I used to get really nauseated for a couple of days after taking my MTX pills...fatigued as well. I switched to weekly injections and have had no nausea whatsoever! Still tired the next day ( I take it at night)....

I also take folic acid every day, except MTX day.

Have been on it for 11 years. No problem as long as you're taking prescription folic acid with it. My rheumy added remicade about 8 months later. The combo has been wonderful.

I take 8 pills of Methotrexate weekly now for about 13 years & I experience some nausea & fatigue usually the day I take my meds & the day after .. I forgot to add I drink a lot of water when I take my pills & eat jello to help

I was on prednisone for a long time and I refused it because I was putting on so much weight from it and that doesn't help your joints either so I definitely like the methotrexate without the prednisone. Thank you for your feedback