med.

[@Rautelakimi]

Can I take methyl folate with vitamin b12 instead of folic acid which is a active form of iron

[@bjchealthAU]

We don't quite understand your question as we feel the compounds you have stated are unrelated. I would suggest speaking to your treating physician or pharmacist to gain clarity.

[@dennisunfft]

My Doc let me have 3 pills of 2,5 mg TWICE a week (3 Monday & 3 Tuesday) is this normal? I am diagnosed with RA

[@bjchealthAU]

Usually, the dosing is once weekly. However, rheumatologists will occasionally deviate from this (typically to reduce side effects). However, please confirm this with your doctors. It would make sense that you actually ask them why it's that way in your case.

[@HYoung777]

do i really have to take ana, rf and anti ccp all at the same time to know if i had ra?

[@arunagupta5015]

One of my Doctors started Methotrate but the Second Doctor asked me to stop it and started Sulfasalazine and Iguratil. Then I showed to a Rheumatologist he told me to stop all the medicines. 16:46 Itoo

[@arunagupta5015]

I took 10 mg of Methotrate for 8 weeks. Should I stop it as no proper diagnosis is made

[@arunagupta5015]

Nausea

[@bjchealthAU]

We have a bias towards rheumatologists for obvious reasons. If you do not have a diagnosis, I would work with your rheumatologist until you can figure it out then appropriate management can take place@@arunagupta5015

[@lorettaturner9144]

Hi, I have been diagnosed with Sarcoidosis of my lungs and have been prescribed this medication at 7.5 mg. I just picked it up today. I live in California and I am worried about taking it. Any advice?

[@bjchealthAU]

It is not appropriate to give specific advice on this platform. I would suggest listening to your treating physician/s especially if you trust them and given them feedback as to how you are doing. Important to work with them collaboratively if possible.

[@asmrsleepycapricorn9939]

How many patients have developed lymphoma after taking this?

[@bjchealthAU]

I don't have any way to answer that question with an absolute number of course. When they've looked at big series of patients on MTX, there has not been any clear causative link between MTX and lymphoma. Please do understand that the autoimmune conditions where we use MTX as treatment, will have by themselves a higher risk of lymphoma. The classic example would be inadequately controlled rheumatoid arthritis. Hope that helps. Regards, Dr Irwin Lim

[@asmrsleepycapricorn9939]

@@bjchealthAU Thanks for your response. I was researching this drug for my brother in law and Lymphoma came up as a possibility. It also said lymphoma in some people disappeared after stopping the medication. That was scary. Thanks again ❣️

[@JustJulesAgain]

I don't care about the name I can't pronounce half of them. Primary doctor I told, told me I just had arthritis so stop complaining. I ended up crying to my surgeon for help. I had 2 trigger fingers, and now it feels like carpel tunnel -text book. Nothing helps that but sleeping hanging off my bed. I took it for 6 months and the pain went away but I felt like crap, and couldn't wake up. SO, they tried lex-something, that gave me hives. Prednisone helped, but I know it's damaging. I don't know, have a check up coming up. Will see.

[@bjchealthAU]

Thanks for sharing your journey. It can definitely be complex and every person is affected differently. Good luck with the ongoing journey. Hope you manage to find a little balance with the medications you use.

[@flaneuredits]

Why do i feel sick-

[@ratneshshrivastava6444]

ILD can be a adverse effect

[@0seve291]

Im prescribed and never used it... thinking about it tho

[@jonnyboi068]

Did you try it?

[@0seve291]

@@jonnyboi068 yes im taking it for chronic constant autoimmune eye inflamation and havent flared since starting :) luckily no side effects besides waking up thirsty or sore throat day after taking so im just drinking more water 👍

[@shahreebell5897]

Me too. Im too scared of the horrible side effects people talk about. I get unwanted side effects from most meds I take, even nausea from simple panadol.

[@0seve291]

@@shahreebell5897 i started right after i posted this and havent had issies besides dry mouth next day so i drink extra water im taking it for chronic iritis amd havent flared since

[@visichinappa8531]

Polymyalgea rheumatica

[@MICHAELCAMPBELL69]

Num 2

[@mother548]

Developed nodules arms and hands dark skin hands and feet skin patches thighs and legs

[@maggiepope2171]

It can be very effective. But for some patients it has very bad side effects, and I have helped some avoid it or come off it with medicinal herbs and diet.

[@MrVjt]

Could you tell me more please..

