Can I refuse to take methotrexate?

Myth: You can stop taking methotrexate once you feel better
You may feel much better than you did before you started methotrexate: less pain, swelling, morning stiffness or fatigue. If you feel better but still have low disease activity, the ACR's treatment guidelines recommend against stopping or lowering your dose.
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What happens if you don't take methotrexate?

Patients who stopped taking methotrexate reported having substantially more gastrointestinal issues — including nausea, abdominal pain, and loss of appetite — from methotrexate than current users did. Just 26 percent of current MTX users reported nausea, compared with 40 percent of those who used it previously.
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What can I take instead of methotrexate?

In elderly patients with RA who are unable to tolerate methotrexate, the alternatives are hydroxychloroquine or sulfasalazine for mild-to-moderate disease and cyclosporin or leflunomide for severe disease, given in combination with low-dose oral corticosteroids.
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Why you should not take methotrexate?

Taking methotrexate may increase the risk that you will develop lymphoma (cancer that begins in the cells of the immune system). If you do develop lymphoma, it might go away without treatment when you stop taking methotrexate, or it might need to be treated with chemotherapy.
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Can you stop taking methotrexate suddenly?

Unfortunately, it's not a good idea to stop methotrexate "cold turkey." Some people experience no side effects to suddenly stopping taking this medication, but it does have the potential for creating an intense RA flare.
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Getting Started on Methotrexate : What You Should Know



What is a natural alternative to methotrexate?

But new research published in the BMJ suggests that a Chinese herbal remedy is just as effective as methotrexate. Share on Pinterest Researchers say a Chinese herbal remedy – TwHF – is just as effective in reducing symptoms of rheumatoid arthritis than commonly used drug, MTX.
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Should I stop taking methotrexate during Covid?

Should I routinely stop my treatment? advice from all of the British, European, and US guidelines is that the treatment should continue. ► It is especially important that you do NOT stop steroid tablets. These must be continued through any illness.
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Is methotrexate a high risk medication?

Methotrexate is a high-alert drug, and extra safeguards are needed whenever it is prescribed, dispensed, and administered, regardless of the setting, dose, or indication for use. While severe harm and fatalities have occurred during hospitalization, many of the adverse outcomes have occurred after discharge.
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Does methotrexate shorten your life?

Editorial comment: This study suggests that effective MTX treatment enhances life expectancy even in severe advanced disease, as evidenced by the lower SMRs in the responders compared to nonresponders.
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What happens if you don't take folic acid with methotrexate?

You should take folic acid with methotrexate to help prevent a folate deficiency. Taking methotrexate can lower levels of folate in your body. A folate deficiency can lead to symptoms like upset stomach, low blood cell counts, tiredness, muscle weakness, mouth sores, liver toxicity and nervous system symptoms.
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What is the safest drug for rheumatoid arthritis?

Methotrexate is widely regarded as one of the safest of all arthritis drugs, though it carries some potential downsides. Gastrointestinal symptoms such as nausea and vomiting are its most frequent side effects.
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How do I get off methotrexate?

It is safe to just stop methotrexate; you do not need to slowly reduce the dose. However, keep in mind, if you were gaining any benefit from methotrexate, it will usually take at least 6 weeks to lose it.
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Is hydroxychloroquine safer than methotrexate?

Safety variables at 6 month were within normal physiological ranges and did not differ in groups (p>0.05) indicating that both methotrexate and hydroxychloroquine were effective and safe to use in rheumatoid arthritis. The difference in the incidence of adverse effects, total or individual, was almost nil.
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How does methotrexate make you feel?

GI problems such as nausea and vomiting are the most common side effects associated with methotrexate, affecting between 20% and 65% of rheumatoid arthritis (RA) patients who take the drug. Up to one-third develop mouth ulcers or sores. Many also complain of headaches, fatigue and an overall “blah” feeling.
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Does methotrexate make you more susceptible to Covid?

Conclusion: The present findings demonstrated that methotrexate does not predispose patients to severe COVID-19; on the contrary, patients taking methotrexate may experience a milder disease, possibly due to their reduced severe inflammatory reactions as a result of inhibited TNFα, lowered IL6, and increased T ...
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How long does methotrexate take to get out of your system?

In healthy adults, it takes up to 1 week, on average, for most of the methotrexate to be gone from the body. Certain medications and people who have reduced kidney function or a condition that leads to extra body fluid may also clear methotrexate more slowly. Methotrexate lowers the body's ability to use folic acid.
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Is rheumatoid arthritis a death sentence?

A person cannot die from RA. However, the widespread inflammation that characterizes the condition can lead to life-threatening complications. According to the Rheumatoid Arthritis Support Network, a person with RA may have a lifespan that is approximately 10, or at most 15, years shorter than average.
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Can rheumatoid arthritis go into remission without treatment?

The hope is that you can stay in remission without RA meds. Some people can. For others, symptoms eventually come back. A relapse can also happen because the drug you're taking stops working.
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Is 20mg of methotrexate a lot?

For rheumatoid arthritis, the usual starting dose is 7.5mg, taken once a week. This can be slowly increased up to 20mg (tablets) or 25mg (pre-filled injection pen or syringe) once a week. For psoriasis, the usual starting dose is 2.5mg to 10mg, taken once a week. It can be slowly increased up to 30mg once a week.
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Why is methotrexate so toxic?

It is generally considered to be safe and therefore, it is not unusual to prescribe doses as high as 25 to 30 mg per week in modern rheumatology [6, 7]. Methotrexate toxicity is mainly due to its effects on folate metabolism.
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What are the toxic effects of methotrexate?

What are the symptoms of methotrexate toxicity?
  • Stomach problems such as nausea, vomiting, or diarrhea.
  • Mouth sores (called stomatitis)
  • Muscle pain.
  • Headache.
  • Fatigue.
  • Difficulty concentrating.
  • Feeling dizzy.
  • Generally not feeling well.
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Is 25mg of methotrexate a lot?

The correct dose of methotrexate (commonly between 7.5mg to 25mg per week) will reduce inflammation and alleviate the condition it's prescribed for, whether that's rheumatoid arthritis, psoriasis, inflammatory bowel disease, and so on.
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Does rheumatoid arthritis make you vulnerable to Covid?

Why is my risk higher? If you have an autoimmune condition and/or if you're receiving treatment to control your immune system your risk from COVID-19 is higher. Some types of arthritis are caused by the immune system becoming overactive and attacking healthy parts of the body, such as the joints, by mistake.
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Does RA make you more susceptible to Covid?

If you have rheumatoid arthritis (RA), you're more likely to get certain infections. That means you may have a higher chance of getting COVID-19. If you do get sick, your symptoms could be more serious than someone who doesn't have RA. Some medicines you take might also make infections more likely.
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Is 15 mg of methotrexate high?

Background/Purpose: Recent recommendations have suggested higher starting doses of methotrexate, i.e. 15 mg/week (3E initiative) in rheumatoid arthritis. However, studies comparing conventional (7.5mg) and newer (15mg) starting dose are limited.
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