How Methotrexate Works to Treat RA
Methotrexate belongs to a class of drugs known as antimetabolites. These drugs function by slowing the growth of skin or cancer cells and by suppressing the immune system.
In addition to its use in treating rheumatoid arthritis, methotrexate is also prescribed for severe psoriasis and certain types of cancer.
As a disease-modifying antirheumatic drug (DMARD), methotrexate helps reduce pain and swelling, and may prevent joint damage by slowing disease progression.
While it can take up to 12 weeks or longer to experience the full benefits of methotrexate treatment, improvements may be noticeable within 3 to 6 weeks.
Signs That Methotrexate Is Working
Methotrexate is considered the primary treatment for rheumatoid arthritis due to its effectiveness and tolerability. But how can you determine if it’s working for you?
In the weeks and months following the start of treatment, you may observe the following signs of improvement:
- Decreased pain
- Fewer painful joints
- Reduced morning stiffness
- Less swelling in joints
The effectiveness of methotrexate can be influenced by factors such as age, sex, ethnicity, genetics, and other health conditions.
Your results may also vary based on the duration and severity of your rheumatoid arthritis.
What to Expect When Taking Methotrexate
Methotrexate is available in tablet form and is taken orally according to a schedule prescribed by your doctor, which depends on your condition. Typically, you may start with a low dose that is gradually increased over time.
It is crucial to follow your doctor’s instructions regarding the timing and dosing of methotrexate.
You may experience the following side effects:
- Dizziness
- Headache
- Sleepiness
- Painful, swollen gums
- Red eyes
- Loss of appetite
- Hair loss
- Mouth ulcers
- Loose stools
- Fatigue
- Nausea
Taking folic acid may help reduce common side effects.
It’s important to avoid alcohol while taking methotrexate, as it increases the risk of liver damage. Similarly, avoid smoking due to a small risk of lung inflammation.
Methotrexate can cause birth defects, so individuals trying to conceive should stop taking the medication for at least three months before attempting to get pregnant. Methotrexate should also be discontinued during pregnancy and breastfeeding. If you were assigned female at birth and have been taking methotrexate, consult your doctor before trying to conceive.
Though low doses of methotrexate are generally well-tolerated, serious side effects can occur. These include:
- Vision changes
- Seizures
- Confusion
- Weakness
- Fainting
Regular blood tests are essential while on methotrexate, as liver or kidney issues can develop from the medication. Subtle abnormalities may be detected through blood work, enabling your doctor to adjust the dosage before any serious problems arise.
Pills vs. Injections
Methotrexate is also available in an injectable form, and the side effects are typically similar to those of the tablet form.
With the injectable form, you administer the medication under the skin on your abdomen or thigh using either hypodermic needles or prefilled pens.
Injectable methotrexate may be prescribed if the tablet format is not effective or if you experience gastrointestinal side effects from the pill form. Injecting methotrexate can increase the drug’s levels in the blood, potentially leading to improved responses.
How Long Does It Take to Feel Better on Methotrexate?
You should begin to notice an improvement in your symptoms within 3 to 6 weeks of starting methotrexate. However, it can take up to 12 weeks or longer to experience the full benefits.
When taken orally, methotrexate circulates in your blood for the next 24 hours. The real benefits occur as methotrexate gradually accumulates in your inflamed joints over time.
The process of medication uptake into your cells is slow, which is why it may take weeks or even months to reach full effectiveness.
It’s important to note that methotrexate can lower your immune system’s ability to fight infections. Contact your doctor if you develop an infection, as severe infections requiring hospitalization may be a cause for concern.
How Long Before Methotrexate Reduces Inflammation?
Rheumatoid arthritis is an autoimmune or inflammatory disease, where the immune system attacks healthy cells, causing inflammation. Signs of inflammation typically include swelling and pain.
Most people taking methotrexate see improvement in swelling, pain, and other signs of inflammation after about 12 weeks. By reducing inflammation in the joints, methotrexate helps to prevent permanent joint damage.
For those who have been taking methotrexate for 3 months or longer without significant improvement, additional medications may be necessary.
Lifestyle Tips for Living with RA
While you’re waiting for relief from your methotrexate treatment, consider discussing with your doctor other ways to alleviate your rheumatoid arthritis symptoms.
Regular physical activity can be beneficial. The Centers for Disease Control and Prevention (CDC) recommends that people with rheumatoid arthritis engage in moderate activities like biking, walking, or swimming for 150 minutes per week.
The Arthritis Foundation offers the following self-care tips:
- Incorporate movement into your daily routine: Even small actions like walking a bit farther or gently stretching can help.
- Rest during flare-ups: Taking it easy can help reduce inflammation.
- Use hot or cold compresses: These can soothe pain and reduce swelling.
- Try relaxation techniques: Meditation, massage, acupuncture, and acupressure may help reduce stress and pain.
- Consider supplements: Turmeric or fish oil supplements might help reduce inflammation.
- Seek emotional support: Turn to friends, family, and community for emotional backing.
Before making any dietary changes or starting supplements, it’s crucial to speak with your doctor.