If you're on Methotrexate, when do you take it?

Hi ! I am glad to hear Methotrexate is helping and I hope you get lots of responses from the community. I have no experience it myself, but I do know that it can lower your iron levels, which can lead to fatigue. Many people supplement with ,folic acid, so you might want to ask your doctor about that. Methotrexate is usually the first medication doctors try because it is relatively inexpensive and many insurance companies require that you try it first, but if it becomes less effective for you, know that there are many other treatments out there you can try. Here is an article about PsA treatments that might interest you: https://psoriatic-arthritis.com/treatment. I hope you recover some of your energy soon. Best of all wishes! - Lori (Team Member)

Hey ! So I also take MTX, 20mg, but I take it on Wednesdays as I like to indulge in a few adult beverages on the weekend and you do have to be a little bit careful of your liver and kidneys when on MTX, so Wednesday was the farthest from the weekend I could get. I also take my Humira every-other week on Wednesdays. I have been on the MTX a couple different times now, and never noticed the medicine itself making me tired, but like mentioned it is notorious for creating a folic acid deficiency and you likely should be on supplements for folic acid, which will also help you stomach the metho better, but more importantly to keep the anemia at bay. This is not iron deficient anemia either the folic acid deficiency anemia is typically called macrocytic anemia or megaloblastic anemia which means your red blood cells become larger than normal and are not properly formed, thus causing the accompanying issues of the anemia. The typical symptoms are tiredness/fatigue (and you only think your fatigued now, just wait until you've dealt with a good dose of anemia too), muscle pain, neuropathy such as pins and needles type pain, foggier brain fog, tachycardia, shortness of breath, chest pain, loss of weight, brittle nails, hair loss, confusion, GI issues, etc. Iron supplements will NOT help with this other than to make you very sick. I've heard some people can take a B12 supplement, does not work for me as my B12 is ok, it is specifically Folic Acid/Folate/B9 for me and the prescription supplements have worked much better than the otc ones. Macrocytic anemia is a constant battle for me, and the alcohol does not help it, but I had the issue pre-DMARDs and pre-diagnosis and is part of what led to my eventual diagnosis. I also wound up with an Iron Deficiency Anemia this last summer after hip replacement surgery, that made for an interesting couple of months to say the least!


Bottom line, I would talk to whomever is prescribing the MTX to you about a folic acid supplement. I take 1mg daily of folic acid.

Thanks for replying.


I have folic acid on prescription too - two tablets a week in between methotrexate doses. My RBC and haemoglobin counts are edging up slightly, which is a relief.


Thanks especially for that warning about iron, as I'd thought about taking supplements for that. It seems best to steer clear.


Re alcohol, I was down to just 1-2 drinks anyway, so it isn't a huge factor, though I enjoy a beer or wine (gluhwein at this time of year) midweek. I'm quite wary of the medication generally, but it seems to be going OK so far...

hi, I take my MTX on Thursday night with dinner. Then I only have to get through Friday before I get a weekend break. I started off taking on Mondays but found the brain fog, nausea and tiredness very hard to balance with work. Slightly lowered dose taken on Thursday works really well for me.