01-06-2017, 03:57 PM   #1
Senior Member
Join Date: Jul 2016

My 15 year old was diagnosed with crohns in May 2016. She is currently receiving remicade infusion every 8 weeks. Her GI wants to start MTX. I would like to here some about your experiences with this treatment combination. Since she is a teen, I'm told he won't prescribe the MTX unless she takes birth control. She isn't sexually active, but he states that MTX can cause birth defects. I'm at a loss when it comes to this. Just really need someone to talk to.
01-06-2017, 04:22 PM   #2
Senior Member
Join Date: Sep 2014
My 15 yo daughter was diagnosed in November 2015. She had a resection in December 2015 and has been on Remicade since. Her GI just added MTX a few months ago because she was developing antibodies to the Remicade and her Remicade levels were a bit low. She doesn't Remicade every 8 weeks and 10mg MTX once a week.Her GI hasn't said anything about birth control so can't help you there (DD isnt sexually active either...never even kissed a boy). FWIW, I was freaked about adding MTX but so far it's helped with the antibodies and Remicade levels and she doesn't have any side effects from it. Good luck!
01-06-2017, 05:05 PM   #3
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Maya142's Avatar
Both my daughters were put on MTX as teenagers. Their doctors did not insist on birth control but did discuss the risks of getting pregnant on MTX. We also added MTX to prevent antibodies and to help with their joint inflammation.

I would speak to your GI if you are uncomfortable - ask if a conversation about the risks of getting pregnant on MTX would work instead.

For what it's worth, my younger daughter is now on birth control for irregular periods and cramping, and it has helped her a lot. And she's had no side effects. But I don't think I would have wanted to give it to her when she was much younger (she is now 20), especially if she wasn't sexually active.
Mom of M (20)
diagnosed with Crohn's Disease at 16
Juvenile Idiopathic Arthritis at 12
Juvenile Ankylosing Spondylitis at 16

Mom of S (23)
dx with JIA at 14
Ankylosing Spondylitis at 18
01-06-2017, 05:34 PM   #4
Senior Member
Join Date: Jul 2016
Thank you both for responding. I noticed that she does experience pain a week prior to the start of her cycle. He said her Remicade levels were good. However, the MRE showed improvement.
01-06-2017, 06:27 PM   #5
Senior Member
Join Date: Dec 2014
Location: Portland, Oregon

My Support Groups:
My daughter was on the Remicade/methotrexate combo for the first year of treatment, and it worked really well for her, with only mild side effects. Some studies have suggested that the immunomodulator (methotrexate, in this case) is only needed for 6 months or a year, so her doctor decided to take her off the methotrexate last spring. By this fall, she was flaring and had developed low levels of antibodies to Remicade, so we added back the methotrexate. She's now doing much better, and we'll test soon to see if the antibody levels have gone down at all. Her doctor has never mentioned birth control, but my daughter is just 14.
Daughter E (15) dx with Crohn's 12/18/14 at age 12

Current treatment:

Remicade started 12/24/14 (9 mg/kg every 6 weeks)
Oral methotrexate restarted 12/2/16 (20 mg weekly)
vitamin D, folic acid, iron, multivitamin, Prozac

Past Treatment
90% EN via NG tube 2/9/15 - 4/2/15
50% EN via NG tube 4/3/15 - 4/18/15
Supplemental EN via NG tube 5/7/15-6/19/15
Budesonide 3/3/15-6/30/15, 3/24/18-5/18/18
Oral methotrexate 3/13/15 - 5/14/16 (15 mg weekly)
Clobetasol for Remicade-induced psoriasis
01-06-2017, 07:12 PM   #6
my little penguin
Forum Monitor
Join Date: Apr 2012

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Ds has been on humira and mtx combo
No birth control conversation from the GI but he is only 13
We have explained that when he gets older and starts to date or anything else he will need to ask all of his doctors at that point in time what risks are involved

But for ds kissing can be deadly if the person had consumed his allergens that day .
Another conversation to be had as well very soon .
DS - -Crohn's -Stelara -mtx
01-06-2017, 07:30 PM   #7
Senior Member
Join Date: Mar 2012
Location: California

My Support Groups:
My daughters both got a pregnancy test prior to starting Mtx and my younger daughter was only 12 at the time. No discussions about birth control. Just wanted to make sure they were NOT pregnant upon starting.

They add MTX to Remicade to help prevent antibody formation. They started doing this a year into my older daughter's treatment and while the liver risks scared me (family history of bad livers) I grabbed it because Remicade works so well for my daughter that the thought of possibly losing it due to antibodies scared me more than the low risks of Mtx.

My younger daughter started with mtx as her first line of defense. When that didn't work alone we later added Remicade.

I get where the doctor is coming from but it seems a little extreme. Perhaps they would agree to having a conversation with your daughter first.
Daughter O dx 2/1/12 at age 12
Crohns & Remicade induced Psoriasis
Vit d 2000IU
Multi vitamin plus iron

Previously used - Prednisone, Prevacid, Enteral Nutrition, Methotrexate oral and injections, Folic Acid, Probiotics, Cortofoam

Daughter T dx 1/2/15 at age 11
Vitaligo, Precoscious puberty & Crohn's
Vit D 2000IU

Previously used, Exclusive Enteral Nutrition, Methotrexate (injections and oral), Folic Acid, Entocort,IBD-AID Diet
01-08-2017, 02:35 PM   #8
Jmrogers4's Avatar
Normally my son's GI would add MTX along with remicade but my son had a pretty severe reaction to it as a monotherapy a few years before starting remicade. I don't remember a discussion involving sex and MTX but I do remember a conversation about alcohol and MTX and not mixing the two, given he was only 11 or 12 at the time it wasn't a big concern but then I think we were hoping for a longer time on MTX.

Mom to Jack (18) dx Crohn's 2/2010
Remicade - started 1/9/14; 7.5ml/kg every 6 weeks
Past meds: Imuran/Azathioprine; allopurinol; methotrexate; LDN; Prednisone; Apriso; Pentasa; EEN

Husband dx Crohn's 3/1993
currently none due to liver issues

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