Hi all, It's been forever since I have last posted, but I do check the discussions regularly. My current question deals with methotrexate dosing. I looked through previous discussions here but didn't get just what I needed.
I finally got back into my PCP after a couple months no ins. Now my PCP does not take the new ins & have to pay cash Arrrgh!
Anyway I have been having side effects from the MTX dose of 8 2.5 mg pills 1x week. I heard that the injection often has less side effects and wanted to know if I could try, Well new insurance does NOT cover the injection Arrrgh! My PCP suggested I take 2 pills every day....Yes 7 days a week. I then asked how will Folic acid go with it as I'm supposed to take every day except on MTX dose day. He said just take every day but to take well apart such as Folic in am with food and MTX at night. I thought about it later at home & think it's too much per week.
Anyone heard of this dosing?
Folic acid is a huge help for size effects and most of the patients that I have encountered who take it along with MTX do very well.
Usually, the injecting is pretty cheap. My insurance does not cover it either, but when I lay had it filled, it was under $30 for three months worth of injections worth syringes. Most patients who do the injection report little or no side effects. I have taken it this way for quite some time and have found it to be so much beget than the oral version.
I have not heard about daily dosing. However, the dose effects usually get better over time. Maybe of you take it this way, you will be able to switch to weekly dosing eventually?
I’m sori that you’re having troubles worth the MTX. You’re not alone in that.
My daughter found MTX injections worked better than pills. You might need your Dr to write a note to get insurance to cover it. Bless you. Carolyn
I’m on the methotrexate 8x week dosage as well but my Rheumy tells me to double up on the folic acid on the day I take them and it seems to help.
Wow. That was badly written! Sorry about that! I also forgot to mention getting a prescription for folic acid. The OTC version is to small, up to 800 mcg. You’ll want 1-3mgs to make to side effects better. It even helps prevent the hair loss that goes with MTX use.
GrumpyCat said:
Folic acid is a huge help for size effects and most of the patients that I have encountered who take it along with MTX do very well.
Usually, the injecting is pretty cheap. My insurance does not cover it either, but when I lay had it filled, it was under $30 for three months worth of injections worth syringes. Most patients who do the injection report little or no side effects. I have taken it this way for quite some time and have found it to be so much beget than the oral version.
I have not heard about daily dosing. However, the dose effects usually get better over time. Maybe of you take it this way, you will be able to switch to weekly dosing eventually?
I’m sori that you’re having troubles worth the MTX. You’re not alone in that.
Thanks Grumpy Cat for the info on injection prices. I think I will definitely check that out. I have been on the oral form for about 2 yrs. I am one of the unlucky ones who cannot take Planquinel. I had a really bad allergic reaction to the generic form. The MTX really helps best for the psoriasis and pretty good for the lupus. I am just worried taking it every single day of week is too much for me.
GrumpyCat said:
Folic acid is a huge help for size effects and most of the patients that I have encountered who take it along with MTX do very well.
Usually, the injecting is pretty cheap. My insurance does not cover it either, but when I lay had it filled, it was under $30 for three months worth of injections worth syringes. Most patients who do the injection report little or no side effects. I have taken it this way for quite some time and have found it to be so much beget than the oral version.
I have not heard about daily dosing. However, the dose effects usually get better over time. Maybe of you take it this way, you will be able to switch to weekly dosing eventually?
I'm sori that you're having troubles worth the MTX. You're not alone in that.
I never thought about that. The new insurance just started and I'm still trying to figure all the fine details. There isn't even a paper formulary of drugs available. I have to check online or download & print 30 pages to bring to any family appointment. I will definitely see about a waiver and the requirements to file one.
I really appreciate the info from everyone here on LWL. There is always some kernel of wisdom or different thoughts about each person's discussion topic.
Carolyn said:
My daughter found MTX injections worked better than pills. You might need your Dr to write a note to get insurance to cover it. Bless you. Carolyn
Do you take 8 pills 1x weekly (8x2.5= 20 mg/week)? That is what I've been on for some time. Or do you take the 8 pills over the course of 7 days (1 each day except last day take 2)? My Dr. Wants me to switch to 2 pills every day 7 days a week.(7x2.5=35) That will up my dose almost double.
