I have had pmr since December. I am now up to the highest dosage of methotrexate I can have at 25 mg a week. I am down from 40mg of prednisone to 15mg a day. Going down to 12 this week. The side effects of MTX for me have been two days of nausea, bad headache, and fatigue but every week I take it the side effects lessen. It’s worth it for me to try to get prednisone levels down so I plan around the two days.