My rheumy recently doubled my dosage of MTX (I'm now taking 17.5 mg one day a week). I'm also on a biologic (Stelara). Just wondered how my dosage compares to what some of you are taking, and if you switched to injections of MTX because of nausea, etc. -- and if so, did that help?
Thanks everyone.
17.5 is still a fairly low dose. (which would be .8 CC) 20 (1cc) is pretty common. As the dose goes up its important to remember you don't absorb as much thus don't get a LOT more Benefit so 7.5 mg weekly dose is absorbed better than a 15 to 20 mg dose. I am currently taking 10 mg with Humira, but that changes sun to 20 as I am coming (off some other meds (eye issues) My 15 year old Granddaughter takes 20 mg.
I have never and would never consider pills. It wasn't even a discussion with my grandaughter. She is disabled so I do use a special syringe so she can self inject safley.
Thanks for the response. Curious. Why never consider pills? My doc didn't even mention injections, just prescribed pills. I'm going to ask for injections.
tntlamb said:
17.5 is still a fairly low dose. (which would be .8 CC) 20 (1cc) is pretty common. As the dose goes up its important to remember you don't absorb as much thus don't get a LOT more Benefit so 7.5 mg weekly dose is absorbed better than a 15 to 20 mg dose. I am currently taking 10 mg with Humira, but that changes sun to 20 as I am coming (off some other meds (eye issues) My 15 year old Granddaughter takes 20 mg.
I have never and would never consider pills. It wasn't even a discussion with my grandaughter. She is disabled so I do use a special syringe so she can self inject safley.
You get more bang with the med and lot fewer side effects.
Heres a general article:
http://arthritis.about.com/od/mtx/f/injection_oral.htm
Scietific:
http://ard.bmj.com/content/early/2014/04/12/annrheumdis-2014-205228.full
However this is a support site so we throw around anecdotal like its fact (I actually call folks on it from time to time) But I don't recall a single member regretting the change.............. It really does help with the gut issues. One company taking advantage of the trend just got FDA approval for autoinjected MTX (not worth the $$$) Its that much better
I started on the same number of pills and then switched to injections. The nausea side effects of the pills went away with the injections and while I was a little afraid of the injection at first I quickly got over it. Unfortunately, even after several months on injected MTX I didn't see much benefit and was still suffering very badly from fatigue and so was switched to a biologic which made a terrific difference.
My rheumie started me on pills, even though I asked for the injectable form. (“We always start with pills”. I should have seen that as a red flag.) I had no side effects. Three months later, when the pills didn’t help, she switched me to the injectable. (“Some people find the injectable works better.” Aaaarrrrghghgh, then why did we start with pills?) I worked my way up to 25 mg, but my liver didn’t like that. So the dose was lowered to 20, and I continued with that when I went to Enbrel. Because of some residual joint inflammation, my (new) rheumatologist wants me on 25 again. I’m sure my liver will kick up a fuss, in which case we will shut it up by going back to 20. LOL, gotta keep my liver happy.
My MTX injection has just become another weekly ritual. Easiest and most painless injection ever.
This is encouraging, Seenie. I have a call in to my rheumie and hoping he'll switch me to injections. I've been able to inject Stelara with no problem (except for the first injection where I chickened-out and went to my doctor's nurse for the injection:) My last few injections have been easy and almost painless.
Seenie said:
My rheumie started me on pills, even though I asked for the injectable form. ("We always start with pills". I should have seen that as a red flag.) I had no side effects. Three months later, when the pills didn't help, she switched me to the injectable. ("Some people find the injectable works better." Aaaarrrrghghgh, then why did we start with pills?) I worked my way up to 25 mg, but my liver didn't like that. So the dose was lowered to 20, and I continued with that when I went to Enbrel. Because of some residual joint inflammation, my (new) rheumatologist wants me on 25 again. I'm sure my liver will kick up a fuss, in which case we will shut it up by going back to 20. LOL, gotta keep my liver happy.
My MTX injection has just become another weekly ritual. Easiest and most painless injection ever.
Thanks for the reply! Sounds hopeful to me. And glad the biologic is helping you! I don't like the fatigue either, but it's hard to know if that's from the MTX or the PsA.
janeatiu said:
I started on the same number of pills and then switched to injections. The nausea side effects of the pills went away with the injections and while I was a little afraid of the injection at first I quickly got over it. Unfortunately, even after several months on injected MTX I didn't see much benefit and was still suffering very badly from fatigue and so was switched to a biologic which made a terrific difference.
Niel, how are things going for you? I hope that you are feeling so well and being so active that you don’t have time for us here.
Seenie,
Thanks so much for checking up on me. Unfortunately it's been a really hard several months. I finally had surgery to replace my TMJ because the pain had gotten so bad. Surgery was Dec. 23 and I spent the next four days in the hospital. My heart started acting up after the surgery so in addition to pain management I had to be on a 24-hour heart monitor floor. It was a lonely Christmas. Returned home to hopefully heal enough to start back at work at the college by start of spring semester. Which I did. But my PsA was getting worse. I had to discontinue the MTX and Enbrel a few weeks before surgery and wasn't supposed to start again until things were healed. After about a month I asked my primary care doc if I could start up again on my arthritis meds and she said ok. So I did. And then I developed an infection in the incision site on my neck (I have an incision that runs down the side of my face in front of my ear, and another one that runs along my neck). So, stopped the arthritis meds and started antibiotic. After three rounds of antibiotics it's still not fully healed -- and the pain in my joint and mouth isn't any better now than before I had the joint replaced. And I'm still not back on either the MTX or the Enbrel. I've found some relief with gabapentin, but mostly I'm in pain all the time and I'm so discouraged that the joint replacement hasn't seemed to help the pain in my jaw at all (although the surgeon tells me to be patient -- six months at least for recovery). I can tell that the joints in my knees, fingers and feet are getting worse. I'm still trying to work full-time (a daily challenge), and be as supportive as I can of my twin daughters who are seniors and both going away to college in a few short months. I don't want to miss anything related to them, but I just can't get to all my daughter's soccer games right now. So, now we add guilt and regret on top of pain and exhaustion -- which means I am often one huge emotional mess:( This is truly an unkind disease. Very unkind. But I'm thankful for YOUR kindness.
Seenie said:
Niel, how are things going for you? I hope that you are feeling so well and being so active that you don't have time for us here.
Oh Niel. What can I say except that I am so, so sorry. You are very much in my thoughts, and I’m sending best wishes for a good recovery, and a speedy return to your arthritis medications.
Understandably, you haven’t been with us here on the site for a while, and I’m sure you won’t visit too often when you are feeling as awful as you are. But I’ll leave you with a link to a collection of quotations that I like very much. Maybe you will too.
http://www.goodreads.com/quotes/tag/becoming
All the best, Niel. I hope you will keep in touch.
Wow! Thanks for the update, wish you didn't have too........ Isn't Seenie special???
I guess its time for tea and cookies while your daughters bring you to date on their games they usually expand. I still remember some of the visits my son and I had about his matches (and life) I was bed bound in those days from my fall. I got to his last match in the back of a pick-up in a recliner though. AND I danced at his wedding.
What a special time for your and your girls. It isn't fair is it? Are they going to the same school next year?
Those infections are a bear, please be careful.