I have heard of higher folic acid doses but never gave much thought to that for me. I just thought it was for those with low numbers. Thanks, I'll add that to my new list.
angelwing said:
I'm on the methotrexate 8x week dosage as well but my Rheumy tells me to double up on the folic acid on the day I take them and it seems to help.
I do take folic acid Rx 1 mg daily except on the MTX dose day. I asked about this if I switch to 2 MTX every day how was I to take the folic acid. My Dr. Said just take far apart. Like folic acid in am/breakfast & MTX at night/dinner/bed.
Don't these meds work against each other? That's why we are not to take any on our weekly dose day? I'm so confused! It's not just the lupus & fibro fog. (The other day I had to go back to the house 4 times before I actually left the driveway!) The contradictions of instructions difficult for me to understand.
I take 10 MTX once a week myself, and a 1mg Folic Acid every day. My rheumy didn't mention anything about not taking them at the same time, nor did he tell me not to take them on the same day. No special instructions at all. I was lucky enough not to have any side affects from the MTX at all.
It does seem odd to me to nearly double your MTX dose in order to spread it over the week. Not sure I understand why that would be. Wish I had more help to offer! Best of luck! ::hugs::
I take MTX 15 mg once a week and folic acid 5 mg thrice a week. Initially it was a bit tough to cope up but now I don’t feel most of its side effects apart for thinning of hair. However Folic acid is essential.
My reuhmy specifically told me not to take MTX and folic acid at the same time. There has to be at least 12 hours of gap between those two.
Thank you for the information on dosages and everyone's different schedule. I feel a little better about maybe taking the folic acid differently than I have been. I may ask if I should maybe take a higher dose of the folic acid to help with the side effects. I know our Dr.s need to tweak our many meds just so for each patient. I'm going to check with my pharmacist about the new dosing & schedule when I next pick up meds.
The more I think about it the more I think something's amiss. My Dr. Said my last ana, anti ds DNA & rheumatoid/ inflammation numbers were down. So I don't think he should be almost doubling my MTX dose. Think I'll call him about it tomorrow. I'll update if anything interesting transpires.
You guys here are great. It's comforting to know that there are so many who understand and always willing to share. Thank you lupi friends :)
Keep up the good fight
Keep hope. Always question that is the only way we get knowledge on this disease. Thank you for sharing.
Yeah, I wouldn’t want to take it daily either. You wouldn’t have any really great days, just mildly yucky. Even with the injections and the FA, I had a slight tender tummy the next day. Nothing to write home about, but I knew it was there. Definitely wouldn’t want that every day.
Your doc can also do an “appeal for medical necessity” to the insurance co. Docs do them pretty often, and they usually work. For example for pts who only respond to brand name synthroid, or people allergic to additive in a generic med. If the oral tabs make you sick, that’s medical necessity enough!
sunnyworm said:
Thanks Grumpy Cat for the info on injection prices. I think I will definitely check that out. I have been on the oral form for about 2 yrs. I am one of the unlucky ones who cannot take Planquinel. I had a really bad allergic reaction to the generic form. The MTX really helps best for the psoriasis and pretty good for the lupus. I am just worried taking it every single day of week is too much for me.
GrumpyCat said:Folic acid is a huge help for size effects and most of the patients that I have encountered who take it along with MTX do very well.
Usually, the injecting is pretty cheap. My insurance does not cover it either, but when I lay had it filled, it was under $30 for three months worth of injections worth syringes. Most patients who do the injection report little or no side effects. I have taken it this way for quite some time and have found it to be so much beget than the oral version.
I have not heard about daily dosing. However, the dose effects usually get better over time. Maybe of you take it this way, you will be able to switch to weekly dosing eventually?
I’m sori that you’re having troubles worth the MTX. You’re not alone in that.
Hi!, Be careful , contact your state rep., or The Lupus Foundation of America or the chapter that is in your area to help you , Lupus foundation has a lot of services that can and will help . Also file for disability in your state , there are laws that help us living with auto diseases now ! Best wishes to you....Beverly L.