Methotrexate Is Making Me Sick...

** Originally posted by jlscards **

Hi, my name is John and I am a new member. My doctor has recently put me on MTX. I take 6 x 2.5 mg every Monday. Yesterday was my first time taking any oral medication for my psoriasis. It was not until Monday evening I started feeling sick. It was not until Tuesday that I felt really sick. It made me nauseated, dizzy, headache, my vision was blurred, I felt hot, and most of all I did not want to do a thing except sleep.

Is this normal? Did anyone have the same symptoms? I am contemplating staying on this medication if it is going to make me feel this way. Will it really help me?

I have plaque and guttate and nail psoriasis, along with psoriatic arthritis. I am 28 years old. Psoriasis first showed up when I was 24. It started with the nails, then moving to all the joints at a rapid speed.

Please, if anyone can answer a few of my questions I will be grateful. Thank you for taking the time......


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16 replies. Join the discussion

** Originally posted by timba **

I have just begun the injections of MTX. Second one will be tommorow. Did you take injections first. did they help. I was on
a course of cyclosporin (ll weeks) did not
help but did at times make me crazy nauseous.

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** Originally posted by beachbound **

Hi John,
I had the same reaction when I used it. I was on and off it a couple times. Always made me sick to my stomach and very, very tired. It did wonders when I first started and then seemed to lose it's punch. I just hated how I felt and stopped. I have heard that for many, MTX in shots rather than pills, is much easier on the stomach. May be worth looking into.
Good Luck!

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** Originally posted by PJLeary **

HI John,

MTX is a very serious drug. I hope you were well informed about it before you decided to try a course. I did once, in my 20's.

If you were not, you are certainly not alone. Many seeking relief , including myself, have failed to ask important questions. I am not going to try to sell you anything. I do not know of a cure. I am a flake, like you.

I have had this disease for more than 20 years. The "cures" make me scared. I have been waiting, and refusing trials, for the last 15 years. I am now 42.

You may decide that MTX works for you. It did for me. It made all of my PA go away, and most of my skin lesions.

But, I was unable to function. I just about wanted to die! I was unable to function in any meaningful way, and my family was suffering.

I chose quality of life. My family.

That does not mean the choice will be the same for you.

I hope the best for you.

PJ Leary

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** Originally posted by rosee_posey **

Hello John,

Since this is your first dose, are you sure it's the meds, and maybe not a virus or something? Just a thought...

But if you continue this, and these really are side effects, FIRST call your doc, and there are some things you can do.

1. Start taking folic acid. Doc will prescribe it for you.

2. Talk to Doc about decreasing the dose.

3. Talk to Doc about a different dosing schedule - some people split their doses to twice a week.

4. Try Trexall - it's just a different formula of MTX. I looked at the drug info that came with it, but it has the same ingredients as regular MTX might just be buffered or something...I know someone here on this board takes it, but I forgot can get more info at

MTX has been around for quite some time (longer than I have, I believe), and it does fabulous things for those with Arthritis and Psoriasis - for those who can handle it. There are many folks who can't, so don't feel bad if you are one of them.

5. If you and your doc agree, give up on MTX altogether and start Cyclosporine. My sister could not stomach MTX either, but Cyclosporine worked fabulously for her.

6. There's always Soriatane too!

Hope this helps,
- rose

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** Originally posted by annekennedy **

I have been taking this drug for the past month. It does make me sleep the day I take it. I have not experienced any other side effects. This is a serious drug. You should tell your doctor!

good luck

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** Originally posted by judiperfume **

Got this from
Hope that this answers your question. Remember that this medication is a form of Chemotherapy.

How Well It Works

Within 4 to 6 weeks, the skin is greatly improved or completely cleared of psoriasis in most people. Symptoms may not return for up to a few weeks to a year or longer.

The medication is effective in treating extensive psoriasis, erythroderma and acute pustular psoriasis, physically disabling psoriasis of the palms of the hands and soles of the feet, and psoriasis in older adults.

It reduces symptoms of psoriatic arthritis and stops joint destruction in certain forms of psoriatic arthritis.

Side Effects

Common temporary side effects include:

Nausea, fatigue, loss of appetite.
Trouble sleeping, tiredness.
Reduced white blood cell count.
Less common temporary side effects include:

Sunburn if the person is exposed to large doses of sunlight or ultraviolet (UV) light either before or after taking the drug.
Vomiting, diarrhea, and occasionally blood in the stools.
Mouth sores.
Easy bruising and bleeding.
Skin rash or sores.
Chills and fever.
Birth defects (if taken by a woman who is pregnant or who becomes pregnant while taking the medication).
Long-term side effects include the following:

Liver damage occurs in 3% to 10% of people with long-term use.
Liver damage that is not severe reverses after the person stops taking the drug. Stopping therapy for 1 year should allow normal liver function to return.
The risk of liver damage is higher if the person takes a higher dose of methotrexate.
The risk of liver damage is also higher if the person drinks a lot of alcohol, uses drugs that contain arsenic, has kidney or liver problems or diabetes, or is overweight.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

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** Originally posted by Kristy **

Hi John and welcome. I took mtx for about 11 months and also had a rough time. I was only on 7.5mg once a week so talk to your Dr. befor you give up totally. I had flu like systems, exhaustion and hair loss with this drug and yet I stuck it out for almost a year because I wanted my pa to get better. It didn't. You have to be the one who decides if it is worth it. You are very young to have the arthitis part of this disease and I'm sure your Dr. wants to keep the swelling in your joints down but there are other options. Enbrel and remicade are two of the new bio drugs that are out there. I hope you find your way through this, there is mountains of information at this sight. Knowledge is power, especially when dealing with Dr.'s good luck. KL

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** Originally posted by jlscards **

I have never taken the injections. I just started on MTX, tablets, about 4 days ago. I am not as sick as I was on Tuesday, the day after I started MTX. It is now Thursday, and I still feel really light headed and dizzy.

