Methotrexate Testing Facts

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If the liver function tests (LFTs) of a patient taking methotrexate are becoming raised? If the liver function tests (LFTs) of a patient taking methotrexate are becoming raised (AST 189 and 330), at what point should methotrexate be stopped?

SusansHusband replied: "Do you not have some form of booklet from your health authority where your results are recorded? In there you will find where the 'normal' levels are supposed to be - you should also have a contact for your consultants or clinic - they are the people to be asking - not the world of Yahoo answerers! Your levels are much higher than mine, but they may be being measured on a different scale. (Also are they continuously higher - these blood tests CAN flucuate now and again but usually settle down)"

Tauri replied: "There is really no definitive answer to this question. It depends on individual circumstances and the doctor who is treating you. Patients on Methotrexate should have their liver function checked regularly. This helps the doctor to detect significant changes in liver function. Most doctors tend to lower the dose given if liver function starts to be impaired, and then see how a patient gets on with the lower dose (the liver function will sometimes drop back to normal). Some doctors are happy with an 'acceptable' rise in liver tests. I.e. weighing the benefits against the disadvantages. Most doctors will stop the drug if the liver function becomes grrosly abnormal. Of course the effect of Methotrexate on the liver can be enhanced by people drinking alcohol when taking the drug. You are always warned that this is a nono when taking Methotrexate, but you will always get those who ignore the warnings and the risk. If those are your last two AST levels then there is quite a rise between the two. The levels are pretty high and I wouldn't be surprised if your doctor stopped the drug, at least temporarily. AST is not the only test done to assess the function of the liver, are your other liver enzymes raised too?"

Is it harmful to take methotrexate for Rhematoid Arthritis? My dentist said that Methotrexate was very bad for me: that it "kills everything." My recent blood test showed a decrease in kidney function. Is it due to the methotrexate. I am not sure if I even have RA because all of the tests for it have been inconclusive and I do not have many of the signs in that all of my symptoms seem to be only on my right side. I do have occasions when I am unable to make a fist. I should add that I have hypertension and diabetes. I take medication for both these conditions. Thank you for any help you can give me.

ckm1956 replied: "In a sense, your dentist is right. Methotrexate is a very powerful drug. A patient taking it should be under the care of a rheumatologist and have periodic lab work. Both hypertension & diabetes can cause decreased kidney function. Ask your rheumatologist about methotrexae & your kidneys. Having said this, it has helped a large number of arthritis (RA & other) patients."

i took methotrexate. Will it alter my drug test for work.? the doctor prescribed the drug methotrxate for me and i have to take a drug test. Will the methotrexate affect my results?

Magic replied: "no"

daddyrx replied: "Methotrexate does not produce a false positive for any drug."

SZO replied: "Basic drug tests are not specific for methotrexate."

Does anyone have any experience with methotrexate and Rheumatoid arthritis? I was diagnosed with RA back in April after SEVERAL tests. I was having severe pain, muscle weakness, joint pain, and the list goes on and on. I made at least one weekly trip to the ER until finally my family physician put me on prednisone for the swelling. After the visits with my rheumatologist and the tests she put me on sulfasalizine.. It made me very very sick. I ended up stopping the medicine because I decided throwing up everyday was not worth it. I was always sick, fatigued, etc. I went back yesterday, to the rheumatologist, and she has once again put me on prednisone because I'm swelling again. She also put me on methotrexate and folic acid. She has said there are a LOT of possible side effects with the methotrexate. I'm slightly concerned about these side effects and wondering of anyones experiences with this medication as a whole. Side effects, things I should eat, food and/or activities I should avoid. Anything and everything. thank you! I do know a little about the medication.. I know that it is a chemo-treatment and I am okay with that. I could NOT be a vegan or even try to be a vegan cuz that's just not me.. Anybody else have anything they might add? Thank you!

Perdita_Durango replied: "Methotrexate is a chemotherapy drug given for cancer...it destroys the immune system, so I suppose that would make your symptoms less severe...but it is like killing a gnat with a sledge hammer...I urge you to consider a vegan diet to lessen symptoms...I have a rheumatoid problem and the vegan diet helped it tremendously..."

cindy1323 replied: "I am on sulfasalazine along with 2 other medications for RA (which they have now decided it's another type of arthritis). In the first few weeks the sulfasalazine made me very dizzy & nauseous, but that passed after awhile. The meds are working and I'm feeling A LOT better. I haven't need methotrexate yet, so I can't answer that. Best wishes to you; I hope you get some relief!"

