Hello @smoshetti, Welcome to Connect. Sorry your husband has to deal with PMR along with his hypertrophic cardiomyopathy. My PMR is now in remission. I don't have any experience using methotrexate for PMR but I'm sure there are other members who can share their experience. While you wait for other members to respond, you may want to scan through the discussions and comments by members on methotrexate side effects. Here's a link to the discussions and comments - https://connect.mayoclinic.org/search/.

You might also find the following discussions helpful:
-- Methotrexate / Actemra: https://connect.mayoclinic.org/discussion/methotrexate-actemra/
-- PMR and Methotrexate: https://connect.mayoclinic.org/discussion/pmr-and-methotrexate/
-- Alternative to Prednisone for Treating PMR?: https://connect.mayoclinic.org/discussion/alternative-to-prednisone/

@tsc, @dadcue, @nyxygirl and others may also have some thoughts or information based on their experience with PMR. What side effect of methotrexate worries your husband the most?