All posts filed under: Methotrexate

Seven year anniversary and infection

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It was seven years ago this month. I was acutely ill with my first encounter of rheumatoid arthritis. My illness had not been given a name yet. A week before that I had seen the ER doc who started me on prednisone and who was  sending me to the rheumatologist that I would see in about another week. I had very little sleep. A few hours a night at most. I was in excruciating pain. Life was not good. I can look back with a sense of relief. I no longer have the kind of pain that made me think I had broken glass shards in my joints. It took several years after my diagnosis for my RA to settle down. I never went into remission. My inflammation has always simmered. Methotrexate was my base. I finally settled into 25 mg subq once a week. It helped. After a few years my pain was never quite the same as it was originally. My feet became central to my discomfort. Custom orthotics and Dr Comfort shoes …

Infection and off methotrexate

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I stopped taking Actemra. I had only two doses this time. Last week I stopped taking methotrexate. I had been on it since 2013. All this was at  a suggestion from my oncologist who was helping me battle a severe breast infection. The infection started in October 2019. I went to a wound clinic for a month. I had surgery to debride necrotic, radiated breast tissue 13 December. Then the infection returned. Perhaps it had never left. I also developed a severe cellulitis. The cellulitis covered my entire breast or what was left of it. Now the cellulitis is down to a couple of inches. The whole thing was caused by  the radiation treatment that I had for breast cancer in 2013. The radiated tissue became necrotic and infected. It is not uncommon. I wonder what part my RA drugs played in this long standing dilemma. This infection has gone on for three months. I do know that methotrexate should be stopped while a person is on an antibiotic. Methotrexate should not be used at …

I thought I was going bald, it was just the MTX

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About six weeks ago, I started noticing my hair thinning. I thought it was odd because my dad had thick hair in his older years. I expected my hair would do the same. My hairdresser also noticed the thinning. It was real. Next, I started noticing bunches of hair on my comb. “My hair is falling out,” I thought. Right again. I quickly realized that it was the methotrexate (MTX). Hair loss only occurs in 1-3% of those on MTX. I have been on it for five years and the last three years I have been giving myself 25mg injections. It works for me. I am also on hydroxychloroquine (Plaquenil). Plaquenil can also cause hair loss. I started taking MTX every eight days instead of every seven. Every nine days starts an RA flare. I stick with the eight days. I also cut the Plaquenil to 200 mg daily from 400 mg daily. My hair is no longer falling out. However, my hair hasn’t grown since my last haircut. Unfortunately, it was the second worst …

Methotrexate NSAID or DMARD ?

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I can now count myself  as one of the few who has read the package insert for methotrexate. I am researching RA drugs for my book.  I give myself injections of 25mg methotrexate weekly. I was opening a new box and preparing to give myself an injection.  Impulsively, I decided to read the insert. Methotrexate has become the gold  standard for RA treatment. It has been one of the few drugs to help relieve my symptoms. Imagine my surprise when I read the following. Medication guide insert with boxed  methotrexate; “Although methotrexate clearly ameliorates symptoms of inflammation (pain, swelling, stiffness), there is no evidence that it induces remission of rheumatoid arthritis nor has a beneficial effect been demonstrated on bone erosions and other radiologic changes which result in impaired joint use, functional disability, and deformity.” So since it doesn’t stop RA progression how can it be classified as a DMARD, Disease Modifying Anti Rheumatic Drug?  Shouldn’t it be a NSAID,  Non-Steroidal Anti-Inflammatory Drug?

Ten things to know about methotrexate and RA

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  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 Sulfasolazine 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 …

Methotrexate Injection

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Why injection?                                                                                                                                            To avoid side effects or to have more of the medication absorbed by the body. There is 25 mg/ml of medication The syringe is either tuberculin or insulin Both have a one ml capacity Both have very thin needles Have all your supplies ready Vial of methotrexate, syringe, alcohol swab. Also access to your upper belly or outer thigh. It’s easy as this Wipe off top of vial with alcohol Remove covers on syringe Draw back on the syringe to add about .5 ml of air Insert needle of syringe into vial Push in the air(avoids med leaks) withdraw the correct dose of your medication( …

RA Drugs-Methotrexate

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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 …