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Experience with Methotrexate

I was recently diagnosed with RA over the summer, and my doctor started me on hydroxychloroquine (plaquenil), along with prednisone early on. While the prednisone gave some pain relief, the side effects were too much for me, so I weaned off it. After 3 months of no significant improvement, my rheumatologist switched me to oral methotrexate 1x weekly. I'm only on my second dose, and haven't noticed any major issues other than upset stomach/loss of appetite. I'm wondering what other members' experiences are with the drug, and how long it took for them to see improvement? My pain has gotten so bad I had to go on sick leave from work, and I have definitely been feeling low now that I have so much extra time on my hands. I do have a pretty physical job taking care of animals at an aquarium, and I'm afraid I will have to leave the field altogether if my symptoms don't significantly improve. Thanks in advance for any advice!

  1. Hi - thanks for sharing your background. Here is a forum discussion where others have shared how they have fared with methotrexate ( It's going to ultimately be a unique experience for everyone because their personal medical history is different, but having those different perspectives can help! Warmly, - Reggie, team member

    1. Thank you for the link!

    2. I found methotrexate injections worked better than the tablets good luck

  2. Hey! Thank you so much for sharing! I have had experience with both the oral MTX and sq injections. I was also a veterinary technician so I definitely can empathize with your work at an aquarium.

    I had an article that detailed my experiences with methotrexate but I cannot find it so please leave any questions or you can DM me if you want to talk to more!

    1. Hi . Until has a chance to reply I want to share with you this article from one of our other patient leaders on RA and skin issues (you may also want to check out the comments section): I can also tell you that in the case of my wife, Kelly Mack (also a contributor here), methotrexate made her very sun sensitive.
      Also, as you try to navigate work and life with RA, I want to share this article on RA and workplace accommodations: Hope this information is helpful. Best, Richard ( Team)

    2. Hey! So, personally, I did not have much itchiness, however my skin became more sensitive. I wear sunscreen (which helped a lot), like it's a paying job, but if I forgot or didn't re-apply, I noticed some issues (not only itchiness). That being said, up until three years ago, I lived in a super humid environment....
      And, now, I live in a very dry environment....and have been having issues with dry, itchy skin....Maybe it's the methotrexate?? I didn't even think about it. At this point, I should be used to the environment so it's not..."environmental". Have you used a humidifier to help with the itchiness? I use one and it helps a lot!

      Long story short: I stayed a vet tech until 2017. The first few years were rough and painful but once I found the right medication and lifestyle regime, the work was tolerable. That being said, I quit in 2017 to focus on my health and get my RA even more under control so I could work towards veterinary school. And, now, I will be starting vet school very soon. TBD how I do but I feel very optimistic. Being newly diagnosed, starting new meds the body isn't used to, identifying triggers, avoiding them and finding lifestyle alternatives is overwhelming (at best) and may take some time. Honestly, sometimes, I felt so low and thought I would have to quit or completely end my dream of being a veterinarian. It took many years to get back to this dream but I am happy to say it is happening.

      Everyone's journey is different. I thought about quitting earlier (than 2017) but I loved my job so much it was worth the pain and stiffness. I was on one medical leave when my body just didn't respond to medications. It was a terrible flare but I returned to work after 2 weeks.

      I haven't look at all the new comments on this thread but I personally also did a lot better with the injections. I used to get severe nausea and would sometimes vomit at work. Once I got on the injections, the nausea went away, I ate more, and had more energy.

      I had exams this past week, I am so sorry for my late response! Please let me know if you have any other questions!!!

  3. I have been on varying dosages of Methotrexate from the very beginning of my diagnosis. Hydroxychloroquine was never an option for me because of other health conflicts, as is also the case for most steroids. I take the Methotrexate as a subcutaneous injection - under the brand Rasuvo - and it has been a WORLD of difference for me! The oral route was never an option due to significant GI complications, so I can’t speak to how that would go. However, I experienced a difference in symptoms within the first couple doses (weeks) with the injections. Literally went from having to have people help me do basic life tasks like getting dressed and tying shoes, to total self-reliance again. As well as minimal to no additional pain medications due to the RA. We’ve adjusted dosages to help find the right balance without needing midweek rescue meds, and I could not be happier with my results. I definitely have side effects - the lack of appetite and other GI issues are primary concerns, but I have learned to live with the difference. I hope you find relief!

    1. Subcutaneous injected Methotrexate at 20mg gave me my life back . I have been taking it once a week for 15yrs and still working . I play golf twice a week and carry my bag . I'm 65 yr old male .

    2. I'm so glad the MTX injections brought you relief!! I had a very similar journey; however, I do take daily Prednisone. We are always messing with the MTX dosage. It's not my favorite medication so when I feel better, we try a lower dosage. Then I just increase it if needed.

      As much as I don't like the medication, I have to admit it worked for me. It made a world of difference in how I operate day to day!

      Thanks for sharing!! ~Monica (team member)

  4. Hello Guamgirl
    I too had been on Methotrexate weekly with Plaquinel and Steroids daily for many years. This regimen worked weel for me for a long time, then I had them stop the Plaquinel and Steroids and was fine for a couple of years with just Methotrexate. I was however also taking Nexium for the stomach problems. Now I am getting worse and will be seeing my Doc to see about doing something more. Hang in there!!

    1. I took Methotrexate by shot for 1 1/2 years after my diagnosis. I never really felt better. I had no stomach issues, but the fatigue was crippling!
      Mary Sophia, contributor/moderator

    2. The fatigue was a weird one when it came to this medication, for me. It didn't hit me immediately but after a few doses the day after my pills (or injection), I was pretty much down the for 24 hours. But, it didn't happen every week. It was really, really strange!!

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