OK, before I start I want to choose the optimal time. I have to take 10 mg once a week and then folic acid the day after (also once a week). Bit confused because the pharmacist said to take this on an empty stomach but I have seen posts that say you should take it on a full stomach. Who can sort me out on this one? My weekends are important so I don’t want to take on Friday incase I feel awful on the weekend. I also see that most people suggest taking it in the evening. I’m sure it’s different for everyone but I’d like to hear what your experiences are. If you take it in the evening does the effect wear off by the next evening?
I get least naucious if I take the MTX in between something to eat… dinner is too early for me… as the nausea starts pretty quickly… so I eat something with carbohydrates like chips or crackers… for me putting something on top of the pills helps a lot…
Did they really mean take the MTX on an empty stomach? I would check again… maybe it was the folic acid?
The next day I can tell I’m not feeling great but it’s not too bad… just tired and a bit weird… I can smell the MTX on that day though no one else can…
I did take them on Sunday for a while but I found I had more trouble sleeping… not from nausea more like if you drank caffeine and your eyes just won’t close… so I switched back to Friday cause I can sleep late on Saturday…
Anyway not everyone gets nausea even on higher doses then you have so don’t go sitting around waiting for it to start 
the placebo effect works both ways if you believe you’ll get naucious you will…
You can change things around… just try what’s best for you… someone suggested to me to take them one at a time over the day (I had 4 little once, 10mg total) which supposedly works wonders for some people.
Thanks Cynthia - you’re right I don’t want to think too much about the possible side effects cos then I might just have them! If I can switch days I will try Wed evening I think to start…heres to MTX without side effects…
hi yael,
i tried a few different scenarios when taking MTX. I would be incredibly wiped out the day after and then would feel hungover the day after that. For me the nauseousness with the pills was too hard to manage and also because it required my taking yet another medicine to manage feeling so unwell, ultimately I switched to the injectible MTX. That posed me far fewer side effects.
Two other pieces to mention: first drink tons of water. I mean way more water than you think you need. Dear Lamb suggests, I believe, 1 fl oz per lb of body weight. That’s a LOT of water. But he’s right. The more hydrated I was while taking MTX the lighter the side effects. Second, take your folic acid as directed without fail. If you’re prescribed to take it every day except your MTX pill day then do so. It is really helping to counteract the depletion of folic acid caused by the MTX.
So many people manage really well with MTX. It has been a reliable tool in PsA treatment for, as we say in England, donkeys years. It’s also really affordable so I do hope it gives you relief.