My situation is getting to the point where my rheum. wants me to consider methotrexate. I would like to know if you have ever tried it? If so, how did you react to this medication, as in side affects, or positive effects-either one. Thank you :)

I am on it now. For me the only big side affect I have is being so tired. I take it on Sunday Mornings and I am useless that day. I sleep most of the day. I know that there are some who get sick from it but I am just tired. I don't think it is working for me tho cause I still have the pain and swollen joints. Good luck with it and I hope it works for you.

I too am on it now, about two months in. I took it in the morning the first time and took 4 pills. It made me feel sick all weekend. Constant gurgling in my stomach, tired, just didn't feel good the entire weekend. I did some research and people said taking it before bed will cut down on the stomach issues that will come up. I switched to taking it on Saturday night instead of the morning and it worked like a charm. I take it about 8 or 9 pm and not too long after that I'm zonked out. I wake up in the morning on Sunday and am fine. So I would definitely suggest taking it at night. It has helped my pain some-- it's definitely not gone by any means. I have some very painful days still. Lately, my pain gets worse right after I take it (also why it helps to take it at night so you can sleep it off) but is a lot better by morning. Hope this helps a bit..

I have been taking metho for 3 1/2 months . I get some slight nausea infrequently , partly from taking on an empty stomach. After 2 months some of my joints were feeling less pain at times and as of today I would say I am still progressing slowly. Most every joint in my body is affected, so any improvement is welcome. Will I ever feel pain free? Doubtful, but I can still remain full of hope. It seems like PsA is a fickle disease, as it treats everyone differently, as well as the different treatments can work for some and not others. But we all seek relief from the agonizing pain. Good luck!

I have been on methotrexate for about 3 months now, and honestly it hasnt really made a diffrence in my joint pain or inflammation, I take it on Tuesday nights after a good meal, right before bed, i try and sleep as much as i can after i take it, because like most of the people who have commented it really makes me feel like crap the day after i take it im weak and sick to my stomach i try to take it pretty easy the next day and eat things that arent to hard on the belly, good luck with whatever choice you make!

I just started it on Saturday so too soon to tell, I took it at about 1 pm and felt nauseous on Sunday morning. Taking it in the evening sounds like a good suggestion. My Dr. said it can take 3-4 months to work although I am like most and want it to work NOW!! :)


I had really bad nausea at first with it. I had to stay on a fairly high dose of folic acid with it to keep the nausea at bay. Took a while to figure out what amount of folic acid I needed. Really felt like I was going through the ringer. I don't know that it helped much either but it did cause hair loss.

I have keen on methotrexateate for 2 months now. Only side effect was little nausea the first morning I took it, none since. I take it Wednesday nights before bed and just slow on Thursday mornings, not much more than usual morning. It is getting rid of the gutate psorias I have, albeit slowly. Inflammation is definitely going down (sed rate from 100 to 22), though pains are still there. Slow and steady progress with it.

Starting enbrel soon to work more on the joints. also, rheume told me methotrexate does not work on the heels, foot, achellies tendon as well as the biologics.

Bottom line for me, the meth works just a bit slow and you should have no worries about takin it.

Hi Lora,

I have been on methotrexate for almost a year. When I first started I had bad nauseau and could not eat and was profoundly exhausted for about two days afterward. It lasted for about 4-6 weeks and just when I was ready to bag it it improved. I have stomach issues already and the one time we upped the dose I also experienced the same side effects. Apparently if taken by injection it dramatically decreases side effects. I have noticed that I have a lot less pain and swelling, although I recently have heard from several sources that the MTX does not actually stop the inflammation, just masks the symptoms. For me, though, it has been a lifesaver. Also, it is CHEAP. At about $2 a month I'm in no rush to move on to the biologics!

Best of luck!


I forgot to mention-- I have had hair loss too. I lost a lot of hair from PsA before I even started the MTX... I didn't know why it seemed like I was losing so much hair (I just thought it was because it was long.. I hadn't had long hair since I was little). The MTX definitely made it fall out much faster... so much that I actually cut it short again because it really upset me seeing it everywhere.. Not to mention I was sick of pulling balls of hair out of the washer and dryer and my clothes. I asked my dr about it and she doubled my folic acid dose. That seems to have helped a bit.

Hi Lora,

I resisted taking MTX for about a year after my rheumy recommended it because I was worried about the side effects. However, the pain eventually overwhelmed the fear and I started it in Nov. 2010. The first couple of weeks I felt a bit queasy/tired/generally ucky but now, even though my dose is at 7 tablets/week, I have no side effects. The two most useful things for cutting down on the side effects are taking a folic acid supplement (it seems that not every rheumy offers this - if yours doesn't, ask about it) and staying *very* well hydrated the day before, the day of and the day after taking the MTX. It really helps with the stomach/nausea issues and helps your body/liver process it.

