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Plan on taking the MTX after a high carb meal like pasta. That really seems to help with the side effects. I found the injections had fewer side effects and were actually easier on me than the pills. It took a bit to get used to giving myself injections, but it really is not bad. Also, if you find you are having really bad side effects from the mtx, ask your doctor about leukovoran. It is the "antidote" to MTX and can be taken no sooner than 24 hrs after you take the MTX.