First Oral Mtx Tonight

[Mehita]

DS is going to start oral methotrexate tonight. He's on a 7.5mg dose weekly (along with 1mg folate daily).

Should I give him Zoran first? Or go without this first time and see how it goes?

Based on what I've read here, many of you have your kids take it right before bed, right?

Should I have him stay awake a bit to see if he has any reactions? Or just let him go to bed like normal?

What might we expect tomorrow?

I read the prescription info sheet in detail. I'm assuming many of those warnings are for the higher doses. How concerning is the sun exposure?

His ped yesterday said that mtx may make the two vaccines he has left less effective (HPV and meningitis), but they are still worth getting. I also asked about live vaccines shedding because my younger son needs a couple live ones this summer. He said if DS hadn't already been vaccinated against these, he personally would keep his kids apart for a couple of days, just in case.

I hope this goes well!

 

[Clash]

I hope everything goes well tonight and he's one of the kiddos that doesn't have the sideefects.

I think the first couple weeks we took the mtx late evening before bed. Since C didn't have side effects I can't really tell you much more.

As far as sun exposure our GI said sun screen was important. It was a constant battle when C lived at home because if I wasn't at the activity he would forget the sunscreen. Funnily enough, he always makes sure I have him some sun screen to take wherever but always forgets to apply it. A bit of a reaction last summer solved that issue last summer but teens tend to live in the here and now so we'll probably go through it again this summer!

 

[pdx]

We did zofran right from the start. I didn't want E to have any negative association with the mtx, so didn't want to risk having her get sick that first time. (About 20% of the time she still gets a little nauseated even with the zofran, so I feel like we're not giving the zofran for nothing.) We always give the mtx right before she falls asleep, including the first time. She sometimes feels a little dizzy the next day, and sometimes doesn't feel that hungry for breakfast the next day. I don't push food on her then, and I also try to give her dinner and dessert earlier than usual on mtx day, so that she doesn't take the mtx on a full stomach.

I hope it goes well!

 

[Worried mama]

Good luck. We did my sons first injection last Friday, he will get one tonight before bed again. But our dr did not prescribe zofran, he said wait and see if it's needed first. Hope you will not even need it.

 

[my little penguin]

Ds did not try zofran with oral Mtx
He does have it at home just in case
Never had an issue
He takes his in the morning before school

 

[Mehita]

He takes his in the morning before school

He takes the mtx before school? And no nausea? Do you think kids who are prone to cause more likely to experience it?

 

[RexMom]

We did a few months of Methotrexate. My son didn't have nausea after taking it and I didn't notice any side effects. We did it on Friday nights before bed without zofran. He was fine. It was working for him as we were able to almost completely wean off pred with no issues.

However, we stopped taking it because he had a bad reaction to it. He would throw up violently for 2 hours at approximately 36 to 48 hours after taking it. He was perfectly fine just before onset of vomiting and quickly thereafter. It's apparently the time it takes the medication to hit some part of the brain or whatever. Zoran wouldn't have helped him.

 

[Maya142]

We know several kids with JIA who take MTX before school or on a school night because they have no nausea.

We did not start Zofran when we started MTX. My girls started on a low dose and increased it every week until they got to the target dose (they had to have weekly bloodwork). Not all docs do that but our pediatric rheumatologist did.

We did give it at night (Friday night usually) and let them go to sleep as usual. I wouldn't worry too much.

My older daughter has nausea with MTX. With Zofran it is mild and manageable. My younger one had horrible nausea and some vomiting. With both of them, switching from oral to the shots helped, but we did that after a month or so of oral MTX.

My older daughter had the HPV shot on Humira and MTX with no issues. No side effects except a slightly sore arm. My younger one just had the first HPV dose last month. She also did not have side effects. I was very worried she would flare with it, but nothing unusual. We were also told it may not be as effective but it was worth getting. They both also got the meningitis vaccine on a biologic+immunomodulator (can't remember exactly what at the time) -- no issues.

7.5 mg is a fairly low dose, if that helps. My girls went all the way up to 25 mg of MTX even with Humira/Remicade. My older daughter is now on 15 mg (0.6 mL shot) with Humira.

Good luck!! I hope he does great!! We have a couple tricks, if he has nausea - let me know.

 

[my little penguin]

Ds gets lots of nausea from
Drinking or eating due to Gastroparesis
But despite that not issues with Mtx
But he takes 2 mg of folic acid

 

[Jmrogers4]

We never did the zofran with Mtx. He took an hour or 2 before bedtime so I don't know if he just slept through any nausea or just didn't have any. If I remember right he slept in pretty late on Saturdays and was just tired the whole day.

 

[crohnsinct]

Neither of my girls had side effects with oral mtx. We actually didn't tell them about the possibility of nausea...didn't want them looking for it. My girls could take it any day anytime. However, now three years in all of a sudden o is reacting. No clue why. We did raise her dose to 12.5 in fall so maybe but not sure when the nausea started. So we recently switched her to injections.

T was in 20mg but recently went down to 15 and still no side effects. She is a little over a year in.

Make sure he takes his folic acid. It is an easy pill for a teen to forget.

 

[Food4Thought]

We started oral MTX (10mg) 7 weeks ago. I have the zofran ready to go, but we decided to try without the first week. He did totally fine. No nausea, no reactions.

We have a family movie night when he gets his. That gives us time to check for reactions, since we're all awake and together, but keeps us distracted from looking for reactions. if that makes sense. I was a nervous wreck the first few weeks.

We give him his dose on Thursday night. He's usually a bit tired on Friday, and then sleeps in a bunch and doesn't want to do much on Saturday.

I had been very alert on the sun thing, but forgot sunscreen yesterday. We live in southern California and it was hot and bright yesterday... 4 hours at the park and still no problems, and he's my one that burns. Still, I'm going to continue being very careful.

 

[Maya142]

Wanted to check how your son did Mehita? Any side effects?

Really hope he did ok with it!!

 

[Food4Thought]

I'm curious too! I really hope it all went well!

 

[Mehita]

Wanted to check how your son did Mehita? Any side effects?

Really hope he did ok with it!!

Thanks for asking! It went well. He was up really late playing video games with friends, so I'm not sure if the 12 hours he slept was from that or the mtx or simply being a teenager, but he was fine all weekend.

So, next silly question... Remi in two weeks. He's doing mtx on Friday nights and Remi is on a Friday. Anything wrong with doing both on the same day?

 

[my little penguin]

Nope
Ds did humira and Mtx the same day a lot when he was on humira every 10 days
Just worked out that way
Good luck

 

[Maya142]

We have done MTX and Remicade/Humira on a same day before. We preferred doing them separate days so we could tell what side effects were definitely MTX (they didn't have any issues with biologics, except tiredness after Remicade) but it shouldn't be a problem for him since you probably know by now how he feels after Remi.

SO glad it went well!! That's wonderful!

Hope next week is just as easy.

 

[crohnsinct]

Both same day here also and no issues.

Glad it went well!

 

[FrozenGirl]

I do Remi and mtx on the same night, have been doing it for about 6 month without a issues. Unless he has side effects from Remi that you don't want to combine with MTX I would say go for it.