Five Reasons Why Methotrexate Isn’t As Bad As You Think
Saying that my heart sank when my rheumatologist gave me a prescription for Methotrexate doesn’t do the experience justice. My heart didn’t just drop; it fell out of my arse and lay beating right there on the doctor’s floor.
I’m no medical student, but I recognised the drug name as soon as I saw it. Methotrexate only meant one thing to me: Chemotherapy.
Cancer Drug.
As soon as I made the link, I went straight to that old maxim: As Serious As Cancer. Ergo, my mind automatically jumped to a new maxim: As Serious As Methotrexate.
But is Methotrexate really that bad? Well, here’s five reasons why Methotrexate isn’t nearly as bad as you might think.
One: New York Yankees vs. The Little League
I don’t want to trivialise Methotrexate — becuase it is a powerful drug — but we need to get perspective here. Methotrexate is not chemotherapy. Firstly, chemotherapy is made up of a great deal more drugs than just Methotrexate, with exotic names like Leucovorin and Doxorubicin and other multi-syllabic drugs. Secondly, the methotrexate dose for use in controlling the symptoms of Still’s Disease is by far more diluted than the therapeutic dose of Methotrexate in chemotherapy. Where rheumatoid patients will seldom be prescribed more than 30mg of Methotrexate weekly, patients in the oncology ward are taking ten to twenty times that dose.
So comparing your Methotrexate dose to that of a person with breast cancer is like putting the New York Yankees up against the West Tahoe lil’ Tigers in the little league… Sure, it’s still the same game, but at a completely different level.
Two: Folate Acid isn’t Just For Pregnancy
Another pill that is often stereotyped is Folate Acid – not a drug, per se, but a naturally occuring substance that is noramlly associated with mothers-to-be that are trying to avoid any birth defects. So what do healthy babies have to do with Methotreexate? Not much. But folate acid is an exceptional cover for any symptoms of Methotrexate.
While I can’t promise that you won’t experience any side effects from taking Methotrexate, I can tell you that I’ve been taking up to 30mg of Methotrexate weekly with a cover of 5mg Folate Acid per day for over two years with nothing more than an upset stomach. So don’t go wig shopping for fear that you’ll lose your hair — with an appropriate folate acid prescription you’ll hardly know that you’re taking MTX (except for feeling a whole tonne better!)
Three: 1 + 1 Usually Equals 5
Before you start questioning my questionable mathematical skills, hear me out. There is a peculiar occurence in Still’s Disease treatment (that is not particularly well understood) called double (or triple) therapy.
The idea behind double therapy is that Methotrexate actaully increases the effectiveness of other drugs. Patients that have failed on Sulfasalazyne treatment and Methotrexate therapy seperately are amazed to see their symptoms fade away to nothing when the two drugs are used in conjunction. Pretty cool, huh?
This unusual occurence of synergy also works with Plaquenil, cyclosporine, Enbrel and a whole other host of common DMARDs and bilogic therapies.
So, what that means for you is that with the right combo of drugs, you and your doctor will quite possible be able to greatly reduce your dosage of seperate drugs by combing the whole lot together.
Four: Don’t Turn The Nursery Into A Media Room.
Another popular misconception is that Merthotrexate means the end of baby-making and inevitably means turning the planned baby’s room into a media room. Well, don’t pick up that paint brush quite yet.
It’s true that Methotrexate is dangerous when combined with a fertile egg and a batch of fresh swimmers, but the contra-indication is only good for when the drug is active in the body. When it comes to Methotrexate, the experts reckon that it’s all gone within three months.
Want to get a little one on the way? Talk to your doctor, bump up your steroid dose to cover your symptoms, put your MTX prescription on hold and eat well for a quarter. Then, it’s up to you and your partner to start that sweet Boom-Chikka-Wah-Wah.
Five: You Don’t Need to Be A Tee-Totaller.
Ooooh… this one’s a bit controversial.
Your doctor will probably tell you that Methotrexate and alcohol are not good bedfellows, but this doesn’t necessarily mean that this is the end of your drinking days.
Now before my inbox is flooded with emails from angry doctors across the globe, let me moderate this statement. Methotrexate puts strain on your liver and it means that it you won’t be able to process alcohol as well as you might normally do. As such, your half-a-bottle-of-Tequila days are most certainly done. But that doesn’t mean that you can’t enjoy a glass of wine once or twice a week. So long as you don’t drink on the day of or either side of your dose, your body will be able to handle a small tipple.
Remember that alcohol (in moderation) has some modest anti-inflammatory properties and some beverages contain valuable anti-oxidants. So, don’t believe that alcohol is the devil’s drink just becasue you’re on Methotrexate.
Caveat: I’m not a doctor. Always follow medical advice over mine. Always talk to your doctor about the medications that you are prescribed.
I’d love to hear what your experiences are with Methotrexate — please leave a comment below, or head on over to the community forum.
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