PMR and Methotrexate

PMR first diagnosed last December, and currently taking 20 mg per day of pred. (10am and 10pm). Need to FU with rheumys office to clear up Rx of mtx. with Pharmacy. Will start mtx next week I suspect.

My insurance would not cover the Mtx with the brand name - only the generic

Hi my doctor stated me on methotrexate about a month ago 10 mg once a week. It’s hard to say if it is helping. I was able to reduce my prednisone from 9 to 7 but last night had a major flair up. I can check back in after another month or so. I heard many people say that methotrexate does not help. All the best!

Hi @kimmgb, Have you tried making any diet or lifestyle changes to help with your PMR? It really helped me during my second occurrence of PMR. You might find this helpful if you would like more information.

Diet and Lifestyle Changes That Can Aid in the Treatment of Polymyalgia Rheumatica: https://arthritissj.com/diet-and-lifestyle-changes-that-can-aid-in-the-treatment-of-polymyalgia-rheumatica/

Hi, I have but I think I need to do more. Thank you so much for responding. Have a great day!

I am new to this group discussion board and at age 74 was disagnosed in Nov. 2020 with PMR first by my PCP then confirmed with my Rheumatologist in Jan. 2021. My pain started in my neck, shoulders and then my feet eventually making my arms and hands and fingers unable to function. I started treatment on 20 mg prednisone daily and have been on some dosage of prednisone ever since. I was treated for latent TB in Feb./Mar/Apr and I suddenly had a serious flare of PCR pain after about 7 weeks on the TB drugs. I learned that they disable prednisone's ability to work as an anti-inflammatory. I was told when I started there would be "no problem" taking the two drugs together. I stopped the TB drugs after 9 weeks on them and had a serious episode of high blood pressure when the prednisone worked once more. Ended up in ER but luckily no stroke occurred. Blood pressure has normalized since.
Since I am diabetic and have high blood pressure those meds had to be increased to control them on prednisone.
After months of testing my liver and kidneys I started taking Methotrexate along with 12 mg prednisone. When I tried taking 11 mg I ended up with two infections, one in my eye lid and one in my throat. I was at the end of the antibiotic to cure my infections when I took my first dose of Methotrexate. On the third day after taking it I had an severe reaction of extreme dizziness, confusion, dizziness and hot flashes. I was afraid to walk for a couple of hours but all subsided and I never had that reaction again. I was not told ahead that antibiotic would magnify the effects of methotrexate even though I asked if it was safe. I have learned to look up drug interactions on my own.
I am now tapering prednisone very very slowly and have been on MTX for a month. I feel so wiped out, dizzy, fuzzy headed and fatigued the day I take it each week I wonder if I can take it at bedtime. Perhaps some of that misery would be over when I get up. I asked my rheumo that question but don't have an answer as yet. Has anyone tried taking it at bedtime? Does it help?

Hi @queenie2030, Welcome to Connect. You will notice that we moved your post to an existing discussion on PMR and Methotrexate so that you can meet other members who have used methotrexate that can share their experience with you. Here's some information I found on when to take methotrexate.

"Methotrexate when to take -- Most arthritis patients take methotrexate orally, in a dose consisting of several pills. Some find that splitting the dose eases GI side effects. Take half the pills in the morning and the other half 12 hours later, preferably with food." -- Methotrexate: Managing Side Effects: https://www.arthritis.org/health-wellness/treatment/treatment-plan/disease-management/methotrexate-managing-side-effects

I know several members have discussed splitting their prednisone dosage for morning and evening also. Have you discussed it with your doctor or pharmacist?

Hi John,
Thank you for your info. I asked my rheumatologist but am awaiting a portal answer. He told me to never split prednisone doses.
queenie2030

My rheumatologist replied that it is fine to take MTX weekly dose at bedtime to sleep through some side effects. Also start taking 8,000 IU of vitamin A daily and if that doesn’t help increase daily dose of folic acid from 1 mg to 2 mg per day. Has anyone tried these suggestions and did it help reduce side effects from MTX?

I’ve been on MTX for 3 months…what side affects????