Starting Methotrexate tomorrow

I saw my doc on Thursday, eight weeks after Plaquenil and feeling worse than ever, with pain, depression and anxiety, even on Vicodin three times a day. Blech.

We have stopped the Plaquenil, added another pred burst, 1 mg Folic acid daily and I am beginning 10 mg of MTX tonight. I don't know if it is the pred, or stopping the Plaquinel, but I feel amazingly free of that awful depressed felling I have had for the last three weeks. ( I had posted about that in another discussion, wondering if anyone else had experiences worsening depression or anxiety on Plaquenil ).

I have Phenergan at the ready, in case I need it tomorrow, and plan to rest. I hope I won't have any problems with the MTX.

My doc is pretty sure that this IS PsA, based on how my symptoms present, with ensopathy being a predominant feature, especially around my hips and pelvis, my IT band, knees and ankles and feet.

I have scheduled another appt for a second opinion with a different dermatologist to look at my nails, which do show some changes, and a tiny patch of scaly skin above my ear that we think might clinch the diagnosis. I am trying to stay positive and I am really enjoying this short lived relief from my bad romance with Prednisone. Maybe I will actually get some things done this week if the MTX doesn't give me a hard time.

Thanks for listening, and I hope you all have the best day possible !

Hi mimiB, I think you will do great on this second round. I am taking my last MTX tonight before starting Enbrel next week. I take Phenergan with the MTX no matter what. I also take Leucovorin the day after. (for any toxicity).You can split the dose up as long as it's all in 24 hrs. Thats what my doc said & it helped with any nausea. I think you'll be fine. You too have the best day possible.

Hey, MimiB, it’s progress! Ten mg of mtx is a pretty low dose, and my guess is that you won’t have a problem with it. As for the anti-nauseant, I’d take some before you dose. Like pain, it’s easier to prevent nausea than it is to stop it once it gets going.
The only thing I ever felt from mtx (even at a 25 mg dose) was fatigue. But it was so mild, sometimes I thought it was my imagination.
Good luck with this! And good that you are getting a second opinion. Like you, I have “it” only in a few of my nails, and one scaly patch on one elbow.

Hi Mimim,

I took my first MTX on Friday eve I was terrified to say the least, but after months of pain and fatigue think I would have taken anything. I also like you have been Prednislone for just over 2 weeks and now tapering the dose, until I get down to 7.5g then I have to maintain that along with 10gm MTX until I next see rheumy.

I have been not been too bad only seem to get very slight nauseous and very tired (sleeping like a baby at night 1st time in months).

I can walk so much better and do things I could only dream about a few months ago. I still must not over do things as this can bring pain and swelling on but on the whole I have really seen an improvement.

I hope things work out for you and you will soon be on the mend.


Goog luck on the MTX…I cope with it at 17.5 mg and had a slow build up to this dosage, its helped a lot and my bloods are good, I just get tiredness on a Sunday/Monday, slight nausea some weeks. Had a worse couple of weeks with returning pain but I usually have a flare at this time of year so hope that’s all it is. My rheumatiologist advice was to take it Saturday night as I don’t work Sundays and just rest., Its been ok on the whole but I notice if I’m really tired anyway the MTX knocks me flat. Hope it works well for you

So far so good then :slight_smile: Good plan for Mondays too

Hi Mimi, sorry I didn’t reply earlier. I had some anxiety that was only evident soon after I started plaquenil - although I’m also willing to admit it was an anxious period. I’ve never had anxiety, or anything remotely resembling it before.

I am glad MTX went ok for you. A specific day sounds like a great idea!

Oh yes! I'd forgotten about the metallic taste. I had that too, but it disappeared a few months in. I found that sugar free mints helped.

Glad it wasn't a nightmare for you. I think you will find that it gets a bit easier each week.

Stay strong!


Hi mimi, Something to try with the nauseau is ginger candy or ginger beer. If you try the candy take small pieces first. Ginger is strong but is great for upset stomach. I eat on the hard candies all day. It does get easier.

Mmmm…ginger beer works for me too, advice from my collegue (who’s a Renal consultant, MTX is used for some transplant patients) drink plenty of fluid on your dosing days to help flush your system through this will help support your kidneys

I took MTX for the first time last Friday night. Only took half the prescribed 10 mg dose because I'm extremely sensitive to drugs and I needed to see how it was going to affect me. Only had slight nausea and heartburn, so this Friday (tonight!) I will take the full dose, along with meclizine (Bonine) to prevent nausea. I hope it works. I try to avoid phenergan -- it really exacerbates my restless leg syndrome. As for taking ginger, I highly recommend Yogi organic ginger tea for any digestive problem. It always makes me feel better. And in the winter, a cup of hot ginger tea has the double benefit of warming you up from the inside.

Hi mimi,

Phenergan is one of my best friends! Hope the MX works for you, I had no luck with it. I just consider the SZ and MX steps to the Enbrel. I have good days with it!

Hope you find your magic med soon, it surely makes a difference in your life!


What works best for me is Lyrica, Oxiprozin and Enbrel. The phenergan is if I have to take Opana. When I take that is when the tailbone is really killing me, I have spinal stenosis there and that can be a pain beyond words! Don't like taking it, but until they come up with something else that works, then that is it. The Pain Management shots only made me worse. As far as the Opana, only when I absolutely have to and I do not drive if I take it, or take it when I have my grandchildren.

The Rheumatologist said "no way" to the spinal stimulator, too many infections, that if I did that I could NOT take a biologic, so that is the end of that idea!

Wishing you success!