[@ginamarie6462]

All the herbs and diet will not fix or reverse something like rheumatoid arthritis. It's a progressive disease.

[@celesterosales8976]

Right! Looks like no reply

[@maggiepope2171]

@celesterosales8976 Ooops! I just forgot! Although I change the diet a bit differently for each individual, the basics are; come off all ultra processed foods, this isn't just the newest fad we have been saying this for years. Then I put them on anti-inflammatory herbs, usually in a tincture: meadowsweet, willow, devil's claw, plantain, turmeric. If they have the odd flare up I usually recommend following an antihistamine diet for a couple of weeks.

[@celesterosales8976]

@@maggiepope2171 hi thanks!

[@zitasolidum3850]

RA

[@patsyhairston8277]

77 don't drink smoke do illegal drugs. Got sick told I was fine got sicker had test and I have methotrexate cirrhosis

[@mirr1984]

Do you not get regular blood tests to check your liver? They should be doing that otherwise it's malpractice.

[@omgediter1292]

Ra

[@Wooburnmusic]

Methotrexate almost killed me.

[@jennifer7648]

How? What happened? I am super sensitive to medicines and am kind of afraid to go to a rheumatologist for this reason. Here in America they seem to prescribe it like it's a cure-all.

[@Wooburnmusic]

Hi there Jennifer, thankyou for your message, well, when I began to suffer symptoms it was soon diagnosed as rheumatoid arthritis, they put me on methotrexate and something else, in time I began to suffer symptoms of brain fog, blurred vision, hair falling out and general being not with it. It did work though, but one night overnight, I couldn't breathe too well and that was my decision to stop taking it, I went on to leflumonide which also helped but to the cost of those side effects I stopped taking it as well, (. Blood tests were needed every two weeks or so ) I had a bad relapse in my left hand, wrist and fingers, the hand became so swollen that it looked like two big Mac burgers put together, the pain was so bad that I couldn't even pick up a sheet of paper ! Well, It did die down after around a week or so, the stiff ess in my legs and knees remains and varies, the only meds I am taking now are just the occasional pain killers but nothing drastic, so I am in some sort of remission at this time, who knows when the next flare up will happen? Could be months or even years with luck but as you say, they seem to hand these medications out as tho they were candy and we are the guinea pigs ! Those meds have definitely affected me and although I stopped the leflumonide a k in October 2021 I fear it will take time for it to be completely out of my system, being a gigging guitarist it devestated me when I just couldn't get my left hand around the guitar Neck properly and I really thought that it was the end of playing 🎸🎵 but things have improved for now and am playing sessions again if reduced times.🙂👍 Yes those meds did help but just be aware of those side effects should you need to go them. Best wishes to you.🌷 🎼🎸🎵🎶

[@jennifer7648]

@@Wooburnmusic Thank you so much! I am digging in and doing a lot of research so I can be well educated on all of it so I can choose what is best for me. Prayers for you 🙏

[@Wooburnmusic]

@@jennifer7648 hello Jennifer, thanks again for your message, I would advise you to see your rheumatologist it will be good to get a professional opinion, not everyone is the same of course and any potential prescribed medication will be tailored to your particular needs. Very best wishes to you and remember that it isn't all bad. 🌹

[@mohansinhjhala9754]

I'm using MTX for 16 years.For last two years I've experienced some side effects that are worse than avoiding deformities.At the age of 82 they're just unbearable.It is a monstrous drug.

[@lynebenoit5124]

I took it for three weeks and no way I am going to take this, no, no, no

[@utahnick]

What happened? I just started

[@lynebenoit5124]

I took it and the back of my head was completely numb, couldn’t feel it no more and I was so dazed out and I started itching all over my body this medication is from hell, I decided that I was going to follow a strict diet, water and lemon in the morning then fruits and finish my day with a vegetable salad and take prebiotic and probiotics. Been doing it for a month know and no more pain in my knees and neck and arms it’s working. Go listen to this old guy on KZbin it’s called fruit n sports

[@Navistar-cu2po]

Methotrexate causes liver disease and pancreatic cancer

[@utahnick]

@@Navistar-cu2po Ugh

[@Navistar-cu2po]

@@utahnick I have observed many cases of people (some I know personally) that took Methotrexate within 1 month developed liver disease and within a year or two manifested into fatal pancreatic cancer. They are all dead, and many new cancer centers are finding new patients from its use. Cumberland Pharma is committing genocide.