Experience with Methotrexate?

After my second flare up of PMR my Rheumatologist put me on Methotrexate, 6 tabs 1 day a week. 95% of hand pain is gone & I’m feeling the best in months. Still on 15mg of prednisone daily. She also added Folic.

My Rheumatologist said hair loss is nothing like when you are on chemotherapy. I lost mine in ‘88 from chemotherapy drugs for cancer. Not a big deal in my book. I lose strands from prednisone & methotrexate now. If I go bald again I can handle it. It eventually grows back. Good luck

This is close to my recommended dosage. I am on Methotrexate 2.5mg 4 tabs a week (1 per day). I also take 15mg prednisone. What is your dosage on the Methotrexate?

I am on the same dosage of Methotrexate and folic acid, and have been reducing prednisone by 1 mg each month. I am now down to 1 mg Prednisone (woohoo), from at least 10 mg daily for 18 months. Exercise is very important, but overdoing it is not advised, but my symptoms were very well controlled. I hiked and walked dogs 6 miles on Sunday and again on Monday, then spent 3 hours on Tuesday removing invasive species at forest preserve workday - bending, squatting, using loppers, etc. I joined this forum about an hour ago, because I am suffering today, LOL . Trying to find out appropriate level of activities.

Welcome @avidhiker, It sounds like you are on your way to remission from PMR. Daily activity is certainly a key factor but I think you may be feeling what a lot of us have learned about overdoing it - it can cause an increase of pain the next day. My rheumy told me I need to listen to my body when it comes to pain and activity.

You might find the following discussion helpful:
— PMR Dosages and Managing Symptoms
https://connect.mayoclinic.org/discussion/pmr-dosages/
I always keep a daily pain log along with the amount of prednisone I took that day. I hadn't thought about also recording activity for the day but in retrospect it might have been helpful. Do you keep a daily log of your pain level and dosage?

Hello John. Thanks for your reply. 1. I have tried a diary, to try to figure out role of foods, exercise, etc. on symptoms, but it always seemed to be so random so did not continue. 2. I do not adjust the amount of prednisone, and did not know it was an option. I have been steadily reducing prednisone by 1 mg every month, and hoping to be finished with it in a few weeks. My activity level is 'active' but this is the first time in a while that I did so much on three successive days. Lesson learned. Thanks for the link to the discussion. I will check it out.

What about pain? My pain-reliever of choice was Ibuprofen, but apparently that should not be taken with Methotrexate. The information recommends Tylenol, which I would rather not use for a variety of reasons. I just bundle up warm and try to stay comfortable.

Most RA doctors have a protocol that they follow to "climb the ladder" on drugs to find what will have a positive effect. Each has side-effects. One ladder is:
NSAIDS
Prednisone
Methotrexate
Hydroxychloroquine
Biologics like Simponi Aria then Orencia

I experienced anal fissures along with the other anal side effects. Had to come off of the drug.

Methotrexate has been a blessing for me! I had a flare up & prednisone was back to 15mg daily with methotrexate. I felt 95% normal. No side effects. Today I’m
Back to 10mg daily prednisone. Hopefully I can handle it. I exercise almost daily, Pilates& walking. Try to keep moving. I need to do better with my eating habits. Good luck to all.

In my last flare up I had swollen & painful hands. My markers were sky high. Got a shot & felt relief. She put me on methotrexate & I continue to take six 2.5 mg each Wednesday. Starting to taper prednisone to 10mg daily. I hope to get to the pain free stage without difficulty. I also take 1mg folic acid daily. I read where you shouldn’t take calcium tabs at same dosage time as prednisone so I don’t take them together.