Hi there,

Could anyone recommend a good treatment for mouth ulcers? And has anyone experienced mouth ulcers as a methotrexate side effect?

My mom has been on methotrexate for 13 years. Over the last 12 months she has had persistent mouth ulcers. She gets an ulcer which takes ages to heal and causes subsequent pain and discomfort when eating and drinking. As one ulcer eventually heals another one starts!!! In the methotrexate info leaflet I got when I started taking this drug nearly 2 years ago, it stated a need to stop methotrexate and inform doctor in the case of mouth ulcers. My mom informed Rheumy who dismissed the problem and gave no advice except to keep taking methotrexate. She has asked GP too, who said the mtx should stop if more than 1 ulcer present at a time - advised bonjella (which made matters worse!) and more recently a paste which is meant to seal the ulcer so it heals from under the protective seal (hasn't worked either).

Would be very grateful of any tips on treating these ulcers and any experiences other folk with RA have had with them. I wonder if I'm blaming mtx and they may be a part of RA in general??!

Many thanks!!
Keep well.
Lottie

Hi Paul

thanks so much, you've hit the nail on the head!! My mom was recently diagnosed with B12 deficiency and has started injections for this - so all makes sense now!!

Thanks again.
Lottie

Hi Lottie
Paul is right Mouth ulcers CAN be caused by a Vitamin B12 deficiency amongst other things .I think you need to get a high dose of this prescribed by you GP if this is the cause rather than the kind of dosage you can buy over the counter.

There is a product called Ad Cortyl in Orabase which I THINK you can buy over the counter but which can also be prescribed -This could be the paste you describe. Another product which can give some relief is called DIFFLAM and comes in a throat/mouth spray and acts like a short term topical anaesthetic leaving the area a bit numb for a while. I know there are other things to try as well but can't think of the names of them right now!
It would be well worth talking to your dentist as they are more savvy regarding problems in the mouth than the GP and if you have a good one they can often be quite helpful regarding mouth ulcers! (I work for one!)

From personal experience having RA, on Methotrexate and getting ulcers I find that if I increase the amount of Folic acid I take this tends to lessen the frequency of the little blighters. ( I take Folic acid 6 days a week if I remember!)

Hope you can find something that helps as they are so miserable.

Julie x

Hi Lottie

was composing my first reply when you responded to Paul's reply about Vit B12 so missed the bit about your mum having been diagnosed with this deficiency --Doh! Anyway hope maybe the rest of my reply was useful !


Hi Anne
Don't know about that one It may be worth looking into though

Julie x