PMR and Methotrexate

You are fortunate if you do not have side effects. Mine are extreme fatigue, dizziness to the point I can’t read or drive on the day I take it. I am extremely sleepy and my mind is very foggy that day. I also feel as if organs inside me are trying to move around and I feel very very hot off and on all day. Has it helped your pain? After a month on it my pain is no different. I guess it takes longer to help the pain.

Whoa. I have none of that!! I’m not sure if it’s really helping. I was on 4 mg prednisone, but upped it to 5 cause I was still pretty uncomfortable. I see my rheumatologist in 4 weeks. I’ll see what the next plan of action is. Praying you can get some relief

Thank you for your reply. I took the vitamin A at bedtime along with the 10 mg of MTX and slept so well. Best part I feel good in the morning. I can function like a real human. I started prednisone for PMR in Dec 2020 at 20 mg. I am now down to 11 mg per day. Your dose seems very low. I am tapering very slowly. I pray all of us suffering the pain can get to remission.

@amom7 so sorry you’re down. I’m battling that too. It’s hard.

Regarding pain meds, My rheumatologist had me try meloxicam and now celecoxib. Not sure they’re helping, but that may be because I find myself being really active when I feel good which then comes back to bite me!

What experience do folks have with methotrexate?

It gave me breathing problems. I ended up with something called ground glass opacity in my lungs. My blood oxygen levels went down and I had supplemental oxygen at home for a few weeks.
After stopping the methotrexate my lungs are now clear.

Hi @elizabethjoan, You will notice that we moved your post to an existing discussion on the same topic here so that you can connect with other members with experience using methotrexate:

-- PMR and Methotrexate:
https://connect.mayoclinic.org/discussion/pmr-and-methotrexate/
@queenie2030, @klpintx, @peach414144, @jcaffrey47 and others may be able to share their experience with methotrexate and PMR.

I had difficulty going below 6 mg prednisone/day so my Rheumy put me on methotrexate starting at 6 pills once a week and now I'm at 8 pills once/week (no alcohol the day before, day of or day after) along with a folic acid once per day. Had some bad did I say bad " lower end" issues that seem to have resolved over time. So far so good as the liver blood work has come back in the green, I'm back down to 6 mg/day of prednisone tapering 1 mg /day every 30 days. My Rheumy's goal is to use methotrexate to eliminate prednisone and hydroxychloroquine targeting, of course, remission...on my own I'm trying to eliminate ibuprofen and acetaminophen use to only when necessary. It's been a journey starting with very severe, i.e., worst pain ever, in Feb '21 finally seeing a Rheumy in August '21 and starting a plan. There's hope as I look for the light at the end of the tunnel - less I digress.

I asked my rheumy about methotrexate when we first met (because my genetic tests showed I wouldn't respond to it) and he said he never used it for PMR because he didn't think it helped. I suspect he was incountering others like myself that clear it too fast for it to help. We haven't discussed anything else for treatment except pred.

I was diagnosed with PMR 5 months ago. Started on Prednisone 40mg, felt great. Just recently started my taper - my doctor had me reduce it by 10mg/month. I am now on 20mg of Prednisone and all my symptoms are returning. My doctor now wants me to take Methotrexate 2.5mg 4x per week and continue to reduce my Prednisone by 5mg weekly. I'm new to this disease and would love to hear from anyone that has used this approach or hasn't and why.