Methotrexate - how to stop nausea

[aliceinwanderland]

I've just started taking methotrexate for suspected arthritis. It's already making me nauseous. Is this likely to settle down on its own or does anyone have any advice as to how to manage this? I'd like to give the drugs a reasonable chance to work.

[Drivingnovice]

How much are you taking each week? Do you take it on a Friday eve or Saturday when maybe you don't have so much to do the next day..?
Are you combining it with any other drugs..?
I've kinda got used to it now

[aliceinwanderland]

It's 10mg. Just took the first dose last night. I was okay until a few hours ago. I'm hoping it will settle down by itself but my sister had real problems with it apparently

[Hulababy]

It does settle down eventually, though it still makes me tired.

Do you have one dose or a split dose?

When I was in one dose I found the nausea much worse. I went to split dose and, although there, it helped. And with time it settles. I find I feel it less if I have eaten.

I find taking them in the evening works better for me. I initially took them Friday and Saturday am; I've actually gradually moved it to Saturday and Sunday evening. I cope better with it then.

Make sure you take folic acid - often more than they suggest.

[aliceinwanderland]

Thanks. I didn't know you could get a split dose. Does that mean 2 pills a week.

How does the tiredness effect you? I was hoping I'd have less fatigue if my inflammation went down. I had a steroid a week ago and I've been feeling so much better.

[SarahJinx]

Unfortunately Mtx and nausea go hand in hand. What is your folic acid dose? I think it needs to ne 5mg daily at least (except mtx day). Take it last thing before you go to bed to sleep off some of the side effects. If it doesn't subside ask for some anti nausea tablets. Hugs though, its tough going but an amazing drug if you can tolerate it.

[aliceinwanderland]

Not sure about folic acid. It's daily so quite high. I am really hoping I can tolerate at least to start to get the pain under control

[Fuckthisforausername]

I take it in the evening to help with the tiredness (also my one great nights sleep of the week). Nausea wise I've never had it too bad, but be kind to yourself whilst you are getting used to it. The nausea could be being made worse by increased movement. Are you taking folic acid? I always feel a bit off if I've missed it.

I'm about 8 years into taking it, I have 20mg weekly subcutaneously and it's ok. The day before and day after I take greater care of what I eat and drink as I know my body will need to process it and the more help it gets the better.

Good luck, I hope it helps.

[Fuckthisforausername]

I found it took 3 months to really settle in and if I'm honest longer before the side effects subsided / I got used to handling them.

[aliceinwanderland]

Thanks. I took it last night and I did sleep very well - one bonus I guess!

Do you find that there are any foods which help?

[Fuckthisforausername]

I stick to blander foods on the day before, the day and the day after. Not too spicy or rich, no alcohol.

[scarfaceace]

I found that coke/pepsi helped with nausea. I don't know if it would work for everyone but it's worth a try.

[Hulababy]

I take 15mg methotrexate over two days so 3 tablets a day at the weekend.
I then take 5mg folic acid each week day.

I have other meds to - Sulfasalazine 2000mg daily (2 x 500mg tabs morning and night) and 20mg omeprazole daily. They are also for the arthritis. I no longer take steroid tablets and haven't needed a steroid injection for a long while either.

I find the fatigue comes and goes depending on the arthritis, but always get some fatigue at a weekend due to the meds. If I'm having a late night out I try and have a relaxing morning to rest for example.

[unweavedrainbow]

You can be prescribed anti-nausea meds which I found helped. If the nausea gets really bad/you struggle with vomiting then you might be able to switch to injections. I found that they massively reduced the nausea compared to the tablets. Make sure you take lots (and lots!) of folic acid too!

[BeautyGoesToBenidorm]

Methotrexate is very, very hard on the liver, so try to avoid very fatty or processed food wherever possible. Stick to lean protein, lots of veg and some fruit, and plenty of water.

[wonkylegs]

I have taken MTX for years and years (although I'm on a break atm as I've just had a baby)
I found that nausea is worst when first starting or when changing a dose but it settles down for me soon after. It's really important to take your folic acid (5mg) and that will help with nausea - different docs recommend different ways (I'm once a week 2 days after MTX, my friend is every day except the day she takes the MTX)
I find taking MTX just before bed means the worst of the nausea is when I'm asleep
I also find that toast with marmite helps with nausea, as does ginger biscuits or ginger tea and ice lollies.

[PurpleRainDiamondsandPearls]

The nausea does settle. I've been on it for years. If it doesn't, you can inject it. I much prefer the injections. I don't get any side effects, although I am tired the day afterwards. I know some people don't love injections but the needles are tiny.

When I started methotrexate, I was also on a high dose of steroids, so the nausea was insane. I found cyclizine very helpful but only needed it occasionally for a few weeks. Try ginger capsules too.

Hold on and I'll got my arthritic fingers crossed that it passes.

[pippinandtog]

Peppermint tea is very good for easing nausea.