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Crohn's Disease Forum » Treatment » Methotrexate » Injectable methotrexate dose/nausea


04-15-2013, 01:18 PM   #1
kromom1
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Injectable methotrexate dose/nausea

I have been on oral methotrexate 15 mg for about 7 months now, but it's not really helping, so now my doc is switching me to injectable methotrexate and at 25 mg. I'm really nervous about nausea as I just don't handle that well. I take Zofran with my dose of oral methotrexate (as I threw up the first dose within 15 minutes of taking it), but I don't need to take Zofran for the whole week, just when I take the pills. My doc says nausea and vomiting are very common with the injectable methotrexate.

For those of you on injectable methotrexate, what dose are you on, and do you have nausea with it? Does the nausea last the whole week?

Thanks!
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Lisa

Diagnoses: Crohn's 8/07; steroid-induced diabetes 11/07; Remicade-induced Lupus 02/09, shingles 7/10, and hypothyroidism.
Medications: Entyvio, Methotrexate, prednisone, Protonix, Synthroid, fish oil, calcium, multivitamin, glimepiride. Failed Pentasa, Entocort, Humira, Imuran, 6-MP, Remicade, Tysabri, and LDN.
04-15-2013, 09:52 PM   #2
klowee
 
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Hi,

I have experienced pretty mild nausea with the injections. I started out at 25 mg for a few months then decreased to 15 mg. Usually the first and second day after my injections I experience the most nausea and fatigue, but it goes away pretty quickly with Zofran. I wasn't ever able to take the oral so I can't attest to any comparison. I have never thrown up with it.

I noticed your sig is VERY similar to mine and all the wonderful reactions to the meds. Sigh...so frustrating, isn't it? Hope you do ok on the injections!
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Klowee
Diagnosed with Crohn's Disease 5/2010


Current Meds:
Methotrexate 15 mg SQ weekly
Kenalog steroid injections into my eyes for severe Iritis flare
Timolol & Lumigan for glaucoma from Kenalog

Failed Meds:
Asacol
Imuran...ended up hospitalized with a severe allergic reaction after 12 days 9/2010
Humira - lupus like syndrome 10/2011
Prednisone - drug induced diabetes 8/2012
Cimzia - lupus like syndrome....Nooooooooo! 3/2013
04-15-2013, 11:20 PM   #3
Jennifer
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Are you also taking folic acid? That's supposed to help lesson the side effects like nausea, mouth sores etc.

I haven't started taking it yet (waiting for the prescription to be filled) but I'll let you know if I have the same issue.
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Diagnosis: Crohn's in 1991 at age 9
Surgeries: 1 Small Bowel Resection in 1999; Central IV in 1991-92
Meds for CD: 6MP 50mg
Things I take: Tenormin 25mg (PVCs and Tachycardia), Junel, Tylenol 3, Omeprazole 20mg 2/day, Klonopin 1mg 2/day (anxiety), Restoril 15mg (insomnia), Claritin 20mg
Currently in: REMISSION Thought it was a flare but it's just scar tissue from my resection. Dealing with a stricture. Remission from my resection, 17 years and counting.
04-16-2013, 12:01 PM   #4
kromom1
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Klowee - it certainly does look like we have had some of the same issues! Is the methotrexate working for you?

Jennifer - Yes, I am taking some folic acid, although my provider says it doesn't help with nausea! I'm hoping it will, though. Are mouth ulcers a problem with methotrexate? I had a lot of problems with them when I was on Tysabri. I really don't want to have to deal with that again!
04-16-2013, 12:52 PM   #5
Jennifer
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Yes mouth ulcers can be common with Methotrexate but the folic acid is also supposed to help with that.

"Mouth sores" (under side effects) http://www.webmd.com/rheumatoid-arthritis/methotrexate
04-17-2013, 07:36 PM   #6
klowee
 
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Sorry about the delay getting back on here! I honestly can't say that the methotrexate is helping me. I am still in an active flare, my four month course of Cimzia does not appear to have put me into remission. We were hopeful that I got enough to start healing, but I am still having some issues. I am curious to see what my GI will say at my next appointment about it. I second the other comment about folic acid. I believe that it has helped the side effects not be as extreme as they could have been.

I hope that the injections treat you better than the oral!

What happened with the Tysabri? I am not really keen on taking this med to begin with given my propensity for contracting the rare side effects. I did test negative for the JC virus (just got those results yesterday). Since our bodies seem to respond similarly, just curious what you experienced.
04-17-2013, 08:15 PM   #7
kromom1
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Klowee - The Tysabri worked great for me for over a year, but then over the next six months it slowly quit working. So I went off and tried LDN and budesonide (along with the oral methotrexate) for about seven weeks. I gave up on that because it wasn't doing anything, but even worse, I wasn't sleeping at night since starting it, and couldn't handle how tired I was all the time.

I'm really nervous about the injectable methotrexate, about the possible nausea. I sure hope it works, though, as I've basically tried everything else.

Hope you get some relief soon.
04-22-2013, 08:14 AM   #8
kromom1
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Well I had my first methotrexate injection last night and have had no side effects so far! I just hope it works and works quickly as I've been having a lot of pain.
04-22-2013, 12:16 PM   #9
kromom1
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I spoke too soon. As I sit here at my desk trying to work, I can barely keep my eyes open! I am so tired. Hopefully this is a symptom that will not continue!
04-29-2013, 05:35 AM   #10
Darius
 
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My husband took 25mg on saturday and is extremely tired and feverish. He slept the whole day yesterday. How long can these effects last?
04-30-2013, 12:54 PM   #11
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Hello,

I just started Methotrexate, 25 mgs through injection, last Friday. I'm on Humira and my GI is hoping the Metho will boost the efficacy of the Humira.

