I was on it for about 20 yrs. Worked well, I had no side affects. Eventually I had to go on something sronger. Tried Humara, then Orencia. Im now on Acterma infusions.

I administer a methotrexate injection weekly which means my digestive system doesn't get so upset. I found I couldn't tolerate 20mg but I'm settled now on 10mg. My rheumatologist warned me that it can take years to get the dose right. I'm in the uk so all meds are free. I take 10mg folic acid on the non methotrexate days to protect against the harm methotrexate can do. I have frequent blood tests and at first my white blood cells went down but now after 4 years it's settled down.
Methotrexate is designed to prevent the disease reforming the joints. It doesn't help with fatigue though,; learn to rest when you need to. Just because one day you wake with energy don't go mad and do masses of tasks because you still need to relax every so often to let your body catch up . My gp told me the other day that an RA body is never at complete rest because it spends so much energy fighting disease, hence the anaemia.
Be kind d to yourself is the best advice I've been given.

This is such helpful advice. Thank you!

I’ve been on it nearly 40 years. No major issues, just have blood tests every 3 months. It does make me anemic but rather that then pain.

Thanks Nancy! I guess I have to evaluate my level discomfort when not on it versus being on it. Not seeing my doc through all this makes me leery of taking it again for the present time.