Thank you for taking the time.........

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** Originally posted by jlscards **

Thank you for all your responses. I thought I did all the research on MTX, maybe I did not take it serious. I did not know how powerful this drug really was. I know there are other meds out there not just MTX. My doctor thinks that MTX is the next step for me. I had many concerns/questions, my doctor answered them all.

I started this past Monday taking 15 mg right off the bat, just as the doctor prescribed. Later that night I felt really sick. Nauseated, light headed, blurred vision, dizzy, headache, and just did not want to do anything. It was worse on Tuesday. Wednesday I felt a little better, the side effects came and gone throughout the day. Thursday I was light headed and dizzy with a mild headache.

I talked to my doctor each day to let him know what was going on. My main concern, is this normal. My doctor told me yes it was. He prescribed folic acid for me, 2 mg each day. He told me to skip this dose of MTX and the following week just take 1 tablet (2.5 mg) increasing the dose by 1 tablet each week until I reach 6 tablets (15 mg). When I reach the 6 tablets, he told me to take 3 in the morning and 3 at night. I asked my doctor if it was possible that I just might have a virus. He told me that it was possible. His approach is no introduce MTX to my body at a much slower pace, I hope this helps.

If MTX is still effecting me the same way after a period of time, I am just going to say "no more". Then I will talk to my doctor about other medication out there.

Again, Thank you for taking the time to reply. This is information I really could use right now. I understand that MTX will effect each and every person in a different way.

Thank You,


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** Originally posted by jessiea **

Hi John: Have had P and PA for 6 years with 4 flares the current lasting 2 years. Been on MTX twice. I had the same reaction. I took mine on Saturday and slept and throwup all day Sat and part of Sun. I have been putting off the doctors from putting me back on MTX rather have P. I did try the shots and they were not as bad - it did not affect the stomach as bad. Good Luck and remember you are not alone. There are a lot of us out here in the same boat.

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** Originally posted by GailBehar **

Hi. I have been taking MTX since November.
I started on 3 tabs/week and now am up to 7 tabs/week. My doctor has been increasing my dose by 1 tablet per month.
When I add a tablet weekly to the regimen it leaves me very tired but then I find that I can tolerate it well the next week.
With my last increase I did get a bloody nose but again a few weeks later I feel pretty good.
My psoriasis is getting so much better and for me it is worth the side effects.
I am on the waiting list for Enbrel and I do hope I can taper my MTX dose down because I do not want to have a liver biopsy down the road.
Good luck to you!

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** Originally posted by khorath **

I've tried MTX several times over the years. Every time I try it, I get very tired and sick feeling. Plus, I did not see much improvement in the P. Therefore, I decided to stop the treatments.

I tried pill form and injection. I also took the folic acid. Nothing helped the sick feeling, though. And, the liver biopsy was not fun, either!!!

I have given up on MTX completely now for treatment options for me. My doctor also had me try 6-thioguinine. It made me feel the same way as MTX, so I stopped.

I'm currently on cyclosporin. I'm waiting, though, to see if my insurance will cover enbrel. I don't have PA but my derm wants me to try it. My insurance denied me, though, because it is only FDA approved for PA, not P. I don't have PA (at least not yet). We are appealing this decision.

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** Originally posted by PJLeary **

Hi all,

One thing that I did learn when I was using the mtx was that I could effectively use the anti-nausea drug composine. I found it helpful in the suppository form.

I was having a hard time keeping any food down at all. So, I would eat a simple meal, then immediately use the composine. Then I would go to bed, because the composine makes you really sleepy. I would doze for a couple of hours, which was a good thing because it gave my body time to digest the food. I am a rather small person, and I could not afford to loose much weight.

I hope that is helpful.:)

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** Originally posted by sickofit **

My secret with dealing with MTX is... I also had the same problems and side-effects mentioined by everyone... the effects are greatly reduced if you eat well before taking MTX. Always take MTX during the weekend and give yourself lots of rest. Eat well & sleep well. As always, MTX is only a temporary solution. When symptoms are under control go back to less risky treatment options like UVB, sunbath, etc... Just my 2 cents.

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** Originally posted by grooveh **

Originally posted by sickofit
As always, MTX is only a temporary solution. When symptoms are under control go back to less risky treatment options like UVB, sunbath, etc... Just my 2 cents.

That's how I view MTX usage too. After weighing the options out, I am on MTX for now...going to try to clear up my PA and P symptoms and then get off the MTX. I have talked to people who have taken MTX for years and years, and appear fine. I dont want to take MTX one week longer than I have to!!!

Its serious stuff!!

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** Originally posted by Patty925 **

Hello John,

I'm on my second week of MTX. I hate it so far. I take it on Friday night, Sat. morning and Sat Night. 12 hours appart. I feel tired and nauseous too. I did clear up after the first week not totally but pretty good but then by Thursday, I started having a rash like flare up. Called in and was told to take it again. I did. Woke up to swollen gums and itchy skin not to mention irritated tongue. Called doctor and said I want to get off of it this week. I have to go to get blood work on Wed., and then have to see my Doc on Friday to discuss. I rather have p at this point.

Hope you are doing better with yours. Good luck and please post a comment as I'm searching for those on it or who have been on it for guidance and information.

Take Care!


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