Methotrexate - Psoriasis

[Dunnoburt]

Hi All,

I have awaful blistering psoriasis on the palms of my hands/soles and sides of feet - I am on top of the tree with a steroid spray and next option is Methotrexate in tablet form.

Just looking to see if anyone else has used this and whether it was effective/any side effects?

DH took it for about a year, was able to come off it. Then after another 5 years had to go back on it for a much longer stint but currently isn't on it.

It would make him tired for a couple of days after then, then he would feel in pain the 2 days before he was due to take it again - one weekly dose. He was on it for psoriatic arthritis, certainly cleared up the lesions.

My DH is on it for psioriatic arthritis. It’s been amazing for him. I’m on it for severe eczema and it’s been brilliant. I’m aware it’s a serious drug and have regular blood tests and yearly liver scans.

It was a game changer for me and cleared up my blistering palms. It didn’t make me feel sick or tired when I was taking it - a wonder drug. But, unfortunately, it damaged my white blood cell count so I had to stop. And so now I’m back to blisters, creams, and endless itchiness. I so wish I could go back on methotrexate. I hope it works for you.

Have you tried UV light therapy? That was brilliant at healing my psoriasis, and without the possible liver issues/side effects.

Relative is on it for psoriatic arthritis, his hands were previously really bad, swollen and hurting plus the blistering sores. Completely stopped all of that, he had a few minor side effects at first, mainly tiredness, but is ok now, much better than the debilitating effects of the psoriasis. I would definitely give it a go.

I'm on the tablet from. Have been on and off for 20 years now for rheumatoid arthritis. You'll need regular blood tests for your liver etc and need to take the dose on the same day every week. Folic acid on the other days. The fatigue and sickness is awful but it does help.

Your type of psoriasis is unfortunately the rarer type.

Don't drink any alcohol and take methotrexate at night.

Drink plenty of fluids too.

It can cause you to be tired a few days after the dose.

Once been on this for many years and had no issues.

I've been on 20mg per week for six years for severe eczema - it's been fantastic, made such a difference to my quality of life, wish I'd taken it sooner. My eczema is around 90% better.

Side effects have been minimal - the first few weeks I'd feel a bit nauseous on the day I took it but since then no side effects apart from my nails are more brittle (which could be my low iron levels or menopause).

I was on it for the same condition. It was miraculous! Cleared up really quickly and I had no side effects.
Just a word of caution though. There is a symptom called methotrexate cough.
I started with the cough about 3 weeks after taking it. Consultant said it was nothing to worry about. 2 weeks later I was admitted to hospital with pneumonia.
Had to stay 3 days.
If you do start getting a cough, mention it straight away.
The drug doesn't cause pheumonia but obviously lowers your immune system.
I was just unlucky, most ppl have no problems at all.
I was taken off the meds when in hospital (8 years ago) and my psoriasis has not returned.

Wow loads of responses, thank you, obviously more common to be prescribed than I thought, looking at all of your comments I think I will give it a go - I'm at my wits end with it being palms and feet I really struggle just doing daily things......and the itching.....oh my god the itching!...... I'll also ask about the light therapy - I've not been offered it but I have to say I've been exposing it to sun on purpose (when we've had some in good ole England) because I've heard it can be beneficial. Thanks again all 🙏

It was briefly considered as an option for me when they were treating my psoriatic arthritis, but I was trying for a baby at the time so it was taken off the table as they told me you cannot take it during pregnancy and they advise coming off it 6 months before pregnancy.
I'm on a biologic instead and it cleared my psoriasis right up as well as reducing the arthritic symptoms.

@Dunnoburt all the very best of luck to you. You'll be amazed how quickly it all dries up. If I had another flair I wouldn't hesitate to use it again.
Xx

taking it with folic acid minimises side effects.

To everyone who has been on the drug, did you exhaust all topical options prior to using it?.... it sounds very promising although conscious that arthritis presents differently xx and @twiddlingthumbs69 you've definitely swayed me I think.....xx I've never had it before and as soon as I hit the big 40 it's reared its ugly head! (Family history..... I'm blaming my gran gran 😃)

@Dunnoburt yes I exhausted all other options. Creams, steroids, cutting out various foods. Nothing worked and my GP was stumped. That when I went to a dermatologist, he recognised it in 2 minutes. Was such a relief to know there was something else I could try.
I was a bit worried about taking it but the speed it worked as incredible.
Mine started at 43 after a particularly stressful time, that's the only thing I can put it down to.
Hopefully you can be on it for a short time and then come off it once your skin has cleared. Keep us posted, rooting for you! Xx

Is it possible to request injections instead? You get more active drug in your system and if you have sickness (not everybody gets it), you're not going to throw the tablets back up again. They're also an absolute doddle to give yourself - and no prescription charges as they use a delivery service contractor.

Make sure you take the folic acid religiously on non MTX days (it can be increased to 6/7 days if you're experiencing too many side effects) and if nausea continues to be a problem, you need an anti emetic that works on the brain, rather than the stomach.

It's also a good idea to request a steroid pulse to tide you over until the MTX gets up to speed.

Never ever miss a blood test, always wear slippers to protect your feet and make sure you don't get blisters and make sure you have access to phone/email to the nurse in advance just in case you come down with symptoms of an infection.

It can have unpleasant side effects or consequences, but it can be brilliant for thousands of people. And if it doesn't work for you, you're on the pathway to biologics.

My relative had tried absolutely everything, uv, steroids etc. It worked almost instantly and as other people have said you are monitored constantly, the misery of the psoriasis and the pain of the arthritis is obliterated. He stopped taking it for a short while during the pandemic worried that he was compromising his immune system and it came back with a vengeance . Wasn't worth not taking it for the misery of the psoriasis and arthritis returning. Hope you get on ok.

How are you getting on OP?

Ahhh only just seen you have asked how it's going.... well...after all the initial blood tests to make sure I could go on the medication and then the fight with my GP to get blood tests on week 1, 3 and 5 I finally took my first dose on Thursday (6×2.5mg)......touching all the wood in the world the only side effect so far was an immense headache on the day I took it.....not noticed any changes in my hands or feet yet (not expecting to)....if anything the blistering is worse but I've taken my before pictures so I can monitor..... just hope that I can carry on after my first blood test on Wednesday xx

Wishing you luck OP. Hopefully you'll start to see some results quickly. Shame about the headache but could be just getting used to it.
Good luck with the bloods too. Keep us posted x

Thank you xx I will do xx

Oh, I'd forgotten about the headache. Take the mtx in the evening before you go to bed and you sleep through the majority of it - and it does tend to lessen over the coming weeks.

And it's possible that sweet stuff, tomatoes and milk could start tasting weird - black tea/Black coffee taste fine and salty things can be the most normal-tasting items: things like olives, pesto instead of tomato or bechamel and hard, strong cheeses taste much nicer than mild.

Thank you, maybe that's where i went wrong, I took them at 7am haha noted about the taste, not had anything yet but if I do then I know why! Xx

@Dunnoburt hi can I just ask how you are getting on with this, my Dd is due to start her medication in a few weeks time, thanks

Hey @BeCleverSquid of course, I'm on dose 4 now (I think lol), I've had 2 lots of bloods and everything internally seems to be coping.....I would say that main side effect has been tiredness the day I take the tablets...... I've not had to wear cotton gloves for 2 weeks so definitely an improvement..... I've attached a pic from week 1 to date xx good luck to your DD xx