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Real members of MyLupusTeam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Has anyone had a major migraine from MTX? Put me in the ER. Doctor wants me to try it again but I am to terrified to do so.

A MyLupusTeam Member asked a question 💭
Camby, IN

I have a history of Migraines on the left side of my head and this one was on the right and went all the way to my shoulder. He said it's probably the Lupus. I really don't know what to think. This was my first dose that this happen on.

September 24
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Reactions
A MyLupusTeam Member

Good luck, Lisa!😘

September 27
A MyLupusTeam Member

Well since I got through the headache the week has been good. It is the first time in 2 months that I have felt decent. I am assuming it is the MTX. I talked to the doctor and he has agreed to let me cut the dose in half. I can't deny that I think it helped, out side of the migraine. Crossing my fingers. Lord knows I can't afford another ER run.

September 25
A MyLupusTeam Member

I haven't been on it myself, Lisa, but I've had several patients on MTX who didn't have headaches as a side effect. I can understand your reluctance, though, as that was a terrible experience for you.

September 25
MyLupusTeam

That sounds absolutely terrifying, and it makes complete sense to feel hesitant about trying methotrexate (MTX) again after an experience like that. A migraine severe enough to land you in the ER is no small thing.

Headaches are actually quite common with lupus — studies suggest around 54% of people with lupus experience Show Full Answer

That sounds absolutely terrifying, and it makes complete sense to feel hesitant about trying methotrexate (MTX) again after an experience like that. A migraine severe enough to land you in the ER is no small thing.

Headaches are actually quite common with lupus — studies suggest around 54% of people with lupus experience them, with migraine being the most frequently reported type. So your doctor may be right that lupus itself could be playing a role.

That said, headache is also a known side effect of methotrexate. It can be hard to untangle what caused what, especially on a first dose when your body is adjusting to a new medication. A few things worth discussing with your doctor before deciding:

- Triggers — Stress, fatigue, and certain medications can all trigger migraines in lupus. Was anything else different that day?
- Folic acid — Doctors often prescribe this alongside MTX to help reduce side effects. Was that part of your plan?
- Dose adjustment — Some side effects are more pronounced at higher doses. A lower starting dose might be worth exploring.
- Monitoring — If you do try again, having a clear plan for what to watch for can help ease anxiety.

It's completely okay to voice your fears to your doctor and ask for reassurance or alternatives. You deserve to feel safe with your treatment plan.

September 24

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