Methotrexate starting dose for RA

@maryjanecowell: Methotrexate is a very strong drug and I advise you to research its side-effects, harmful affect on kidneys & other bodily functions (also protect your nerve health). Please accept responsibility to be your best health advocate including 2nd/3rd medical opinion on diagnosis and all options of treatment for your symptoms. Methotrexate is widely prescribed, however you deserve a treatment to relieve your symptoms with as little risk to organ damage and the best treatment results.
We need to make best health decisions. Take care! dbamos1945

I have PMR. I am on weekly injection of 8cc methotrexate. I am down to 2 mg of prednisone. To be honest, this is my second bout of PMR in 10 years. The first time it was prednisone only. I can’t tell you for sure that the methotrexate makes any difference for me. Except that I do get irritated stomach from it. But I understand with RA it really is they main go to. I know for sure you wanna get off the prednisone eventually. It’s a wonder drug but the side effects are very nice. Short-term or long-term. Good luck.

I had a similar protocol 4 years ago using increased doses of prednisone to determine the actual dose of Methotrexate needed to relieve the RA symptoms. It took a few weeks before the symptoms started to get better. As you have been already told , Methotrexate is a high risk drug and the Doctor wanted to only use the minmal dose necessary. My initial dose was determined at 17.5 mg once every 7 days. However, as the months and years passed without any further flair ups. pain or symptoms, the Methotrexate was reduced slowly about 2.5 mg each time. Now I am at 12.5 mg weekly, but in six months, if nothing happens, the dose will be reduced to 10.5. Daily folic acid, blood work and exams every 3 months, with X-rays of joints about everything 6-9 months has been the standard protocol for me. I wish you many blessings and hope for the best.

After several rounds of taking prednisone and my pain coming right back as bad as ever when I stopped it, my PC doctor found I had high inflammatory markers in my blood work and she referred me to the rheumatologist. He did more testing and gave me a a 6 week taper dose of prednisone and then started me on methotrexate after they concluded I "probably" had seronegative RA (I did not have the RA blood marker but 30% don't). I started out slowly and now am on the maintenance dose of 20mg/once a week. I don't think I've had any side effects although I did have diarrhea 3 days after taking my dose once. (It could have been something I ate.). I'm now totally off the prednisone. My pain issue came out of the blue early last summer and was debilitating until about mid-day when it would ease up and I could function normally (ie. use my hands!). They also think I have psoriatic RA because I've had some weird rashes over the years . Oh and I also have been having severe dry eye problems and now using prescription drops. I may have Snogrens.

My mother had a crippling episode if pain in her hands diagnosed as RA.
She was initially started on prednisone for a period of time to relieve her from the onset of pain. She was a tiny woman and put on two sizes of clothing due to weight gain . Once tapered off the prednisone, she began a regimen of methotrexate. The cost was less expensive with the injectable vs the pills. (She was on Medicare ) Very easy to administer once a week. I would do it for her.
She never experienced any side effects. Had regular blood work every three months, with a brief visit with her rheumatologist.
MTX was a life saver for her.

Thank you so much for giving us hope that my hubby can be pain free at some point!! Thank you for taking the time to encourage us.

He needs to be checked for TB before starting it’s a blood test. I was on methotraxate for 9 months it did help but had to stop because of side effects. Folic acid is taken 6 days a week but not on day taking methotrexate. Also blood tests should be done every month or other month to see how drug is affecting liver and kidneys. Sores in mouth, rash, hair loss all regular side effects. There are more so check on Mayo site. Being a female I kept getting UTIs and had terrible side effects so stopped. Now I am 5 weeks on hydroxychloroquine which so far is working. I am still taking .25 prednisone but in December will wean off

@voll I agree about getting off prednisone, I tried dropping my dose to 2 mg and couldn’t. Lots like 3.5 mg is my dose. I am also on .8cc of methotrexate but take it before bedtime and it doesn’t affect my stomach.

@mdm5 we’ll hang in there. Everyone is different and I know the finish line is difficult with every dose reduction.