Methotrexate (MTX) is used to treat certain types of vasculitis. For Wegener’s Granulomatosis, it is used as a maintenance drug. Like any drug used for suppressing the immune system, methotrexate has good aspects and bad aspects.
The following list contains the possible side-effects of this drug:
- A small number of patients will have nausea or develop a mouth ulcer. To counteract this problem some patients take the drug as a shot.
- Pneumonitus (inflammation of the lungs) which mimics pneumonia with cough and fever. This side-effect can happen at any time in the treatment (beginning or after several years).
- Liver problems such as scarring or cirrhosis.
- Anemia (low red blood count) which causes fatigue.
- Thrombocytopenia (low platelets), which leads to a higher risk of bleeding.
- Leukopenia (low white blood count) which may increase the risk of infections.
- A slightly increased risk of developing lymphoma, a type of caner after taking MTX.
Prevention of MTX side-effects:
- Blood test every 4-6 weeks.
- Take 1 mg of folic acid every morning
- Follow-up with your doctor (rheumatologist) regularly
- Keep in close contact with your primary care physician.
My experience with MTX:
My first maintenance drug after cytoxan was MTX. I took 12 1/2 mg of the drug for almost a year. That level was unable to contain my WG. I had to go back to oral cytoxan for 6 months.
After talking to other patients about taking this drug, I found that they are on 25 mg and higher. Because it is hard to take this drug orally at this amount (25 mg), they take it as a weekly shot. Some of them take up to 5 mg of folic acid to prevent mouth ulcers.
The day they take the drug, they are usually fatigued and nauseous. Not everyone has these symptoms, but they all say that they feel fatigued for at least 24 hours. Evenso, this drug is much gentler than cytoxan and many WG patients are relieved when they change from cytoxan to MTX.
For more information on this drug go here.