• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Johns Hopkins Arthritis Center

Show Search
Hide Search
  • Disease Information
    • Rheumatoid Arthritis
    • Psoriatic Arthritis
    • Ankylosing Spondylitis
    • Osteoarthritis
    • Gout
    • Osteoporosis
  • Patient Corner
    • Drug Information Sheets
    • Managing Your Arthritis
    • RheumTV – Patient Education Video Library
  • Our Research
    • Patient-Centered Outcomes Research
    • Current Research Studies
    • The Camille Julia Morgan Arthritis Research and Education Fund
  • About Us
    • Appointment Information
    • Contact Us
    • Our Faculty
    • Our Staff
    • Rheumatology Specialty Centers
  • Donate
Home / Ask the Expert / Methotrexate and Side Effects

Methotrexate and Side Effects

April 9, 2007 By Arthritis Center

Question

My questions are regarding a 48 yr. old male patient that was diagnosed with rheumatoid on Feb. 6, 2004 (with a rheumatoid factor of 300+). His current medications are: -Prednisone 5mg daily (began Feb. 6th) -Minocycline 100mg (antibiotic)every 12 hr. for fighting the acne caused by the prednisone and in aiding the treatment of rheumatoid (began April 5th) -Methotrexate 20 mg once a week (began March 19th) -Folic Acid 4mg daily -Tramadol HCL 50mg for pain as needed Is methotrexate known to cause nausea (an hour after taking it and lasting for 24 hr. with or without food)? The weekly treatment was recently changed from taking all 8 tablets at one time to taking 4 tablets in the morning and 4 tablets in the evening in an effort to reduce the nausea yet the result is the same. There is the possibility that the methotrexate will be replaced with another medication because of the nausea. Are there other medications (proven to be equally successful in fighting rheumatoid) with less severe side effects than damage to the liver or kidneys that the methotrexate may cause? Every 8 weeks tests are performed to learn of any damage. And is it general practice not to test the rheumaoid factor as treatment progresses (or more than once).

Answer

Although infrequent, there are patients who do not tolerate methotrexate because of nausea or GI upset after each weekly dose. Sometimes switching to methotrexate injections help, but not always. Look at the RA treatment section for a discussion on alternative treatments and talk with your doctor. Possiilities include the TNF inhibitors (Remicade, Humira, Enbrel) and leflunomide (Arava). The rheumatoid factor is occasionally repeated during the course of the disease but is not useful in assessing the activity of the disease on a regualr basis.

Arthritis Center

Founded in 1998, the Arthritis Center at Johns Hopkins is dedicated to providing quality education to patients and healthcare providers alike.

Primary Sidebar

Ask The Expert Topics

  • Alternative Therapies
  • Ankylosing Spondylitis
  • Associated With Other Illnesses
  • Bursitis and Tendinitis
  • Corticosteroids
  • Diet and Exercise
  • Disease Modifying Antirheumatic Drugs (DMARDs)
  • Enteropathic Arthritis
  • Fibromyalgia
  • General Arthritis
  • Gout, Pseudogout, Other
  • Infectious Arthritis
  • Myositis
  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
  • Osteoarthritis
  • Osteonecrosis
  • Osteoporosis
  • Polymyalgia Rheumatica
  • Psoriatic Arthritis
  • Reactive Arthritis
  • Regional Pain: Back and Neck
  • Rehabilitation
  • Rheumatoid Arthritis
  • Surgical Therapy
  • Systemic Lupus Erythematosus (SLE)
  • Systemic Sclerosis
  • Vasculitis
RheumTV Logo

Rheum.TV is an informational platform created to educate patients living with a rheumatic disease. With over 100 disease education videos produced by the team at Johns Hopkins Rheumatology.

Visit Rheum.TV

Footer

Johns Hopkins Rheumatology

  • Johns Hopkins Rheumatology
  • Johns Hopkins Lupus Center
  • Johns Hopkins Lyme Disease Research Center
  • Johns Hopkins Myositis Center
  • Johns Hopkins Scleroderma Center
  • Johns Hopkins Sjögren’s Syndrome Center
  • Johns Hopkins Vasculitis Center

Connect With Us

  • Facebook
  • Twitter
  • YouTube

Johns Hopkins Medicine

© 2023 Johns Hopkins Arthritis Center
Patient Privacy