Great, but not a terrible.

 After a diagnosis, which put   in me as rheumatoid arthritis, doctor prescribed methotrexate and for the long time.Am  in panic, that he is taking for chemo therapy in oncology, and how are feeling such patients you are knowing.  Please share about a remedy, and how to use his and what are to avoid?

Till 1990 years beginning his in rheumatology looked as a remedy for reserve, as prescribed, when other anti inflamed remedies are not effectivity. Today lots of patients his using as in joints diseases and  his saving, effectivity is not affecting by doubt. Suppressing inflammation he can prescribe in any stage for rheumatoid arthritis or psoriatic is a having high duration for not stopping curing till are ten years and more, simple for dosages, good controlling in a plan for toxic  reactions and price is not high.

And in oncology his using as dropsy with a 10, 100 times  as a higher, than rheumatic.  Thus and here a hard enduring in patients. Methotrexate having are pills, and use his for 1-2 times/week, for a good enduring remedy a dosage can to add on 2 or 3 methods with intervals for 12 hours,thus a using shortening till 1,5 days/week.

Today rheumatologists using are high dosages , than ten years ago, start begins not with 5 mg/week, but 10-15 and slowly leading till 20-30 mg/week, if these are not toxic reactions displaying.

Also, his using for subcutaneous or intro muscularly injections, and on 20 mg and higher/week , thus better are here using of pills. Remedy is better digesting   by organism, and enduring, but not in all patients having. And for a better enduring methotrexate we are prescribing and folic acid, she's lowering  gastroenterological plan, preventing risks for stomatitis, cardiovascular pathologies, folic acid here using everyday   and with days, where you are using methotrexate as on 5 mg/week. That is lowering nausea, discomfort in a belly, and weak affecting his on the liver. Or you can use every day a folic acid, and for exclusion  for a days are using methotrexate, if folic acid bad enduring by organism, thus doctor will search for you a alternative remedy.

Avoid a self prescribe methotrexate, as doctor by a selecting dosages and on every 2-4 weeks by blood test checking a cure dynamic. And for blood test using SSE, S reactive protein, ACT, ALT, creatinine B, for a future are blood tests doing for one time in 2-3 months. Avoiding using methotrexate in pregnancy, feeding by breast, planning pregnancy if, thus stopping using for 3 full months.

If kidneys function moderated destroyed, dose is decrease on half, and use 10-15 mg/week, in damaging kidneys his is not using.

If blood ferments are rising by blood tests, thus for 2 times lowering dosages, or cancelling. And in any infection this remedy too cancelling, when infections signs are removed,thus again using methotrexate. And for patients using methotrexate am advising doing vaccination against flu and pneumococcus, and preparations for selections are Ultrix, Vaxiflu, Influvac, Prevenar 13, pneumo 23, this is lows risk for hard infection course.

By I.Smitienko, rheumatologist, C.M.S.