I started MTX 3 days ago, 10mg a week. Today I feel nauseous & my stomach hurts. Could this be a sife effect so quickly? I take prilosec daily, since I also take Naproxen daily, and I've never felt this stomach pain before. Thanks
6/30/10 12:11pm
Stomach side effects are very common when you take methotrexate, but there are a number of things you can do to help them simmer down to a dull roar- check out my post on managing side effects for more information. As your body gets used to the medication, it's likely that the intensity of the side effects will decrease, as well. If you continue having a hard time, ask your doctor if you can reduce the dose for a while - I'm very sensitive to medications, so often start on a much lower dose than is usually recommended to allow my body to get used to the medication, then increase when things have settled down, wait a while, then increase again, etc. And down the line, if the side effects that works, you can ask to switch to injectable methotrexate, which can be easier on the stomach.
6/17/10 10:53am
It is a drug they use for cancer patients ...and I have heard it causes nausea etc. You are taking the pills? I heard that the shot is better...in as far as attempting to bypass the stomach issues.
You can call the pharmacist as well. They can often tell you the answer in not time at all...and if what you are experiencing in 3 days is normal or not. I would say it probably is.
This is what I found as side effects...but your pharmacist, if you call ahead of time...can actually print you out a PDF file..and talk w/ you about it when you go to pick the paperwork up.
Nausea, vomiting, stomach pain, drowsiness or dizziness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Tell your doctor immediately if any of these serious side effects occur: mouth sores, diarrhea, fever, fatigue, persistent sore throat, unusual bleeding or bruising, black stools, skin rash, enlarged glands/lymph nodes, dark urine, bone pain, unusual pain and discoloration of the skin. Tell your doctor immediately if any of these unlikely but serious side effects occur: yellowing eyes/skin, change in the amount of urine, chest pain, dry cough, trouble breathing, calf pain/swelling, vision changes, irregular heartbeat, muscle weakness, mental/mood changes, seizures. Temporary hair loss may occur. Normal hair growth should return after treatment has ended. A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.
6/17/10 11:21am
Tell me about it. I have IBS...so most meds that upset a stomach anyway, usually hit me twice as hard. I always ask a dr because they know my history w/ IBS if there is any drug that can bypass the stomach...a patch, a shot, a gel..anything.
- But yes, joint pain and then stomach issues...is not a good combo. Because my joint pain is like a 2 and comes and goes for a yr, I'd deal w/ the pain because my stomach is a mess.
But I don't know what your pain is at. I guess after you talk to the pharmacist, and then once you talk to your dr again...weigh out the options...maybe he or she can find something different. I know the only Rheumy that thought I had IA/RA said he never starts off w/ MTX...always something less harsh-UNLESS it calls for it.
As my chiropractor has told me...everytime you are at a Rheumy visit and they throw out meds..you ask for every option they know of...and ultimately...it's your call...they are there to guide you in what their "opinion" is as drs only..but as I have learned...their opinions are not always correct.
G'luck.
6/17/10 5:19pm
Yes, mtx can cause nausea for some of us. But there are other DMARDs out there also that do not cause it. Arava being one of them.
The shots truthfully are not much better on the nausea. It's not the pill that causes it, it's the medication.
Yes, mtx started as a disease modifier to treat cancer way back in the dark ages. But hell, every med started as something. Enbrel treats a blockade of diseases now.
Our DMARDs are necessary to slow down the progression of RA. Without them we are only treating the symptoms and not the disease.
So talk to your doc about another med if the nausea is a bit much for you. Some people make the choice to live through a few hours or days of nausea because..well.."because its a side effect." I lived through all that BS because there were no alternatives back in the day. Today you can pick and chose your battles.
6/30/10 12:18pm
Stomach side effects are very common when you take methotrexate, but there are a number of things you can do to help them simmer down to a dull roar- check out my post on managing side effects for more information. As your body gets used to the medication, it's likely that the intensity of the side effects will decrease, as well. If you continue having a hard time, ask your doctor if you can reduce the dose for a while - I'm very sensitive to medications, so often start on a much lower dose than is usually recommended to allow my body to get used to the medication, then increase when things have settled down, wait a while, then increase again, etc. And down the line, if the side effects that works, you can ask to switch to injectable methotrexate, which can be easier on the stomach.
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By Kathy— Last Modified: 12/26/10, First Published: 06/17/10
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Thanks so much for your reply. I thought it was too soon to experience stomach pain, but I will call my pharmacist as you suggested. My RA doc believes in pills first, they injections. I don't know what's worse, joint pain or stomach pain. Either one stinks, but both at the same time is, obviously, twice as crappy.
Thanks again