Methotrexate Club

This is a place to provide information for other parents about you and your child's experiences with Methotrexate.

It is also an area to ask questions and please bear in mind that there is no such thing as a dumb question. If you haven't found an answer to what you are seeking then there is every likelihood that it has never been asked and therefore you won't be alone in wanting to know, so ask away!

This is a list of questions for those parent's that have travelled the Methotrexate path and hopefully by answering them newbies to the treatment will have many, if not all, of their questions answered.

1. Why was your child prescribed Methotrexate?

2. Does your child take any other medications in conjunction with Methotrexate. If so, which?

3. Is your child diagnosed with Crohn's disease or Ulcerative Colitis?

4. What dose and regime was prescribed?

5. Was your child prescribed tablets or injections?

6. Has the dose been changed over time and why?

7. Did your child have any adverse/allergic reactions?
If so what were they and how was it dealt with.

8. Is there a preference for brand or generic tablets/injections?

9. If your child is prescribed injectable Methotrexate how long does the injection take?

10. Do you use a pen or syringe?

11. Did you have a choice of which method to use and if so why did you choose the one you did?

12. Are there any preparations that need to be made?
e.g. Do you/they prepare the injection site in any way to reduce the pain caused by the injection. For tablets are there any preparations that need to be made to make the tablet easier to take?

13. Does your child do their own injections?

14. Where do you/your child inject on the body?

15. Is there a time of day and/or day of the week that is preferable for either tablets or injections?

16. Can you still administer tablets/injections if you are unwell or have an infection?

17. Did Methotrexate work for your child and how long was it prescribed for?

18. If it didn't work or treatment has been discontinued why is that?

19. How is the treatment monitored for success (i.e. what tests and how often)?

20. What indications/results does your GI look for that would indicate a problem, either that the medication is 'failing' or that the medication is causing an adverse or concerning reaction?

21. How often are bloods drawn?

22. How is the cost of the tablets/injection covered?

23. How do you obtain supplies if prescribed injections: Pick up from a pharmacy/hospital or are they delivered to your home?

24. Any other tips or information?

Thank you to those that are able to contribute to gathering of this information and if you think of any other questions that would be useful please let me know and I will add them.

For those wishing additional information please have a look at the Methotrexate article located here in the wiki and at the Methotrexate Forum located here.

Thanks,
Dusty

1. Why was your child prescribed Methotrexate?
My son was already on Remicade but unable to make it the full 8 weeks between infusion, the Remi dose was upped and the schedule tweaked but he was still having issues so the next step was to add MTX

2. Does your child take any other medications in conjunction with Methotrexate. If so, which? When he was on MTX, he was also on Remicade, daily folic acid and daily Vitamin D3.

3. Is your child diagnosed with Crohn's disease or Ulcerative Colitis?
My son is dx'ed with CD, the inflammation was located in his TI.

4. What dose and regime was prescribed?
He was prescribed 25mg or MTX(oral form) once a week

5. Was your child prescribed tablets or injections?
He was px'ed tablets

6. Has the dose been changed over time and why?
He took 25mg of MTX the entire time he was on it.

7. Did your child have any adverse/allergic reactions?
If so what were they and how was it dealt with.
No

8. Is there a preference for brand or generic tablets/injections?
His GI said he may experience flu like side effects from the MTX and if it was too much we could switch to injection since it seems to not have as bad side effects.

9. If your child is prescribed injectable Methotrexate how long does the injection take?

10. Do you use a pen or syringe?

11. Did you have a choice of which method to use and if so why did you choose the one you did?
There wasn't a choice per se although my son would've opted for the pill instead of injection

12. Are there any preparations that need to be made?
e.g. Do you/they prepare the injection site in any way to reduce the pain caused by the injection. For tablets are there any preparations that need to be made to make the tablet easier to take?
No for my son.

13. Does your child do their own injections?

14. Where do you/your child inject on the body?

15. Is there a time of day and/or day of the week that is preferable for either tablets or injections?
For tablets we started off on Friday in case he were to experience nausea or anything but he didn't have any side effects and due to a fever from a virus at some point we had to hold it off until Wednesday and that became his schedule day from then on.

16. Can you still administer tablets/injections if you are unwell or have an infection?
We were advised to wait 2 days after a fever but also to call with any questions we might have about it.

17. Did Methotrexate work for your child and how long was it prescribed for?
It did seem to work for my child, his FC test level came below normal after several months on MTX.

18. If it didn't work or treatment has been discontinued why is that?
My son skipped a few weeks of MTX due to vacation and teen temperament and after discussing it with the doctor made the decision to discontinue, since all of his tests(lab work and FC tests) were normal and he wasn't experiencing any symptoms. Also the GI had a plan of using the MTX for only a set amount of time to see if it would help.

19. How is the treatment monitored for success (i.e. what tests and how often)?
My son had lab work every 2 months to check his liver levels as MTX can affect those as well as his inflammation markers and other labs. He also had an FC test(fecal calprotectin stool test) every 3 months.

20. What indications/results does your GI look for that would indicate a problem, either that the medication is 'failing' or that the medication is causing an adverse or concerning reaction?
I know they check liver panels to see if the MTX is having an adverse effect on the liver.

21. How often are bloods drawn?
Every 8 weeks

22. How is the cost of the tablets/injection covered?
His tablets were covered by our prescription insurance

23. How do you obtain supplies if prescribed injections: Pick up from a pharmacy/hospital or are they delivered to your home?

24. Any other tips or information?
I've read that many have side effects when taking the pill form so I would think it very important to start MTX on the weekend so as to not get in the way of week day activities. Also, our GI felt the folic acid was very important in helping with side effects. MTX is an anti folate so folic acid supplementation is important.