Users on an oral steroid cycle may experience a sudden increase in body weight and muscular development, insomnia, irritability, aggressive combative behavior, puffy face, severe acne, bad breath, a yellowing of the eyes and skin, premature hair loss, hyperactivity, and exaggerated mood swings that include uncontrollable outbursts of anger. Males may also experience testicular shrinkage and can develop female breast tissue on the pectoral muscles. Females may also experience a deeper voice and decreased breast size. Continued use can result in life-threatening situations involving the liver, cardiovascular system, and brain.
However, folinic acid may be more likely to reduce the effectiveness of methotrexate. “High-dose leucovorin (folinic acid) supplementation was tested in a prospective, unblinded manner for 4 weeks in 7 rheumatoid arthritis patients who were being treated successfully with low-dose methotrexate (MTX). Nausea caused by MTX disappeared; however, the underlying rheumatic disease worsened in all patients. Subjective clinical assessment, Ritchie articular index, grip strength, erythrocyte sedimentation rate, and levels of C-reactive protein showed statistically significant deterioration. All these parameters improved after the leucovorin was stopped. This is the first direct clinical evidence implying folate antagonism in the action of low-dose MTX therapy in rheumatoid arthritis patients,” Arthritis and Rheumatism .
It is interesting that you refer to kidney involvement, and I think it is quite possible that people taking bisphosphonates may not realise the dangers of Aledronic preps, and indeed could quite likely have a kidney condition without knowing it. I am CKD Stage 3 and when my GP mentioned bone protection I was able to ask how suitable medication would be with this condition. The Fracture clinicians hand out a 'Pathway' leaflet for patients (I had a distal radius fracture of my right wrist) and this states that CKD Stages 3&4 patients be given Risedronate only, and NOT Alendronate. I am waiting now for a DXA Scan (I'm 82) and I shall think very seriously before accepting medication if it is suggested/advised. I have quite enough pain and stress to cope with now, without adding to it if that can be avoided. I realise that circumstances are probably very different for younger people, who may be coping with families and jobs along with pain, and my thoughts go out to them.