Methotrexate

My husbands PMR is well controlled with only methotrexate. He only took prednisone in the beginning.

Doctors tried to get me off Prednisone - wanted methotrexate - I did not react well - still on Prednisone

Sorry about your struggles.. but don’t give up..recovery takes a long time.. I had the same problem.reducing prednisone after being on it for 2 years… . Actemra, seriously elevated liver enzymes, so my doctor prescribed methotrexate… symptoms worsened. Now on Rinvoq and having relief.. tapering prednisone every 2 weeks and am now down to 4 mg prednisone and feeling so much better!

I have been taking Methotrexate 2.5 mg for over 6 months, and I have been managing my PMR. I also take folic acid and Hydroxychloroquine. My pain level ranges between 2 and 3.

I have been on prednisone since end of March 2025 & added methotrexate end of May 2025. I’ve been lowering prednisone as suggested by rheumy & now at 2 mgs dropping very slowly.
Methotrexate I suppose it working? My pain levels are extremely low (yea!) except for maybe arthritis creeping up in shoulder? I’ll be 73 in a few weeks so a few old age related mild aches are extremely acceptable right now!!
Methotrexate does cause me fatigue a day or so after taking & I nap if I need to. Then I’m ok.
I see rheumy early next month & we’ll look at all the lab #s. I’d like to know when & how fast I can be weaned off methotrexate! I take 15 mg once a week. I don’t know what it’s doing to my internal body!

@brittg I also had terrible reaction to it. Doctor's were thinking that I had developed bone marrow disease. Ended up being methotrexate toxicity after 18 months of taking it.

@kare1 as well as the usual things, make sure they pay attention to the blood cell counts. Apparently some changes in ratio of white cell counts are expected, but from personal experience changes in the red blood cell counts can be more problematic.

@gmdb
Gads. My Rheumy had said I’d be on methotrexate for 6 months AFTER weaning off prednisone. I sure as hell want to lower that dosage I’m taking sooner than that!

@kare1 my doctor's told me that 6 - 12 months was the likely timeframe for PMR. Three years later and I still can't taper below 10 mg of pred a day. Had two lots of extensive testing in 2023 and in 2025, which conclude both times that all I had was PMR. But 2025 was a right-off due to methotrexate toxicity and the recovery from that, so making progress on tapering pred didn't happen. But my reaction to methotrexate is uncommon, and may have been exacerbated by the doctors also prescribing Bactrim/Resprim antibiotics at the same time. It has the potential to increase methotrexate side effects, but supposedly not at lower doses. A lot of the doctors in Australia insist on the antibiotics when prescribing medium to high doses of pred. If I had been able to access Actemra in Australia I think that would have been a better option. Quite a few people on this forum have reported great results with that biologic.