Experience with Methotrexate?

Posted by abbeyc @abbeyc, Feb 14, 2022

Hello, I have been on 20 mg of Prednisone for about 2 months and at my next Rheumatologist check-up this week, my doctor is going to talk to me about the option to add Methotrexate on top of the Prednisone. Has anyone tried this? Any success? Any advise? Seems like another strong drug to have to worry about the side effects. Wondering if it's worth it.

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@marieirene

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.

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Hi, marieirene. Your post was really interesting and helpful. I could not remember the reason why I take these meds at different time of the day, so you reminded me. I also separate calcium and prednisone, but might move the calcium even later to a different time. So complicated.
My experience with tapering prednisone after starting Methotrexate was that the early stages were quite smooth, with no difficult flareups. As my dosage got smaller it would take longer to settle down, dropping by 1 mg every month. But it would settle down. Good luck.

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I think MXT is a very strong drug. Google the 2015 Recommendations for the Management of poly Myalgia Rheumatica and look on page 2572. Then scroll down to the very bottom of the page to Number 5. It recommends consideration for an IM injection of Methylprednisolone every three weeks then taper. It also recommends using MXT early on but I would give that some strong thought, as you
are doing. All these drugs have to be weighed up against benefit vs harm

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Hello
I was diagnosed with PMR in July 2020 and on 15 mg of Prednisolone. During the 2 following years I reduced it to 8 mg. Had bad flares each time and couldn’t get below 7.5 - 8 mg. I started MTX 10 mg 3 weeks ago with 15 mgm of Prednisone and all the PMR symptoms have been wiped away! I take Folic Acid 5 mgm x 6 days a week and have no side effects whatsoever. It’s been miraculous so far! I was moribund with pain and fatigue last month. Do give it a try! Good Luck. 🍀

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@chickpea44

Hello
I was diagnosed with PMR in July 2020 and on 15 mg of Prednisolone. During the 2 following years I reduced it to 8 mg. Had bad flares each time and couldn’t get below 7.5 - 8 mg. I started MTX 10 mg 3 weeks ago with 15 mgm of Prednisone and all the PMR symptoms have been wiped away! I take Folic Acid 5 mgm x 6 days a week and have no side effects whatsoever. It’s been miraculous so far! I was moribund with pain and fatigue last month. Do give it a try! Good Luck. 🍀

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Hello ne again!

I wish that I had started MTX earlier than October ‘22. 🍀

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Has anyone had hair loss with MTX? I may have to start, but I know someone who claims her hair fell out while taking. I am concerned by that.

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@flymetothemoon

Has anyone had hair loss with MTX? I may have to start, but I know someone who claims her hair fell out while taking. I am concerned by that.

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Folic Acid is key to minimising hair loss. I’m ok so far taking 3 weeks of 10 mg MTX. The diagnosis of PMR and the accompanying weight loss and starting Prednisone in 2020 was when the hair thinning. In U.K. L’Oreal sell Serioxyl shampoo and conditioner which is wonderful and I take 4 capsules of Marine Collagen daily which is good for hair strengthening too. MTX has been miraculous so far. I believe illness, pain and inflammation cause the damage not the medicines - I’ll stand corrected!

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@chickpea44

Hello ne again!

I wish that I had started MTX earlier than October ‘22. 🍀

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Hello @chickpea44, Welcome to Connect. It's great to hear your PMR is under control and methotrexate helped. Hopefully the PMR will go into remission as you taper off of prednisone and MTX.

Another thing that helped me in my two occurrences of PMR was keeping a daily pain log and the amount of my prednisone dose while I was tapering. Did your rheumatologist give you a tapering schedule to help?

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@johnbishop

Hello @chickpea44, Welcome to Connect. It's great to hear your PMR is under control and methotrexate helped. Hopefully the PMR will go into remission as you taper off of prednisone and MTX.

Another thing that helped me in my two occurrences of PMR was keeping a daily pain log and the amount of my prednisone dose while I was tapering. Did your rheumatologist give you a tapering schedule to help?

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Hi John
Thanks for your welcoming email.
I was given a script from Rheumatologist for MTX and Folic Acid and had all blood tests beforehand. No instructions as yet! Pain has been mitigated a lot and analgesia needed is much less. I’m looking forward to reducing Prednisone… don’t know how long it’ll be before he starts the reduction. How are you?

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@chickpea44

Hi John
Thanks for your welcoming email.
I was given a script from Rheumatologist for MTX and Folic Acid and had all blood tests beforehand. No instructions as yet! Pain has been mitigated a lot and analgesia needed is much less. I’m looking forward to reducing Prednisone… don’t know how long it’ll be before he starts the reduction. How are you?

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I’m doing good. My last PMR flare lasted a year and a half and ended in 2018.

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@johnbishop

I’m doing good. My last PMR flare lasted a year and a half and ended in 2018.

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WOW that’s wonderful! I believe males are are stronger at overcoming PMR than women! What was your PMR history? Did MTX help you into remission with steroids and how long did your illness last? Would love to hear!

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