I am now up to 17.5 mgs a week and am feeling a little mixed-up at times and even fearful of something at times. I also have a sore throat that will not go away. Are these things normal. I have been on methotrexate for 3-3.5 months. I am being treated for Crohn's disease.
Yes, it can cause moodiness.
Sore throat is a serious side effect, discontinue methotrexate and contact Dr. asap.
Nervous system side effects include headaches, dizziness, drowsiness, blurred vision, subtle cognitive dysfunction, ******moodiness*****, tinnitus or unusual cranial sensations. After intrathecal administration, headache, back pain, fever, and even transient paraplegias have been reported. A case of acute chorea and a case of a woman who couldn't speak after receiving methotrexate by intrathecal administration have also been reported. Serious neurotoxicity has been associated with the use of high-dose MTX after intrathecal or intraventricular administration to patients who have undergone craniospinal irradiation, but has also been described in other patients who have received low-dose oral therapy.
The development of serious neurotoxicity is more likely if MTX is given in high doses to patients who have undergone craniospinal irradiation.
Significant neurotoxicity can present as an acute stroke-like encephalopathy or a chronic leukoencephalopathy. Unique features of the former include its acute onset (seizures, confusion, hemiparesis, speech problems, loss of consciousness) and reversibility within days.
The use of high-dose IV MTX has been associated with the development of chronic delayed leukoencephalopathy in patients with or without a history of craniospinal irradiation. A syndrome of subtle personality changes followed by a progressive dementia, focal seizures, pseudobulbar palsy, spastic quadriparesis, and stupor may begin several months after the initiation of therapy. Affected patients often improve after discontinuation of therapy.
Intrathecal or intraventricular administration of MTX has been associated with the acute onset of headache, nausea, vomiting, fever, back pain, dizziness, and meningismus. Acute symptoms usually resolve within one to two days. In some cases, subacute neurotoxicity, with myelopathy or encephalopathy, may occur within days to weeks. Subacute neurotoxicity is usually characterized by paresis/plegia, dementia, confusion, tremor, ataxia, irritability, and somnolence.
Delayed leukoencephalopathy, as described above, has also been associated with the use of intrathecal MTX. The condition can improve but can be progressive and fatal.
Progressive dementia and leukoencephalopathy has been reported in at least one case after low-dose, oral administration of MTX for the treatment of rheumatoid arthritis.
Some side effects of methotrexate may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to methotrexate: oral tablet
Get emergency medical help if you have any of these signs of an allergic reaction while taking methotrexate: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using methotrexate and call your doctor at once if you have any of these serious side effects:
dry cough, shortness of breath;
diarrhea, vomiting, white patches or sores inside your mouth or on your lips;
blood in your urine or stools;
urinating less than usual or not at all;
fever, chills, body aches, flu symptoms;
*****sore throat**** and headache with a severe blistering, peeling, and red skin rash;pale skin, easy bruising or bleeding, weakness; or
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects of methotrexate may include:
nausea, vomiting, upset stomach;
dizziness, tired feeling;
bleeding of your gums; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
Read more at: https://www.drugs.com/sfx/methotrexate-side-effects.html
Get well soon,
In addition to the extensive post above, I need to ask has your Dr also given you prescription FOLATE (folic acid) or lucovorine? This medication blocks folate, a.B-vitamin intrinsic to the development of nerve cells. So many problems ( not the sore throat) could be B vitamin deficiencies.
I take 30 mgs weekly. I had terrible nerve and anxiety problems until I was started on 1mg of folic acid DAILY and bi monthly B-12 injections.
Now aside from nausea and tiredness the day after, I am doing much better!
- Methotrexate Information for Consumers
- Methotrexate Information for Healthcare Professionals (includes dosage details)
- Side Effects of Methotrexate (detailed)
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