How do you fight nausea of MTX

Hello PsA peeps,
The nausea of my post MTX dose has increased dramatically over the last couple of months, so I’m off to the GPs on Friday for some assistance…any insight into what has or hasn’t worked for you be helpful, all my usual tricks have failed

Have they given you Zofran for the nausea? Are you splitting the dose on the day you take it?

Hi Louise,

Sounds odd but I use travel bands. I put them on just before I take MTX and leave on for about 2 days, works a treat. I left them off one week and woke during night with the nausea back, put bands back on and went back to sleep nausea gone.

Told my Rhuemy this and he was impressed and could see the logic and is now spreading the word in clinic. I am not saying it will work for everyone, its worth a try and saves taking yet another drug.

It states on the bands they are also use the in hospital for chemo.

Hope this is of help.

Paula.

I've been on MTX for quite a while. Are you taking folic acid? That usually helps a lot with the side effects. I take my MTX on Friday about a half hour before bed. Friday I make sure I eat a solid meat/potato type meal for dinner and drink a good amount of water all weekend.

I am sorry you are dealing with this Louise but I am really glad to see you on the boards again! Hi from Vermont!

I know that for many, injecting vs. taking orally makes a big difference.

Hi Louise, sorry you are having a hard time with MTX. I hope your GP can offer you something to help the side effects. I was on it for a month last November and unfortuntely the side effects got worse each week until one week ran into another with no relief from the nausea, dizziness, extreme fatigue and a weird intoxicated feeling in my brain where nothing made sense and I couldn't talk sense. Keep us posted to how you feeling

I used to take MTX 10 pills once a week Had all the side effects took folic acid no help doc switch me to shots big difference took shots probably over a year done real good I say the nausea and headaches wasn’t as bad. I have mail order meds and they could not get the shots anymore so had to go back to the pills this time I could not tolerate it. Call doc and told him how sick I was getting now. He switch me to leflunomide take 1 every day so for I have not noticed any bad side effects but I take a but load of meds but I do like the leflunomide better.

How long have you been on leflunomide? Some of the side effects seemed to buildup over time for me. I take it every other day now to lower the side effects. It doesn’t work quite as Wellbutrin the side effects are more manageable.

Thank you for all your replies my friends :)

I take 25mg weekly in a single dose, as advised by my Rheumatologist, I take it at bedtime on a Saturday and have the Sunday and Monday to recover before returning to work on a Tuesday. I've been taking it for nearly 2 years now and am also taking folic acid. I've always found having a starch type of meal in the evening before dosing very effective and had ginger tea when the nausea started, and kept well hydrated. But these measures are no longer helping and for the last few weeks the nausea has been so bad I've not slept the night of dosing. Last Sat I also sweated all night badly and its now Monday morning and I still feel queasy...........but that's ok I can deal with that, it's just the 8 or so hours post dose that's really getting to me.

I'm seeing my Rheumatologist in early May so will discuss the options open to me then. I'm in the UK so I have to go through certain treatments before I can go on to the biologics, so I may be changing on to another DMARD or try injectable MTX if thats an option. Mean time I'm going to ask my GP for an antiemetic such as Metoclopramide as I know it can work well when taking cytotoxic drugs.

Thanks for your insights and I'll let you know how I get on :)

Been taking leflunomide for over a year seems to work well for me

Hi, quick update
Been prescribed Cyclizine to take as needed for the nausea of MTX dosing night
So fingers crossed I’ll be in a better state than last week :slight_smile:

Couple of things (work for me)

If you are taking pills change to injectable, if you are to sub Q change to to IM. with each of those changes you are getting more effect from you medicine. (not to mention quicker absorbtion leading to fewer SE's) I can't stress enough how much difference going to IM injections made for me not only in terms of SE's but effect. (IF you are getting more effect from your meds you may even be able to lower your dose I used to tak 25 in pills I'm on 15 IM. That will lowe SE's too.

Folic Acid. YOU NEED TO TAKE EVERY DAY. the discussions as to when to take it after before with are moot. Its an every day thing becaus the MTX is supreesing its production every day. take it on an empty stomach if you are not.

These change made MTX into "just another drug for me" well other than 4 days a week I'm on the Wagon am Mondays when I zombie through about half the day (I shoot mid-Sunday afternoon.)

Thanks Lamb, I intend to bring these issues up in a couple of weeks when I’ve got my next rheumatology visit. Been thinking of asking for IM injectable for a few months now, but was happy to try the docs way first. I can deal with a bit of nausea but last weeks sweating pre vomit feeling for 8 hours was just too much lol…was waving my white flag by 4in the morning lol

Definitely go with injectable MTX. It is the only way, IMHO, that it should be dispensed! Before I requested a MTX script from the rheum, I cruised this board for tips. I followed Lamb and Robert’s tips on taking it (folic acid daily, and injected). I have been on it a month so far and no side effects at all. No fatigue, nausea, hair loss, or howling at the moon. Granted, I am on a starter dose, but I have noticed that many have trouble even with the low doses. My tip to you, is to go with the least invasive method that provides the best relief from the SE. Try sub cutaneous first. If that doesn’t work, move on to the IM injections. I don’t know how tough you are, but I think IMs hurt! I’m not sure I would want to do it if something that is almost painless would work just as well. I do hope that whatever you decide to do works and gives you some freedom from the nausea.

Lamb,
Did you feel wiped out on the lower doses of MTX as well? Or did that happen as the drug was increased? This is assuming that your doc increased MTX over time.



tntlamb said:

Couple of things (work for me)

If you are taking pills change to injectable, if you are to sub Q change to to IM. with each of those changes you are getting more effect from you medicine. (not to mention quicker absorbtion leading to fewer SE's) I can't stress enough how much difference going to IM injections made for me not only in terms of SE's but effect. (IF you are getting more effect from your meds you may even be able to lower your dose I used to tak 25 in pills I'm on 15 IM. That will lowe SE's too.

Folic Acid. YOU NEED TO TAKE EVERY DAY. the discussions as to when to take it after before with are moot. Its an every day thing becaus the MTX is supreesing its production every day. take it on an empty stomach if you are not.

These change made MTX into "just another drug for me" well other than 4 days a week I'm on the Wagon am Mondays when I zombie through about half the day (I shoot mid-Sunday afternoon.)

The cyclizine worked…only slight nausea!!! :slight_smile: Still going to push for IM MTX or change of med next month but this should help in the mean time.

OH! I forgot to mention ginger! My pharmacist is in the same building as a fertility group, so he gets quite a few pregnant women in with nausea. He has ginger hard candies that he swears by for nausea. They must work, because these ladies clean him out regularly. There are sugar free and regular varieties. I think the brand that he stocks is called Go Green and Go Lightly. Awful name for the second product, btw.

Thanks grumpcat, Ill give them a go…ginger tea helps me too…think ill have to go for the sugar free now I’m type 2 :slight_smile: