Methotrexate Side Effect -- HELP!

[Nancy60]

I let my rheumy know about the nausea and diarrhea and she switched me right over to injections. No GI issues at all with the injections. I'm happy to report. Call your doctor, don't suffer needlessly! 

Nancy

[SjoAmy]

Nancy,

Was there a difference in the effectiveness of the shots vs oral ?

[Nancy60]

The shots are utilized by the body better from what I've read. Also if you need a higher dosage they will switch you to shots because they can give you more than what they can give orally.

[irish]

Are you taking folic acid with the Methotrexate?? I think that is the correct med!!!!Someone correct me if I am wrong. This drug helps to tame down the side effects of the methotrexate, i.e.:, nausea, etc. irish

[SjoAmy]

Before beginning Mtx, I was on 3 MG of folic acid a day.  I thought that was going to be plenty.  I was taking that dose to keep the hyperhomocysteinemia in check. Just took 1 mg of folic acid just now.....because this has been the gift that keeps on giving.  I am probably going to have to cancel out of my pulmnology appointment tomorrow.  I just can't control my stomach.  Can't get on a bus like this!

I hate canceling the day of the appointment but I am certain that they don't want me wretching and vomiting in the office. 

I could be wrong though.

[Nancy60]

Yes Folic acid is given to help control the side effects of methotrexate. My doctor told me up to 3mg is the most they can give and has me taking it daily. I started out at 1mg.  I'm still taking 2mg with the injections. The nausea for me got better as I got further out from the day I took my methotrexate I took it Friday, felt kind of crummy mon and Tuesday but managed to work, usually was feeling better by Wednesday.

Hope you start feeling better.

Nancy

[SjoAmy]

Called the doc this morning.  Nurse has to talk to doc, but I may be Rx-ed nausea med.

Nausea, vomiting & diareah from 7 PM To 2 AM.  Took an extra mg of Folic acid at 1 AM, guess that helped settle down the stomach.  Slept till 7:30 AM.  Feel pretty good this morning.  Bought extra folic acid.

Took Mtx. Tuesday night 11:30 PM.  Wed my stomach was okay.  Thursday @ 6 pm.....notice first sign....didn't think of it related to Mtx until 7....when I looked at the clock and realized, I'd had this problem for a hour......down hill from there.

[SjoAmy]

Sometimes I wonder how I pick these doctors!

Got in touch with my PCP.....oh Nilly!

His nurse first tells me about how he wants me on NO MORE THAN 400 MCG A DAY.

I did end up talking to him on the phone.......his nurse & him say that FOLIC ACID CAUSES NAUSEA.

After reading your posts last night, I surrendered to your suggestion of taking Folic Acid.  At 1 AM, after 6 hours of misery, having called the visiting nurse last night and was told by her "Well, what do you want me to do?" -- by the way my PCP said that same question to me as I talked to him, calling rite aid and getting no result in trying to get in touch with a pharmacist to talk to.

I surrendered to your suggestion and took 1 mg of folic acid.  By 2 AM, stomach was in the process of settling down a little -- enough to fall asleep in my hospital bed after 6-7 hours of stomach pains that were piercing with nausea, vomiting and diarrhea.

Experience from fellow sufferers always goes farther than medical data of doctors.

He wanted to fire me for not taking his guidance on the folic acid.

My pharmacist supported your view, which is now my view too.

Alas, I think I pissed off the best doc I had in my pocket.

C'est la vie!

[Ripvanann]

C'est la vie is right! Sometimes the "best doc" in your pocket just means your pocket doesn't smell as bad as it did when you had the "bad" docs in there as well. Still smells though. So sorry Amy!

I finally have some awesome docs and I still don't feel as though they're permanent. I keep thinking they'll one day take off their people mask and reveal a lizard... Or something like that. =)

I think I told you that I couldn't hang with MTX but one thing that I *thought* was common knowledge, was the anitnausea properties associated with the folic acid. Also, as someone or a couple of people mentioned, the side effects all the way around, are supposed to be much, much less pronounced with injections.

Still praying!

~Andrea

[SjoAmy]

There are no rheumys in my area that are taking new pts until 2014.

So PCP stepped up.

I mentioned to PCP about the MTX injections bypassing the stomach.  He said if I wanted THAT then I would need to get a rheumy.  My PCP knows that rheumys are not accepting new pts until 2014.  I said "You know that is not possible yet, and you know I need care, that it would be unethical to not treat me."

But he is willing to write an anti nausea med.  Geez.

[Nancy60]

Can you call and get an appt with one of the rheumies for January 2014?  Get the appt now so you don't have to wait any longer than necessary.

I guess the anti nausea meds are better than nothing. I read somewhere that splitting the dose between 2 consecutive days sometimes helps lessen the GI side effects. You might look into that.

Sorry you're having all these issues

Nancy

[SjoAmy]

I have tried it on my own, and through referral.  Honestly, I just think they don't want to take my case.

Mind you I am forthright, sometimes tactless, I don't mince words, or pretty up a dirty picture.

I'm gonna split the MTX to twice a week, continue Folic Acid supplementation btwn 3-5 mg per day.

I'll take the nausea meds before bed, so my stomach doesn't begin to sour in my sleep.

My gratitude to all of you.  Because of you, my stomach recovered. 

[SjoAmy]

I feel like a new woman with supplementing with folic acid.

I'm going to print out at the library, my sources for this folic acid debate.

I'm going to get the opinion of my Endo & Neurologist  on the folic acid debate.....My bet is that they agree with us that folic acid needs to be supplemented.

My pharmacist and I agree folic acid would be very difficult to  "overdose" on.  My PCP and his nurse thought I was overdosing on it.  3 mg is not an overdose.  Especially with hyperhomocystinemia and seizure disorder and stroke in my history.

Folic Acid is also called B9.  ALL B VITAMINS PEE OUT EXTRA.

He's a compassionate PCP, just not too smart.   lol

[SjoAmy]

This is bumped for a fellow Methotrexate user, new to the medicine.

Also, the PCP here, is the one who wanted to learn about Sjogren's Syndrome.....same one I gave the books to.