Methotrexate for Rheumatoid Arthritis and Methotrexate Side Effects
Methotrexate is one of the most common forms of treatment for Rheumatoid Arthritis and is arguably the most important medicine used to treat RA today. It is the staple of RA treatment since it is effective at reducing disease activity for a large percentage of patients and most people with RA will go on this drug at some point or another.
Because of it is prescribed so frequently it is all too easy to forget that this is a serious toxic chemical. Let's take a quick look at 12 facts about Methotrexate so that you do not lose sight of what you are dealing with.
1. Methotrexate's brand names include Methoblastin, Trexall and Rheumatrex. It is called a disease-modifying anti-rheumatic drug (DMARD) and attmepts to decrease pain and swelling associated with Rheumatoid Arthritis. In doing so, Methotrexate can prevent damage to joints and therefore reduce the likelihood of disability. Symptoms of Rheumatoid arthritis may improve within 3 weeks of starting treatment (which is precisely how long it took for me) but it may take 12 weeks or even 6 months of treatment for full benefit to be realized. Some patients do not see any benefit at all from Methotrexate.
2. Although Methotrexate was only approved for RA treatment in the US in 1988, it had already been used to treat cancer and psoriasis.
3. It still remains unclear exactly how methotrexate decreases arthritis activity. It is known that Methotrexate interferes with certain enzymes which play a role in immune system function. Methotrexate prohibits the enzyme dihydrofolate reductase, thereby affecting the production of a type of folic acid, which is required for actively growing cells.
4. Typically, Methotrexate is taken once day a week for RA. The starting dose for most adults with rheumatoid arthritis is 7.5 to 10 mg and this dose can be increased to 20 to 25 mg each week. Around 25mg/week tends to be towards the upper oral limit according the to Rheumatologists that I have consulted with. Methotrexate is also available in an injectable form which can be self-injected by the patient.
5. Folic acid supplementation is required if you take methotrexate. Doctors vary in their approach with how this is prescribed. Sometimes the Folic acid is taken daily, in other cases it is taken in a larger dose 8 hours before and 8 hours after the weekly methotrexate pill.
6. Methotrexate can cause an abnormal functioning of the liver. Therefore, it is very important to have blood tests on a regular basis to test for liver functionality. At a minimum, doctors will ask for blood tests every 8 to 12 weeks. However, there is a greater benefit to the patient if the tests are done as frequently as every month to allow not just the liver health to be reviewed, but the inflammation levels of CRP and ESR as well to view the overall disease activity. (Part of my strategy for curing my RA was to be copied on the monthly blood test results and using the CRP and ESR to guide me as to how my holistic methods were performing. I strongly recommend you get your blood tested monthly for this benefit alone!)
7. Avoid alcohol whilst taking Methotrexate since alcohol increases the risk of liver damage significantly.
8. Besides the aformentioned side-effects on the liver, Methotrexate may also cause fatigue, nausea and vomiting. Personally, I found the fatigue on Methotrexate to be quite severe so that I felt tired most of the time. However, side effects may be dose-dependent and some patients have reported no side effects at all.
9. Methotrexate should not be taken if you are pregnant or planning to get pregnant. Methotrexate can cause birth defects and/or complications during pregnancy. Do not fall pregnant whilst on methotrexate and for at least 3 months after you stop taking methotrexate. In fact, to be sure it is best to wait even longer (my Rheumatologist told me to wait 6 months - that stuff is not to be messed with!).
10. Some medications may alter methotrexate function. So, tell your doctor of all the medications you take (both prescription and over the counter). Also, NSAIDs, though often prescribed together with methotrexate, can affect the level of drug activity.
11. If it works at first, it doesn't mean that it will work forever. Treatment for RA often needs to be changed because the body can build resistance to a treatment. Some people find success with methotrexate at first and then later find that it stops working. Then, alternative drugs are tested or even a combination therapy is proposed where more than one drug is used at the same time.
12. Whilst on Methotrexate it is still possible to heal your body through natural methods. This was something that I discovered myself, by remaining on Methotrexate whilst I implemented my holistic experiments until I was able to reduce my inflammation to zero. So the great news about Methotrexate - is that unlike NSAID's and antibiotic drugs, it doesn't seem to interfere too heavily (if at all) on the delicate environment of your intestines (which is where the real cause of Rheumatoid Arhthritis really lies). This means that your determined efforts to get well naturally whilst on Methotrexate will not be undermined by the drug side effects. Finally, some good news huh?!
I hope you enjoyed this article and I'm sending you wonderful vibes of healing!
"The best doctor gives the least medicines" - Benjamin Franklin