Seema K replied: "Shark cartilage helps in reducing pain.Grape seed extract reduces inflammation.More information on natural remedies for arthritis can be found at"

RedQueen replied: "For nearly 3 years, I have been taking 17.5 mgs of methotrexate weekly for my RA, and thus far I have had no real ill effects from it. When I first began treatment, and for a period of about 6 weeks, I experienced mild nausea on what I dubbed "methotrexate day," but I found that taking my dosage before bedtime allowed me to sleep through most of the unpleasantness. Along with the nausea, I had mouth ulcers and a sore throat, but these were relieved with a saltwater gargle. I experienced minimal hair breakage and no hair loss. All of these symptoms became practically non-existent after the initial 6-8 week period. After this point my body became used to the medication and I'm no longer bothered by any of this. The only complaint I have about mtx now is fatigue, but I simply allow myself a 30 minute nap each day to remedy this. I am very happy with the success I've had on methotrexate. There are no limitations concerning food, activities, etc. You don't need to change your lifestyle in anyway as long as you remember to take your folic acid. This will help to reduce side effects. You should probably take a daily multi-vitamin, along with calcium and vitamin D. Before doing so, discuss the use of all supplements with your doctor, but I've been taking them safely for years. Remember not to become pregnant if you are taking the drug, and to stop mtx at least 3 months prior to becoming pregnant if you plan to have children. I've included three links to methotrexate information, one for a diet that may be beneficial to arthritis sufferers, and a link to the arthritis foundation homepage. Good luck to you, and I hope you get to feling better soon."

Is it normal to have a hsg test after an ectopic pregnancy & the methotrexate shot? I had an ectopic pregnancy & I had the methotrexate shot about 2 months ago. I go in next month for and hsg test, I have read they are very painful and that scares the heck out of me, but what scares me more is that something could be wrong..it sucks because I have went through this horrible event and it could even get worse.... so i need help does the hsg always hurt? is it normal to have the test done after the ectopic or does it mean something is probally wrong with me? (my dr didn't seem like too much was wrong but i worry to death, and i have read so much on the internet about ectopics i am so scared...) thanks my prayers are with anyone who has had an ectopic!!! or who is going through this LONG process!

Darci H replied: "I do not have personal experience with this, and let me start out by saying I am so sorry you are going through this. However I can tell you that my sister went through the same thing. Her Dr told her that she would be needing the testand didnt seem to worried. My sister ofcourse freaked out and read everythign she could find and freaked out some more. After everythign was said and done, she had the test, she said it was uncomfortable but not anything like people described, everythign was fine, it was just a measure to ensure everything was fine. Three weeks ago she gave birth to beautiful identical twins. I only hope your story ends as well, best wishes and good luck. I would say your best bet is to try and relax, your mind can play a very large roll in how the test feels, and etc. Stay calm, and I am sure everything will turn out for the best!"

Jenny replied: "I'm so sorry for your loss. I had an ectopic pregnancy in January and had an HSG done in May. It wasn't something that my doctor required to be done, but I wanted to have the procedure just to know where I stood as we started ttc again. My doctor agreed it was a good idea because I have continued to have pain off and on where the EP was. I'm not going to lie to you-- the HSG was painful, but it wasn't unbearable. Really the most painful part was when he was trying to force the dye through my left tube (where the EP was, which we now know is completely blocked.) So clearly the blockage made it more painful and I have heard this from other women too. But it only lasted a few minutes, then I just had a little cramping and spotting for the rest of the day. Everyone is different-- some women describe an HSG as very painful and others say it's nothing. And even though it wasn't great news that my left tube is blocked, I was glad to have had the test done. We did find out that my right tube seems perfectly clear, so that makes me optimistic. It felt empowering to me to have the test done-- like I was finally able to do something to take control of this situation that has been for overwhelming. And one good thing about the HSG: it tends to give you a higher chance of conceiving for the next few months afterwards by helping to clear everything out. It hasn't happened for us yet, but we're hoping! Nonetheless, just because you had one ectopic doesn't necessarily mean you'll have another. Many women who have had an EP go on to have healthy, normal pregnancies later. It could be even better news for you that you didn't have to have surgery, possibly avoiding further damage and scarring to your tube. I wish you all the best. Feel free to e-mail me if you have any other questions! Good luck!"

Methotrexate question? My mother has been on methotrexate for over two years , and gets blood tested monthly to make sure everything is ok, her last blood test the docter said it was a little bit low ? what does this mean , should she be taken off this? and what measures will they take to make sure everything is ok.

Maria R replied: "Methotrexate lowers folic acid and vit b levels so it can cause anemia. If it gets too low he might prescribe vitamins or, in a pinch, a blood transfusion. Why did you post this under "pregnancy"?"