I slept all weekend, and was exhausted yesterday and today. I am taking the folic scid to help prevent mouth sores. I did take my under the tongue Zofran 1/2 hour before my injection.

The nausea wasn't great, but it was manageable. I have nauseas as a general symptom of my CD, so I was scared that the side effect of the Metho would be horrible. I didn't find it to bee too bad.

I hope this exhaustion goes away!

I wish everyone well.
04-30-2013, 09:38 PM   #12
Inwe
 
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I was on injectable methotrexate for quite awhile, 25mg dose. Even though I was on Ondansetron, I still got sick to my stomach every time. It usually lasted about 3 days. It was unpleasant but manageable. hopefully everything works out for you!
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Currently On:
- Vedolizumab (Trial Drug)
- Sulfasalazine (for Arthritis)
- Sertraline,Vitamin D, Folic Acid, Multi Vitamin, Calcium


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- Sulfasalazine, Asacol, Imuran, Remicade, Humira, Methotrexate

04-30-2013, 09:51 PM   #13
klowee
 
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I was on injectable methotrexate for quite awhile, 25mg dose. Even though I was on Ondansetron, I still got sick to my stomach every time. It usually lasted about 3 days. It was unpleasant but manageable. hopefully everything works out for you!
Hi, Inwe

Could I ask you an off topic question? I noticed in your sig that you are on the vedolizumab trial...are you allowed to say how it is going for you? My doc wants to put me on Tysabri, but I was hopeful to wait until the vedolizumab reached the market. Just curious if you are seeing anything positive (I know the possibility of you being on placebo is there, but am hopeful for some good news).
05-01-2013, 04:23 PM   #14
Inwe
 
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Hi, Inwe

Could I ask you an off topic question? I noticed in your sig that you are on the vedolizumab trial...are you allowed to say how it is going for you? My doc wants to put me on Tysabri, but I was hopeful to wait until the vedolizumab reached the market. Just curious if you are seeing anything positive (I know the possibility of you being on placebo is there, but am hopeful for some good news).
But of course I was added as a new "short term" user into the phase three "long term user" study. So I automatically get the real drug, no placebo (which was pretty awesome). Any who, I find this drug amazing. I honestly haven't felt this well in the last 8 years! I consider myself in remission. I've gained all my weight back and I can go out without worrying if there is a bathroom near by!

I haven't had any side effects either (which seems impossible!). Compared to Remicade, Humira, steroids, etc, it's a pretty "safe" drug too in terms of what CAN happen to you. I know the drug is SUPPOSE to come to market soon and hopefully it will. I think it will help a lot of people. if you have any more questions just ask away
05-03-2013, 02:40 AM   #15
klowee
 
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Thank you, Inwe! I am thankful to have some hope with this new drug. Hope it gets on the market soon! I am so happy that it is working for you.
05-03-2013, 10:02 AM   #16
kromom1
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Well this week (two days after my second injection) I started with head pain, not really a headache, but shooting pains in my head that come and go. Tylenol doesn't help. Hydrocodone does, but I'm only taking that at bedtime as I'm afraid of the dizziness/drowsiness side effect, and I need to be functional during the day. Does anyone else experience these sharp, shooting pains in your head?
05-03-2013, 07:56 PM   #17
klowee
 
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Well this week (two days after my second injection) I started with head pain, not really a headache, but shooting pains in my head that come and go. Tylenol doesn't help. Hydrocodone does, but I'm only taking that at bedtime as I'm afraid of the dizziness/drowsiness side effect, and I need to be functional during the day. Does anyone else experience these sharp, shooting pains in your head?
I am so sorry that you are having pain! I have not experienced that before. It's too bad the Tylenol isn't helping.
08-23-2013, 09:54 AM   #18
Avw
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Well this week (two days after my second injection) I started with head pain, not really a headache, but shooting pains in my head that come and go. Tylenol doesn't help. Hydrocodone does, but I'm only taking that at bedtime as I'm afraid of the dizziness/drowsiness side effect, and I need to be functional during the day. Does anyone else experience these sharp, shooting pains in your head?
Hey Guys, was just reading this thread as I sit here about to do my first Methotrexate injection. @ Kromom, the shooting head pains you described sound similar to the 'brain zaps' I used to get while taking certain antidepressants. I don't know if the pains are similar at all, or if you're on antidepressants, or if other drugs are known to cause these... Just thought it may be a possibility. Best of luck to you all, and I truly hope the MTX starts doing it's thing soon, for all of us! After reading some of your signatures, it seems many of us are at the end of our ropes for treatment options.

XoXo
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Diagnosed with CD in 2004 at age 18.

Previous Medications:
Every oral medication,
Remicade,
Humira,
Cimzia, etc..

Currently Taking:
LDN 3 mg
VSL #3
Prednisone 10 mg
Flagyl 1000 mg
Entocort
Protonix
Xanax as needed

Insurance still rejecting appeals for Stem Cell Transplant. Tested positive for JCV Antibody so Tysabri is not an option. Searching for matches in Cord Blood Registry and working with an attorney to fight insurance company. Fingers and toes crossed!
08-26-2013, 08:59 PM   #19
Cosmojo
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I just saw this thread, I get the same thing, for the first day I will want to throw up all day, then day two a little, but I mostly just feel nasty and then it starts to fade. I do 2mg folic acid every day and that has helped a lot. I'm on 20mg injectable weekly right now. You do get use to it a little more, I've learned that injecting right before bed helps the most, that way I sleep through the worst of it. I also like to take the injection Friday or Saturday nights because then I can function for work once Monday roles around.
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