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Community > Expert Q & A > Medications > Blood Test Frequency for Methotrexate
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Blood Test Frequency for Methotrexate

Q: I have been taking 15 mg of methotrexate weekly for the past seven years. I have had blood work done at least every other month during that time; however, my doctor wants me to have blood tests every month. Since none of my past blood tests have shown any problems, I am wondering why I need to have these tests so often. Wouldn't every few months suffice?

A: No, I wouldn't recommend having those tests any less frequently than your doctor recommends. In general, patients taking methotrexate should have the tests monthly. Just because you haven't had any problems for the past seven years doesn't mean you can't develop problems at any time in the future. 

Frequent blood tests may detect subtle abnormalities that could alert your doctor to modify your methotrexate dose before a serious problem occurs. If you still have concerns about the frequency of your lab tests, I would recommend bringing up the subject with your doctor at your next appointment. In the meantime, I know it's a hassle to have the tests monthly, but in doing so, you may save yourself serious problems down the road.

Bernard Rubin, DO, Rheumatologist

Rikki
01 Feb 2012, 17:03
Hi, I have been diagnosed with exteme RA for the last 7years. I have been taking 10mg Methotrexate wkly to control my condition.
The meds have done great wonders on me, due to the excruiating joint & imflamation pains that i was goin thru. I have now taken these meds very serious & that i do my monthly blood checks to monitor my bloods cells & liver to make sure everything is fine.
Sian
20 Nov 2011, 13:15

I have just started taking it after 2 years of trying Cyclosporin. That worked quite well - all my legs, back and much of my torso cleared up within 6 weeks but the side effect were bad. I have not seen an improvement in my psoriasis yet on this new medication - but it has only been 6 weeks (on 10mg) and fingers crossed - there are no side effects as of yet!

I was really honest with my Dermatologist and told him I drink at least 1 -2 glasses of wine a night and he said so long as I don't go over the RDA I will be fine.

However, reading this and some other stuff online I am starting to seriously worry that he has mis-informed me Should I not have any alcohol at all?

Sian
Livinoz
20 Nov 2011, 08:24
I too experienced hair loss on .8ml injections one a week. My Rheumatologist suggested Nioxin shampoo and increased my folic acid to 4 mg a day. Huge improvement. Good Luck.
Don
04 Nov 2011, 17:36
i have been on 10 mgs of methotrexate for 3 mths for plaque psoriasis i have not gotten any better, seems to be getting worst.Does anybody have any tips?I can't seem to get aby good answers from the dermatoligist.
plural,like in ive seen 3 different ones.
rosa a ortega
24 Oct 2011, 09:40
i am taking methotrexate 2.5 their are times when i wake up in the mornings in so much pain ,my bones just hurt,i havent been told that the meds arent working but i am the type of person i dont like taking anything for pain i walk alot at least 45mintues a day for five days.Just tried of hurting
Roohee
08 Dec 2010, 19:21
I was dignosed with RA few months ago.
I am taking Methotrexate 7.5 mg from the last two weeks after trying Plaquenil an Sulfasalazine..had to stop them due to the side effects.
My liver function test were slightly high due to side effects from the Ibuprofen...ALT was 100..but My Rheum suggested this MTX after discussions. I am already feeling a dfference in general well being, joint pains, exhaustion and fatigue.
I will keep praying that Liver does not get affected any more and no other side effects as I have read all about them.
My advice..please try these meds.
Exercise, exercise and exercise....it does miracles.
Sleep well, Eat well.
Roohee
Sheryl
24 Nov 2010, 10:52
Hi,
my derm suspected i had psoriasis so he prescribed me with methotrexate 2.5mg (2 tabs, 2 times weekly). However it didnt improve my condition.
Therefore i went to seek a second opinion from another derm and he said it wasn't psoriasis and prescribed me with another kind of medicine. my condition improved after taking a diff med.(so it was clear that my conditon was not psoriasis)

At that pt, i have alrdy taken 4 tabs of methotrexate 2.5mg.
Though i stopped taking it, i am concerned if that will cause any form of side effects or is it necessary to take a blood test even though i just started on MTX and on such a low dosage.