SZO replied: "It's probably the white blood cells level since methotrexate is known to cause leukopenia or lower normal white blood cells. With low WBCs, the patient is at risk of having infections. Just make sure that your mom avoid crowded places and contact with individuals whom she can get disease like colds, etc. I'm sure your doctor's going to give your mom advise as well."

Question about Methotrexate...? I have undifferentiated mixed connective tissue disease. I've tested positive for Sjogren's syndrome a few years back, but it is not primary. That means that I either have Lupus or Rheumatoid Arthritis. I've been taking plaquenil for 4+ years and had some toxicity. My dose has been decreased and I started taking Methotrexate in August. I currently take 10 mg. I've noticed minimal (very, very minor) improvement in joint swelling. I seem to have 2-3 good days a week, but still have considerable swelling in my joints. I see my rheumatologist in 3 weeks, but I thought I would ask anyone who is taking methotrexate to see how long it took them to know it is working. My major complaint is fatigue. I'm exhausted and I don't think the fatigue is worth the minimal improvement. If anyone who is currently taking this med can give me some advice, I would greatly appreciate it. Should I hang in there? I'm also doing homeopathic treatments with a doc and aqua therapy 2-3x a week.

Linda R replied: "I have systemic lupus. I have not taken methotrexate, but I did receive it intravenously in the hospital along with pulse steroids. I had bone marrow failure from the lupus and a very high sed rate, including pericarditis and other things. I too take plaquenil. I have been off prednisone for 6 months. I still take mycophenolate mofetil-Cellcept-for lupus kidney disease. It is hard to know whether it is the medication or the disease making you tired. Autoimmune mixed connective tissue diseases are extremely trick to manage. I would hang in there until you see your rheumy. Keep a journal of your activities and your symptoms. You may see some connections and this journal will be very useful to your rheumatologist. Please be sure to tell all your doctors and practitioners what the others are doing. If you have a good working relationship with your rheumatologist, you should be able to talk about your homeopathic and other complementary treatments with him or her. If you cannot talk this openly, get another doctor. The stress of the disease and its management are enough to bring on fatigue. Add to that the fact that the disease ITSELF causes fatigue and it is no wonder you feel that way. You did not get to your current level of inflammation overnight and it will not go down overnight. Are you on prednisone too? Did you have chloroquine retinopathy from the plaquenil? Feel free to email me at Best wishes. Be patient."

Sharon M replied: "I have had RA for 8 years and have been on Methotrexate for all 8 years. I previously also took plaquenil but was told by my rheumatologist that the side effects were not worth the small benefit. With methotrexate you must be careful about mouth ulcers, therefore be sure to take folic acid as well to deter this side effect. Methotrexate does minimize the pain and aches but not as effectively or consistently as either Enbrel, Remicade or Humira. I have been using Enbrel with the methotrexate now for a year and notice an significant improvement, however none of these will help with the exteme fatigue. There are other meds that can help with the fatigue, you just have to be the "squeaky wheel" and don't give up. I would suggest asking about one of the other three meds I mentioned (however they are all pretty expensive so check with your health insurance first). Hope this helps."

Methotrexate and alcohol.? I’ve got Crohn’s disease (had it 11 years now) and have tried most medications out there and have had 3 operations to date to remove various parts of my bowel. Recently I was prescribed Methotrexate which I administered myself via injection, from February 2008 until April 2008. Unfortunately my body couldn’t tolerate the stuff and I was told to stop taking it in April as my liver was showing signs of damage, the ALT was over 140. I know that you are not supposed to drink alcohol while taking Methotrexate and I was teetotal for this time, but I am going on holiday next week and wondered if it would be OK to drink alcohol while I am holiday. I plan on getting a blood test done before I go to see if my ALT is back down to normal and I will also be asking my Doctor for advice too, but has anyone here been in a similar position to me? I’m not an alcoholic by any means but having a few drinks on holiday is always a good way to relax and being told you can’t drink only makes you

Steve F replied: "I currently take 7 wee Methotrexate in one go once a week, with the Celebrex and of course the Folic acid. Have done for the last 7 years with arthritis I drink with these drugs no problem, they do say 20 units a week but regular blood tests will give you the confidence to just tip the balance now and again. I wouldn't worry about it too much but taking the tablets on a Monday, they are pretty much in the system so the weekends I go mad. Healthy living, good food and excercise not to mention drinking water keeps mind and body together. Enjoy your life and don't let these pills control it. Have a great holiday"

Bren replied: "if u have a liver problem then u should check with yr doc if its ok to drink in moderation sorry to hear that u have had to stop the methotrexate. my daughter has had crohns for 12 yrs shes 24 and recently started on infliximab intravenous infusions every 8 weeks, so far it is working miracles for her, so maybe u could ask yr doc about the possiblity of thing being suitable for u. good luck."