As to effectiveness - I thought that it hadn't been helping that much until I had to go off MTX and Enbrel for a couple of weeks due to a combination of sinus infection and UTI (talk about feeling ucky!). Got the sinus infection and UTI cleared up but oh MY did the PsA flare up something fierce without any drugs! So I am happily back to taking both MTX and Enbrel and while some days are worse than others, it has helped a great deal. I wish you luck with finding the right drug/drugs that will help you!



I have also had a really large amount of hair loss while on MTX the last few husband jokes with me and says he is suprised I have any hair left lol

I've been losing my hair anyways so I guess it will seem normal, I know it is much more traumatic for women so hang in there....

I was on Metho (1 tab per week) about 12 months ago- first 2 weeks -no prob. 3rd week- dizzy, nausea for 1-2 days. 4th week- WHAMMO- so ill for about 3 days, same for 5th week then I refused to take it any more. No hair loss, however I am still on treatment for my stomach- which kinda exploded from the metho. Yet, I know of other people who it has worked really well for! Actually, everything I've taken has made me ill one way or another - guess I'm just delicate LOL

I have been on MTX for 2 years now. I first started on the pills but chose to switch to injections, as I could take less and receive 100% of the benefit, rather than a lesser amount from the pills. I haven't had hair loss or thinning from it, but do get somewhat tired on the injection date and sometimes the day after. My biggest problem with it is nausea. I did get it mildly the day after, but I think I have developed a repulsion from the needles because I get sick when I think about doing it. All in all, I get really good results if I take the medicine as prescribed. Good luck -

I have taken 2 doses of Mtx....4 tablets. So, of course, I'm not seeing any results yet. I have seen a bit of nausea and stomach cramping ! I take it at lunch on Saturday and if I take my folic acid first thing in the morning on the other days, I seem to be better.

I really hope it does something - I've had more pain in the last two weeks than ever. I've only been dealing with this for a year but it is definitely progressing, hence finally trying Mtx. This really sucks. It is amazing though how one can adapt & just put up with a certain amount of pain on a daily basis.

Hey, Lora! I've been on mtx for five months, and it has had no effect on me, either good or bad. In the beginning, it made me very tired but either I'm used to that feeling now or it's not as bad. Oh, and it gave me a bad, metallic taste in my mouth. I bought a supply of sugar free mints! After four months and no improvment, the rheumatologist added sulfasalazine and plaquenil to the mix. I see her in three months, and by then we will know if that combo has worked. If not, I am guessing that the next step is a biologic. We will see.

Good luck to you with the decision -- I don't think you have much to lose by trying it. Apparently bad side effects stop when you quit, or sometimes if you switch from oral to injectable.

Hi Lara,

I was reluctant to try MTX, too. But my rheumie kept ecouraging me until I finally gave it a go. I can't say it's been dramatic but I do see an improvement.

Most docs prescribe folic acid on days you don't take the MTX to help with side effects. Many people say side FX are fewer if you are well hydrated the day you take it. If side FX are bad, you can switch to injectible. It bypasses the tummy and you get a higher level of drug staying in your system because it isn't being lost in the digestive system. I always take mine after my evening meal. That way if it does cause nausea, I pretty much sleep through it.

Everyone reacts differently to these meds. About the only way to know if it will work for you is to try it. I agree with Seenie--it's worth a try if you are up for it. I would be reluctant to give it up. Keep us posted on your decision and good luck.

Hi Lora
I have been on it for 19 years now and it has been the one medication that keeps me stable. It is no longer strong enough on its own but the one time a doctor tried to take me off of it i flared horribly. It dose have the down fall of making me feel sick on occasion but I feel it is well worth it. It would not hurt to try it out and see how it works for you… Best of luck!

I have had it for 7 weeks & don't think it has helped. Hard to say. I am on a low dose (10mg). The first couple of days after taking it I hurt, the middle of the week is ok, the last part I I don't think it is helping, I'm just flaring ? That's the last 2 weeks....before that I just hurt. It could be dumb luck or some improvement.

I had minor side effects the first 2-3 weeks (stomach issues mostly, some hair loss)....those have gone. I am meeting with my doc on Monday & I think I will ask for a higher dose. There are still those days I struggle to get through my day. I am in Vancouver right now where it is rainy & wet - down from a cooler climate (-18 this morning) so I am hurting at the moment. I take my next dose Saturday. I'd like to have something that I know is helping....

I have some business down here so my routine will be messed up - I expect to pay for it in the coming days. Ugh.