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Trying Methotrexate for UC

I'm in the back row.

Well, I’ve had two colonoscopy exams this year and they are still showing mild to moderate UC up to about 25cm. I have been getting remicade infusions for four years now so my Doc decided to send me up to the Melissa L Posner Institute for Digestive Health and Liver disease at Mercy Hospital in Baltimore, MD. I went and had a good discussion with the doctor and I decided that we would try methotrexate injections once a week in addition to the remicade to see if we can get me to go into remission. It turns out that methotrexate is widely used to treat Rhuematoid Arthritis (brand name Rhuematrex). Well, rhuematrex is given as an oral tablet. However, due to possible intestinal side effects and the fact that we don’t necessarily absorb things well in our intestinal tracts, Crohns and Colitis people have to give themselves a subcutaneous injection to take methotrexate. The other issue with the drug is that it can be hard on the liver, so you must go for blood draws every two weeks to monitor that and YOU MUST ABSTAIN from ALCOHOL. As a winemaker, brewer, and wine and beer connoisseur that was kind of a bummer. So, I decided not to start the medication until after my trip to Aruba – I wanted to be able to sample some tropical drinks. I also had some trouble getting a local doctor to train me on how to do the injections myself so I had to go back to Baltimore to get them to show me. And, that was fortunate because it turns out that I was running around with a staff infection in my skin and the doctor said no methotrexate or remicade until I got that cleared up. A two week course of Bactrim did the the trick and I started methotrexate September 13th and have done two injections so far. I was told that the course is 12 weeks and then I will have another colonoscopy to see how it is working (#3 this year!). So, I have to figure out the logistics of having that done in Baltimore which is 100 miles away. So far, I have only noticed slight nausea a day or two after the injection. I also had a remicade infusion 1 week ago and noticed that it seemed much more effective at shutting down my symptoms – I am feeling pretty good right now with 4-5 bathroom trips a day. I will blog more as the treatment progresses to let people know how it is working.

5 thoughts on “Trying Methotrexate for UC”

  1. Hi Paul,

    My experience with MTX (pills not injections) is that it works as a good maintenance drug when in remission but isn’t great at stopping a flare. As you say, Remicade is the one for that.

  2. Hi Paul:

    I`ve had chronic UC for 4 years now and have been on Prednisone for over 3 years. I`ve been on Asacol, Mesalamine, Canasa, Hydrocortisone enemas you name it. I`ve been doing the Methotrexate injections for 16 weeks and have notice some improvement. My problem is that whenever I try to taper off of the Prednisone or skip the Hydrocortisone enemas for a couple of days, my UC condition gets worse and I start having a slight flare. My doctor tells me that it`s an indication that the Methotrexate isn`t working for me and it`s only the higher doses of Prednisone that is keeping my conditions at bay. She said that it`s doubtful that I will be able to use Methotrexate as a maintenance drug. I would have to agree with my doctor`s evaluation. My doctor has recommended that I start on Remicade infusions and stop the Methotrexate as soon as possible. I was hoping that the Methotrexate would work for me and I wouldn`t have to go on Remicade because of the cost but it looks like I don`t have many more options. I have to get off the Prednisone soon.

  3. I started mtx 5 weeks ago in combination with Humira which I started in Feb and also asacolon. No results yet but I believe it can take 12 weeks to start to work. I went on holidays recently and I asked my Dr could I have a drink and she said one glass of wine max a night and I did and my bloods came back perfect. I am on 10mg orally. Can I ask how much you are on?

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