如何应对甲氨蝶呤的副作用

Sophie98 · 6. Apr 2020, 01:53

Hi, so I ended up with an emergency rheumatology appointment a few days ago. I was on sulfazalasine, abatacept and leflunomide. However, they've stopped the leflunomide because it has made my blood pressure high and even with amlodopine and lisinopril it is still higher than it should be so they said that it's not safe to continue with it. I've been on sulfazalasine for a few months now and I've only had 3 doses of my abatacept so far so it's early days for that. They've advised that I should try methotrexate again in replacement of the leflunomide. However, I was on methotrexate years ago when I was 10-13 years old and the nausea was awful and my parents had to fight with me every week because I didn't want to take it. It sounds so stupid but I'm so anxious about the thought of it like when they mentioned it I wanted to cry. At first I was adamant that I wanted to wait and see if the abatacept and sulfazalasine would work alone but now I'm considering giving it a go. I've been flaring for over a year no matter how many painkillers, steroids or anti-inflammatories I take it isn't getting better. Does anyone have any tips on how to ease the nausea and cope with taking the methotrexate? I just want this to be over and get my life back. Thank you x

Frogmorton · 6. Apr 2020, 06:41

Hi Sophie

希望，因为您现在已经年纪大了，所以您的身体能够更好地应对。

I suggest - you take it in the evening so you sleep off some of the effects. Then the following day you rest as MUCH as possible.

Some people recommend carbs...chips, pasties that sort of thing? Eating little and often not getting over hungry. Fizzy drinks help me with nausea too - slightly flat fizzy drinks. I never drink them as a rule but with nausea for me they help.

最重要的是，如果可以的话，以及当您醒着干扰时，我敢肯定，无论如何您都擅长。

Take care and I think you are very brave giving it another go ((()))

Grace111 · 6. Apr 2020, 12:10

Hi Sophie

I used to get nausea too, I found ginger tea helped and as Toni suggested, taking them in the evening so you can sleep some of the symptoms off. I know others found mint tea useful. Keeping fingers crossed for you, let us know how you get on

Grace111

Sophie98 · 6. 2020年4月13:48

谢谢你！I promised myself that I would never take it again so it's such a hard decision to think about giving it another go. But I'm no closer to remission than I was 8 months ago so I might just have to try it again and get on with it. Thanks again for your advice.

phoenixoxo · 6. Apr 2020, 18:22

嗨，索菲，

Sorry if I've asked this before, but are you on course to take tablets or to self-inject methotrexate?

I ask because I had trouble with nausea on the tablets, but the injections are fine. My rheumatologist didn't make the change due to nausea, though, as I dealt with it by eating a big roast dinner before taking the tablets. I drank a lot too (water, that is!). I had to come off the tablets because I'd started to feel as though my eyebrows were sliding down my face. They weren't (I checked), but he seemed very concerned by it. Anyway, I hope this is of some use to you.

最好的祝愿，

Phee

Sophie98 · 7. Apr 2020, 02:06

Hi Phee,
When I was younger it was actually the injections that kick started the nausea and made me physically sick when I was on the higher dose. Then when I was eventually reduced to a lower dose of the tablets I felt really sick then too but I think it was mostly in my head at that point. My dad is on the tablet form now and I can't even bear picking the box up let alone touching them or swallowing them. Also the yellow colour of the liquid in the syringe makes me feel sick. I think the anxiety is because I scared myself so much about it as a child, I can even still remember the taste of the tablets and I would get the same taste when I'd had an injection. I honestly feel so anxious about it because of what I remember from taking it as a kid even though I know logically that it probably isn't as bad as what I used to think it was. They said that I'd be started on the lower dose tablet form to see how it goes before building it up. Thank you for your advice x

Frogmorton · 7. Apr 2020, 05:50

Hi Sophie

当我的女儿16岁时接受化学疗法时，她曾经为某些化学疗法而生病，所以我非常了解“记忆”可以产生的效果。（即使确实使她病了），这不是MTX）。她从事化学疗法已有2。5年了，我记得正在研究恶心的原因。有3个原因，但我不记得他们当时所有麦克米伦给我的信息。

One is definitely 'in your head' (not being disrespectful of course) so could it be possible to ask the GP for a course of something???? CBT??? To get it out of your head prior to restarting.

