Why do symptoms feel worse after starting hydroxychloroquine and methotrexate?
It's important to know that both medications take time to work effectively. Methotrexate typically needs several weeks to months before you'll notice improvement in your RA symptoms. During this adjustment period, your symptoms may continue or Show Full Answer
Why do symptoms feel worse after starting hydroxychloroquine and methotrexate?
It's important to know that both medications take time to work effectively. Methotrexate typically needs several weeks to months before you'll notice improvement in your RA symptoms. During this adjustment period, your symptoms may continue or even feel worse, but this doesn't mean the medication is causing the flare-up.
Some myRAteam members have experienced similar concerns when starting methotrexate. One member shared that they felt worse the day after taking it initially, but after about six months, the problem resolved and the medication started working well.
The increased swelling and burning sensations you're experiencing could be:
- Your RA continuing its natural course while waiting for the medications to take effect
- Side effects from the medications themselves
- A combination of both factors
Methotrexate can cause side effects like gastrointestinal issues, fatigue, and headaches, which might indirectly make you feel worse overall. However, increased joint pain and swelling aren't typical side effects of methotrexate.
It's crucial to contact your rheumatologist about these symptoms. They can evaluate whether you're experiencing a flare-up, adjust your dosage, or recommend additional therapies like corticosteroids or NSAIDs to help manage your symptoms while the medications take effect. Don't stop taking your medications without medical supervision.
December 28, 2025
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