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RA Drugs-Methotrexate

I take my 10 little pills of methotrexate on Sunday afternoon.  I put the ten 2.5 mg tablets in a little white bowl.  I take them over a 4-5 hour period.  My little ritual makes a major difference.  I have no nausea from the medication.

My first dose was 2/17/2013.  It was 10 mg.  My dose was increased gradually to 25 mg on 4/28/2013.  Nausea is the most common side effect.  I did have some initially  but as long as I followed my ritual,  I was fine.  Additionally,  for the first year I was  tired on the day following the dose.

Low dose methotrexate has been the drug of choice for the treatment of Rheumatoid Arthritis for 30 years.  It is safe and generally well tolerated.   It is a DMARD, disease-modifying anti-rheumatic drug.  It helps with pain and swelling.  It slows the progression of RA over time.

Methotrexate was one of the first products of ” intelligent drug design”.  It was introduced as a treatment for cancer in the 40’s.  It was introduced to treat RA in the 70’s and 80’s.  The treatment pathway of methotrexate is different for RA than it is for cancer.

Methotrexate is frequently used in combination with other DMARD’s and is quite effective when used with the biologics.

I take Folic Acid as a prescription dose daily.  Folic acid helps avoid side effects of methotrexate. I have regular labs that measure blood values, liver and kidney function.  I have normal function.  In the USA it is recommended that a person on methotrexate  abstain from alcoholic beverages. I do. It was tough giving up the glass of wine while cooking dinner. I am fine with it and I still enjoy cooking dinner.

Methotrexate is on the World Health Organization’s List of Essential Medicines, a list of the most important medications needed in a basic health system.

For further reading:                                                                                                                                         Methotrexate(Rheumatrex, Trexall), American College of Rheumatology

Old Drugs Can Learn New Tricks, Methotrexate and its mechanism of action,  Bruce N. Cronstein, MD, The Rheumatologist, November, 2011

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