Thank you for ur time :)
Freda W.
23 Nov 2010, 09:37
I take remicade every six weeks and 15 mg of methotrexate once a week and it has changed my life.
I have severe R.A. and uveitis and this combo along with 3 mg of prednisone daily, 100 mg celebrex, calcium, borage oil, folic acid and 1 mile walks every day has proved to be an amazing regimen for me. Eating healthy is very important as well. Stay away from too much sugar and salt and processed foods.
I agree with other posts, that having blood drawn every six weeks is a pain.




Linda S.
29 Sep 2010, 23:32
I was told that I had Lupus 4 years ago, befre that I was being treated for Fibromyogia. After a huge flare up and quite abit of trial and error.. I was put on methatrexate and plaquinial. I am able to work and have a grip on my life again. Thank your stars that testing and meds are availble to us. If you have a Doc. that does not give the right feedback about EVERYTHING THEN GET A NEW ONE. Most fear is from not knowing. Good luck to all.
Mary Beverly
08 Sep 2010, 12:07
Comments later.
pauline
23 Aug 2010, 13:25
i was diagnosed with ra in 2007 started on plaquenil then sulfaseine and in dec last yr was put on 7.5mg of methtrexate have bloods done each month, went to hospital to see my consultant he did not explain nothing to me just said my bloods are not right and increased methotrexate to 10mg does any one know what it means drs dont seem to answer questions any more .
Trish
22 Jul 2010, 17:46
I have wegeners granulomatomas which has caused RA and have been on methotrexate for the past 2 years. The doc said I need to be on it for the rest of my life. I would like to know if anyone has actually stopped taking it and if so what happened. I stopped a few weeks ago but only stopped taking one week and got scared and went back on it. The trouble is, that the Pharmaceutical companies are making a lot of money from our illness and I wonder if we really need it or not. Sure it helped to stop the trigger but every week for the rest of my life is scary. Love to hear anyone elses comments.
mary
16 Jul 2010, 09:17
i have been prescribed with mtx 15g every week for six weeks. what are the possible after dosage effects on my body,

my main problem is oedema in the retna
Megan
23 Jun 2010, 00:34
New methotrexate laboratory test. Has anyone ever heard of this new lab test? It is supposed to tell if the body is absorbing the methotrexate. At this point only very few labs do the test.
Rubin
30 Apr 2010, 14:04
I have psoriasis and my doctor put me on Methotrexate. Guessing I was on it about a year and developed a terible cough so he discontinued it. I went to several doctors and no one can give me any relief for my cough which still continues. I have been off the Methotrexate for a year now and I believe it was the cause of of having these injection.
What can I do about it? as no doctor seems to know what to give me to clear up this problem...
Pat, out west
22 Mar 2010, 21:31
Specifically to New York: You stated you are on methotrexate at 15mg once a day. Is that right or a typo? If you really taking 15mg once daily, I urge you to contact your doctor before you take another dose. MTX is supposed to be taken weekly, in order to give your liver time to heal itself between doses. You are running a much greater risk by taking it daily.
I've been off and on it since 1992 and honestly can't figure out the difference between being on and off. I take it because secondary Sjogren's from the RA caused scleritis to develop and I was in danger of losing my eyeball!
I don't have the usual symptoms of RA, such as severe joint pain (although I do have ulnar deviation in my right hand). If I had my 'druthers, I'd be off it but I can't keep running the risk of losing my eyesight from an autoimmune reaction.
When I was under the care of a rheumatologist, he ordered blood work every two months, after an initial spell of monthly tests.
ann
08 Mar 2010, 13:52
I'v had rumatoid since 1987 no meds, just controlled me stress level, then had a bad flare up. dr put me on HUmera and methrotrexate for one year, I got off for 2 months because switching insurance. i went to new dr. said she couldn't put me back on because I have a double stranded dna and something about a 9? Said if she put me back on humeria could cause problems like a cancer? Now only take methrotrx but scared has hell, I feel like I am a walking time bomb has any one heard of this situation before, I almost think I rather not take any of this crap!
bill
22 Feb 2010, 12:37
I have been on MTX for two years @ 10-15 mg/wk.
I drink a beer or two almost every day, but try not to drink Thurs. night when I take the MTX.
So far my blood tests re: liver & kidney are good, except when I briefly took 20 mg/wk MTX,
so dr. cut me down to 15 mg/wk, and I have cut myself down to 10 mg/wk for past several months. But when I try to go to 7.5 mg, my joints complain, so I go back to 10mg/wk.

