Have you tried taking a cough syrup with a DM in it? You're supposed to take it day before methotrexate and the day of methotrexate. One dose in the morning and windows at night each day. This was told to me by a pharmacist to work for an infusion clinic that deals with Biologics. I swear it really cuts down on the exhaustion! I was suffering badly! This is the information she gave me:

"This was a practice Pearl presented by Dr Jack Cush, a prominent American Rheumatologist.
Methotrexate stimulates a receptor called the NMDA receptor in the brain. This stimulus is now thought to be responsible for the adverse effects of fatigue and the foggy feeling people get the day after methotrexate. This is not part of the way it provides benefit for RA. DM blocks this receptor to prevent these side effects. I am fortunate to attend all provincial, national and international meetings in rheumatology. I here about these findings before they are published, so I would be shocked if your community pharmacist would have known about this use of DM. "

My rheumatologist here in Raleigh is really good. They do clinical trials for RA and they stay up on the latest. Last summer they ran a test to see how the meds were working in my system and then switched me to the injectable. When I asked for the handicap they immediately handed me a form no discussion it's like they understand what we are dealing with.

You should ask your Rheumatologist if you can try arava. It does the same thing as Methotrexate without the side effects. I take one pill every day now and have no side effects at all. Best move I ever made. If a med they give you is making you sick let them know and ask for something else. There are so many out there and new ones coming on the market all of the time.

I take my Methotrexate in the morning on Thursdays. By the weekend I am feeling okay I don't seem to have the side effect as bad as others..

I tried methotrexate, too! Ugh! Switched to leflunamide, and didn't feel half as sick! My hair started falling out, and I started taking biotin.. Great stuff!! Not only did my hair start growing back, but also I had lost all of my eyelashes, no hair on my armpits, none on my legs... My eyelashes grew back, but I haven't had to shave my armpits or legs for 9 years!!
Yippee!