- Methotrexate has been used for RA since the late 80’s. It is the cornerstone for RA treatment and considered to have an impressive safety record.
- Methotrexate is classed as a DMARD, Disease Modifying Anti-Rheumatic Drug. It decreases pain and swelling. It can lessen joint damage and consequently long-term disability.
- Methotrexate is taken once a week usually in pill form. The injectable form is reserved for those who don’t tolerate the pill or to extend the effectiveness of the drug. Self injection is not hard to learn for those who need it. It can be easy to do with a prefilled auto-injector that comes in a variety of doses. The auto-injector is useful for children with JIA, too.
- Methotrexate is frequently paired with other DMARD’s. Plaquenil, an anti-malarial drug is often used. Sometimes sulfasalazine is added, too. Drugs used in combination with methotrexate are usually more effective.
- Methotrexate is also paired with the biologics including Orencia and Rituxan. The biologics become more effective when teamed with methotrexate.
- RA can continue on its destructive path when there are no obvious symptoms. It’s reassuring to know that there are drugs on board slowing the inevitable progression of the disease.
- Nausea and vomiting are the most common side effects and usually dissipate as the body adjusts to it. There are a few who cannot tolerate the drug.
- Fatigue the next day is also common. It is wise to take the Methotrexate on a a weekend or when at home the next day.
- Blood tests are ordered periodically to assess the impact of methotrexate on the body.
- It takes 12 weeks for methotrexate to become effective. Some see changes at three weeks and some need up to 6 months to be effective.
- On a personal note: I no longer take methotrexate. I developed soft tissue necrosis on radiated breast tissue. It took ten months to heal. Soft tissue necrosis is black box warning number thirteen.
Published on 2015-09-08
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Ten things to know about methotrexate and RA
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