Was on prednisone for a year after my original flare-up 2 yrs ago, and then had a bone density test which was abnormal & showed significant bone loss, as my dr. put it. I am on the cusp between osteopenia & osteoporosis.

Am taking strontium & other nutrients to strenthen my bones after very negative experiences with Fosamax generic for 3 months.

Best advice: spend lots of time researching your issues on the internet; you may find, as I did, that my doctors were giving me bad advice!@

P.S. I am 62, and if my liver fails b/c of the beers I enjoy, well, that's o.k. ... I've lived long enough, and I wouldn't mind being dead.
New York
21 Feb 2010, 11:29
I have RA. I want to avoid the biological drugs and would prefer a more holistic treatment, but can not seem to find an RA Dr. that considers more natural treatments, therefore I have been taking methotrexate on and off for the past four years. I am now taking 15mg daily, along with 400mg of Placquinol. I have a daily wine. I do have my blood tests taken once every 3months. Haven't had a problem as yet. By having a cocktail daily, am I setting myself up for trouble with the liver later on? Has anyone taken this amount of Methotrexate for longer periods of time? ms
Carol
01 Feb 2010, 05:40
I was on 20mg Methotrexate tablets for 12 months and they made me sick each week. I now inject myself with just 15mg and feel much better. I had some hair thinning when on the tablets, but my hair is starting to thicken since on the injections, although this could be due to the reduced dose.
I developed a DVT last month and the thrombosis doctor told me that being on methotrexate increased this risk. I am now on warfarin for 6 months, but I am concerned about the risk of another clot when I come off them. Has anyone else encountered this problem.
Lois
29 Jan 2010, 15:43
I have had RA for 4 yrs. and I am on Methotrexate 2.5 mg and Hydroxychloroquine 200 mg. I have blood work done every 12 weeks after doing them every 8 weeks. I am doing great on these drugs and haven't had any side affects. I was in very severe pain when first diagnosed and can't thank my dr. enough for getting my life back.
Maria
07 Nov 2009, 15:13
Maggie, I don't think that you should be drinking beer but I do believe that some doctors let there patients have a few drinks a week but I wouldn't recommend it considering that the medicine could damage the liver. I haven't heard of it causing appetite loss but I would LOVE that side effect!!! I'm concerned about the hair loss that will totally suck!!!! This medicine effects people differently just like any other medicine. If you find out about the hair loss please let me know.

thanks, Maria
maggie
05 Nov 2009, 17:02
I'm in the same boat as Maria, and I'm scared too. Is there alot or a little hair loss? Can you drink beer? Will I be sick?
What about appetite loss, I'm looking forward to that one.
maria
01 Nov 2009, 08:48
Has anyone experienced hair loss with methotrexate and if so is it mild hair loss or total hair loss. Thanks
Maria
01 Nov 2009, 05:40
I'm suppose to start methotrexate but i'm scared to death of it. I have read all the side effects. Has any one had any side effects from this medicine. This is a night mare for me I was a healthy woman on day and woke up in a nightmare. HELP
june
20 Oct 2009, 18:08
i have been taking methotrxate forat least 5 years!!i am suppose to get my labs blood work done every month, i try my darndest to comply because this is my life. do as your doctor orders,ive had to decrease my dosage due to elevated enzymes in my liver. so do follow thru this is a life changing disease.also i take quite a few other ra meds.
naomi berkson
15 Jul 2009, 09:14
Help!

My former MD had me get blood tests every 3
months (I have RA and DiabetesII--am on Humira and Celebrex and Metformin)

My NEW MD only wants blood tests every 4-6 months Is that right?
Diane L. Bronner
30 Jun 2009, 10:39
I just started methotrexate and I am doing my first blood work up, I will follow what my doctor says when it come to the testing. I dont want to take a chance.This is new to me and concerning!
Laida
22 Jun 2009, 12:48
Hi,
I used Methotrexate for a year and a half and my doctor told me I need to have blood work every six weeks in case something abnormal showed it the test. They do it to make sure that its not harming your liver. But you should ask your doctor to be sure.

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