I have just been prescribed 10 mg Methotrexate weekly. I was prescribed 24 tablets and took my first one last Friday. I have not been feeling so well this week and put it down to the new medication. However, when I went to take my 2nd one this Friday I noted that 4 tablets had already been taken. I realised that I must have taken 3 Methotrexate instead of 3 mg of Prednisolone one morning this week. Is this a big enough overdose to worry about. I have had stomach pains and headaches so far.
Hello Marie, I'm sorry but I have no medical training so I cannot help you with anything technical but I live in a little village and can simply phone up or call into our village pharmacy where the pharmacist knows everyone and their prescriptions. So I would simply pop in or call the pharmacist up and ask and they would advise me.. So my advise is to either contact the pharmacy that gives you your medication or simply pop into the nearest one and get this sorted Asap for your own peace of mind. All the best, christina.
Hello Marie, I take 10mg of MTX [Methotrexate] weekly too. Are you in the UK?
MTX comes in 2 strengths, 10mg and 2.5mg they are similar colours - I think it would be better if they were different colours!
Most UK doctors ask the pharmacists to dispens 2.4mg tablets and they only supply one month at a time.
You need to check what strength your tablets are. It could be that you haven't overdosed at all.
I keep my MTX and folic acid separate from my other drugs. I, too, take mine on a Friday but I take it on a Friday afternoon, when I don't have to take any other drugs. I keep a record in a diary.
If you find that you have taken 30mg of MTX, then you should contact your doctor. This is a chemotherapy drug and they use a much higher dose for chemo but, all the same, if you have taken more than you should, contact your doctor before you take the next dose.
Are you taking folic acid too? You should be.
Good luck!
I don't know where my 'e' went from dispense!
I've just posted the following message on another thread to someone else who found a typing error too late to amend it. If you follow the link, you will be able to vote to an 'edit' facility:
"On mentioning to the moderator that it would be helpful to have an 'edit' facility on this site, he gave me the following link. The more votes we place the higher the chance of us having this option available when we look back and see that we have perhaps made a typing error that alters the gist of what we were trying to say:
mariemb, if you have taken a first dose of 40mg MTX instead of the recommended 10mg starting dose, it isn't surprising that you have been feeling unwell. Perhaps there is an antedote that would help you feel better although a week has gone by since taking it now. As it's the weekend and no surgery, then perhaps you can ring the out-of-hours service, or, if there is a good pharmacist locally, I feel sure they would be the best person for advice as far as drugs are concerned. Perhaps a weekly pill box might help to avoid this in the future. Easily done, unfortunately. Good luck, I hope you feel better soon. Do come back and let us know how you get on
An overdose of methotrexate will mainly affect the haematopoietic system, which is responsible for forming blood. An overdose can be treated with calcium folinate, which neutralises the effects of methotrexate toxicity.
Hi Marie -
I take Methotrexate once a week - 6 tablets at one time - in total 15 mg. I am lucky in that I don't suffer from side effects to the methotrexate - prednisolone is another story!
If you have any doubts about overdose I would give the pharmacist a call - I would imagine that they could help.
Hope you feel better soon.
Thank you to everyone who has responded. However, panic over - I must have been having a senior moment as my tablets are 2.5 mg so there would have been 4 taken for the first dose! I feel such an idiot. I wasn't sure whether my stomach pains and headaches were down to starting Methotrexate or due to missing a dose of Prednisolone a few days ago. I can't believe I have caused myself to fret all night...thanks again for your help - at least I've learned a lesson here and will definitely keep my weekly tablets separate from my daily ones. My daughter is suggesting that I should get a App on my mobile to manage my medication - I have to smile at this as I don't really think I have lost my mind to the extent that I can't manage 5 types of medication. Just for information, I have been informed that if I miss a dose it can be taken in the next day or two after. Any longer than that and I should wait to take the next dose on my usual day.
Hello Marie, all's well that ends well. Sit yourself down with a lovely cup of tea, put your feet up and just relax! All the best, christina
I'm glad that everything is ok Marie!
Thanks - I think I will do just that! Have a nice day.
Thank you - I'm far more relaxed now.
Marie, phewee! It happens to the best of us! I bet you feel much better already!
"MTX toxicity has not been described following acute oral overdose. Patients who ingest more than 500 mg in adults or more than 5 mg/kg in children should be referred for further assessment.
Acute ingestions by adults of greater than 500 mg are extremely unusual, as this is the dose contained in one full bottle. Similarly, accidental paediatric ingestion of more than 20-30 mg is rare. Parenteral MTX doses of less than 2 mg/kg are not usually associated with toxicity and is likely that the poor bioavailabily following oral administration, especially following overdose, affords greater protection."
Which means: If you weigh 70kg and take a dose that is less than 140mg you are unlikely to suffer toxic effects. 70kg is 11st.
If you did take a lot more then there is an antidote, folic acid, the stuff you take to prevent too bad side-effects anyway - but you would need to go to A&E to get it by infusion probably. If you go within a couple of hours they give you charcoal.
Hi again Marie
Glad that panic is over!
I had the same worries - 4 different types of meds. some daily others once a week and one twice a week - no wonder we get confused - I resolved my problem with one of these "weekly dose" holders - I fill it once a week - one "tube" for each day -
each "tube" split into 3, morning/day/evening - saves confusion added to that I can see if I have forgotten anything!
That sound a good way to manage your medication. I have got down to 3 mg per day of Prednisolone (not feeling too great but I can persevere). Like so many others, I am determined to get off it completely and have been told that taking Methotrexate should help do that. The clinic estimates I will need to take it for about 5 months.
Thank you. I did fret when I thought I had taken the tablets in error but hoped that the dosage was too small to worry about which is why I thought it best to post my query and not bother out of hours services. Although I have not contributed here at all in the past I have been following various discussions for quite a long time and have gained so much more information than through any doctor or specialist. I have had PMR for the past 3.5 years and have benefited from the advice to reduce slowly. This is my second attempt but I have managed to get down again to 3 mg per day. I am so grateful to people like yourself for sharing your knowledge.
"I have got down to 3 mg per day of Prednisolone (not feeling too great but I can persevere)"
If the dose isn't enough the PMR will flare so if you feel the symptoms you have could be a flare - think twice.
The most recent recommendations have been that methotrexate dosesn't help in the long term and advising against it in PMR. It doesn't replace the pred, it merely reduces the amount you need, but even that isn't proven. There were 3 studies, one said it helped, on said it didn't, one didn't know.
If the underlying autoimmune disorder is still active nothing will get you totally off pred, just at best to a lower dose - unless you don't have PMR but another arthritis and you have been misdiagnosed which isn't uncommon. MTX is the first line drug for many other forms of arthritis.
do you take folic acid aswell,it may be wise to take one for a few days thereafter...speak to your local dept that prescribed them,but 3 tabs extra should not do any damage