Keep in touch with us let us know how you get on.

phoenixoxo · 7. Apr 2020, 18:41

嗨，索菲，

You're welcome for the advice; sorry, I didn't realise it was both the tablets and the injection that made you feel sick, and still do, clearly. I don't know much about these things, but it almost sounds as though you've developed a phobia.

I think Toni's suggestion re. CBT is worth mentioning to your GP, or perhaps you might benefit from anti-nausea medication, prescribed as a placebo? Or something for the anxiety, even? Well, I don't know much about that either, but I do think it would be a good idea to talk things through with a medical expert️

最好的祝愿，

Phee

louisealice · 9. Apr 2020, 10:58

这里有很多很棒的建议，但是由于我也遭受了恶心的痛苦，尤其是甲氨蝶呤注射剂，我会添加以下有助于我的实用技巧：

a friend who had had chemotherapy recommended the anti motion sickness wrist bands. they are drug free not awfully expensive and widely available. If you can't get out at the moment they should be on boots online
as well as the ginger tea, when the nausea was nagging all the time and a sick feeling even when not being sick I found little pieces of crystallised ginger helped. Chew them like a sweet and as well as helping settle your stomach, they have such a strong taste they distract your mind from the nausea. (holland and barrett or health/whole food shop is your best bet)

在心理恐惧方面：当我被转移到新的注射治疗中时，因为我再也无法应付恶心时，几乎让我感到痛苦和担心。我发现我改变了注射的情况，在哪里做了我的手，我以前洗手了，拭子我用了任何东西和所有东西使它与众不同。防腐擦拭的气味几乎引起了恶心，因为我将其与甲氨蝶呤相关联 - 我改变了品牌并获得了不同的气味。我知道这听起来很愚蠢，但请尝试任何改变您脑海中关联的事情 - 播放一首喜欢的歌曲，您可以随身携带！

You're very brave to go ahead with this, all the very best.

Louise

Sophie98 · 11. 2020年4月22:09

Thank you everyone! I might speak to my gp and see if there is anything they can do to make feel less nervous about it. I definitely do want to give it a go because I know it could really help me I just need to figure out how to not over think it and how to not make myself feel sick at the thought of it x

Frogmorton · 13. Apr 2020, 06:50

Sophie do let us know how you get on because I would love听到MTX并很好地应对（（（（（（（（（（（），），）

Aberjonest · 3. 2020年5月，09：46

Ask to be given the epi pen injections - I too suffered from nausea and dreaded taking the tablets, but since being on injections the nausea has disappeared (and the injections don't hurt at all!).

trepolpen · 4. 2020年5月，07：48

FOLIC ACID , that is your answer , they gave me 5mg six times a week to sort the problems with raised liver inflammation ( ALT ) they had to keep stopping MTX & after upping my results was back to normal & hair thickened over time , just some doctors dont like giving much folic acid , ask them ,

the injections would be better than the tablets & being pens are very easy like your biologic

Bluebell7 · 4. May 2020, 19:55

Hi,

您的DR可以开处方反挑剔的片剂，他们将控制恶心。

小心

Adi65 · 10. Jun 2020, 20:17

hi I also suffer with nausea and inject Methotrexate I find sipping lucozade pink lemonade seems to help might be worth a try .fingers crossed

Kazza52 · 18. 2020年6月11：56

I dread taking my six Methotrexate tablets every Friday but I take them before bedtime and I find that if I have something lightly spicy for dinner beforehand and them take them with a glass lemonade I have no side effects such as nausea and stomach rumblings. However, last Friday I just had a sandwich for tea (had nothing spicy in the house) and the following day (Saturday) I was physically sick and this was how it was when I was first prescribed them four years ago. This was the first time in ages that I had a side effect of taking this medication. My mindset is that Methotrexate is helping my RA but I do hate taking them and I know that I will probably be on them for the rest of my life.

保重并保持安全的每个人。

Sophie98 · 18. Jun 2020, 13:28

谢谢你！我和consultan有个约会t in July to discuss medications because this biologic has also failed and I'll definitely think about giving methotrexate a go

克鲁斯西 · 18. Jun 2020, 13:52

I had all sorts of problems with the oral option, I told my consultant who tried me on a Metoject Pen injection, which I self administer once a week, no more problems.