Switching from MTX to another DMARD

I am seriously thinking of switching from MTX to another DMARD.
Life before RA 3 years ago was very different and one of the differences was that I was a social drinker.
My onset was very severe but MTX and a high dose of prednisone turned me around from being an invalid to a high functioning RA sufferer. (now I am completely off prednisone and on 20 mgs. MTX per week)
What I mean by highly functioning is that I work full time and I do not miss days from work but it takes all that I have. I battle fatigue and I have pain & stiffness every day but no one wants to know about it my doctor included. He keeps blowing me off telling me how different I am from the first time he saw me. My family....well lets not even go there- I'm just responsible for everything and just get it done please.

Last RD visit I made mention that I have been drinking socially on the weekends and he went through the roof. He pretty much said I had a choice to make. It didn't have to be that day but it has to be made right away.

I'm sorry but I have had it. If I can't enjoy drinks on the weekends with friends that the world can go to hell. I'm so fed up with how I feel and all I do and I feel good after a couple of drinks. No I don't want to have a now & then drink for a special event. No I don't want to have a sip of wine with my friends just as a taste as the doctor has suggested. I feel like tying one on both days of the weekend.

So now if I sound like a lush- that's the way my doctor made me feel- maybe I am.

The real question is- has anyone after achieving this kind of success with MTX changed to another DMARD with the same success?

I once had to go off MTX for an infection and I flared in my shoulders, wrists and hands pretty bad for a month. On MTX I have chronic pain but no flares. I am terrified to ever have a flare like my onset was. I had to go out on disability from work for 3 months and could not even feed myself.

Can anyone make a suggestion?

If so which one and how did you do it? Did you have to wean off MTX?

sorry weary, i am one of your viewers and i dont take mtx so do not have an answer for you. best of luck finding your answers

Hi weary.  Ok well I have been and still am on methotrexate.  I'm seriously debating if its even working for me at this point.  I'm flaring and in pain constantly.  Now where I can deal with pain, this pain is just not right....even for me.  Anyway, I dont blame you for wanting to have a couple every now and then.  Heck every weekend if ya want.  I dont drink, however, my vice is I smoke.  So my doc's like, well if you would quit smoking you would feel better and so would your JRA.  I looked him square in the face and said"I plan on quitting, however, right now in my life, with the pain I have and the emotions I have and the stupid people I deal with who think its sooo easy to quit......I'm not quitting right now.  So just load me with my Remicade and lets get to it".  He laughed hysterically, nodded he understood and walked away.  I think that if we have to deal with pain on a daily basis, and deal with non-understanding people, and deal with needles, then we should be allowed our 1 or 2 vices.

Sorry I couldnt help with your question, but had to write that I understand the rest.  Best of luck if ya switch.  ((( gentle hugs)))) 

Most of the other arthritis meds are usually used WITH methotrexate not instead of it. I take plaquenil and MTX.
The other DMARDS-there aren't many-are probably not what you are looking for.
How about one of the anti TNFs enbrel, humira etc.
Again they are usually used with MTX but you can use them without.

I think Arava is in the same class as Methotrexate. I found out the hard way I can't take either....but plaquenil seems to help.....you might want to look in to that and if you can tolerate a drink or two on the weekends...it takes a while for it to kick in though, like 5-6 months before you realize you're doing much better than you were.

I know how frustrating this is for you (we all do).....giving up something or modifying your life because of something you can't control. It really stinks.

**

Jay- I am not sure what a "unit" is- can you elaborate? Is it the equivalent to a shot?
I too have been drinking for at least a year with perfect blood tests. However I have always been worried I am kidding myself that I will be fine because everything I read is so adamant about no alcohol with MTX and my doctor....well he flipped out. he seems to think that out of no where BOOM- cirrhosis.
Why don't they do a stinking study on this? I know there has to be a lot more people like us. The doctor always says- well we just don't know. We know MTX alone can cause cirrhosis so there is no safe amount of alcohol. Well how many people on MTX alone get cirrhosis? I never read about it. Maybe it's only dangerous if you are taking MTX in the doses that cancer patients have to take- ours are so minimal compared to that....
Yet if I risk it based on what ifs and my liver goes....I'd have no one to blame but myself and then I would feel guilty for letting my family down.

Thanks again to all who have responded- it feels good to get this off of my chest.

I have noticed that the alcohol guidelines are more relaxed in the UK. Perhaps I should move LOL!
I do believe my RD is extra cautious because he has flat out told me he never had a drink until he was 30 and he doesn't care for it at all and does not even sip wine. We are clearly not on the same wave length in that regard. If you could have seen his face when I confessed to drinking on the weekends...I thought he would blow a gasket. I felt like he thought I was an alcoholic or something! It was totally embarrassing. But I'm with you-taking my social drinking away affects the life style I have always lived and it is very upsetting to me. My husband and all of our friends drink and not that they get fall down drunk but they are feeling good and to be the stone cold sober one in the group is a total drag. If I have to live like this I will have to divorce my husband and find a new set of friends because I feel very resentful and my husband has already told me he will not stop drinking just because I cannot.

Ah Weary, it does appear that over at your side of the Pond MTX has a far greater propensity to cause liver damage, LOL. Must be something to do with... the earths magnetic field.

Seriously though, I'm treated at a world leading research centre, and was told to moderate my alcohol intake, but given no specific instructions beyond "not over 12 pints of beer a week", of course the Brits are naturally accustomed to copious amounts of alcohol so I guess they dare not deprive us.

It is a risk each person has to evaluate individually, being a 6'2" well-built male with no history of illness aside from RA, I thought if I drink alcohol I'm likely to get away with it - and so far, I have!

Isn't it strange how in Australia & the UK this issue is no issue? Makes me have half a mind to have a couple of drinks this weekend. I haven't had a drop since my last RD appt. July 17th. When the weekends roll around I get depressed. A couple of drinks was kind of like a reward for getting through the grueling work week. Now what? I hate RA.

Jay I thought you were a bad boy!
I didn't know what you were drinking so Wikipedia told me this:
Armagnac is the oldest brandy distilled in France, and in the past was consumed for its therapeutic benefits. In the 14th century, Prior Vital Du Four, a Cardinal, claimed it had 40 virtues.

"It makes disappear redness and burning of the eyes, and stops them from tearing; it cures hepatitis, sober consumption adhering. It cures gout, cankers, and fistula by ingestion; restores the paralysed member by massage; and heals wounds of the skin by application. It enlivens the spirit, partaken in moderation, recalls the past to memory, renders men joyous, preserves youth and retards senility. And when retained in the mouth, it loosens the tongue and emboldens the wit, if someone timid from time to time himself permits."

Sounds like it's good for you to me! Wonder if it would work on these canker sores better than salt water?????

I found a site where you can ask a pharmacist a question so I posed this question-

question: Is it really dangerous to drink alcohol while on methotrexate? My doctor won't allow it yet my methotrexate comes with all kinds of warning labels on it from the pharmacy but it does not have a label that says do not drink alcohol. I have had some antibiotics come with that warning- why not methotrexate if it's so deadly?

their answer was:

Thank you for submitting your question to Everyday Health.

Methotrexate affects cell growth and suppresses the immune system. Methotrexate is used in the treatment of cancer, psoriasis, and rheumatoid arthritis. Methotrexate can cause acute and chronic liver disease. Liver disease generally occurs after use for 2 years or more and a total dose of at least 1.5 grams. The chronic form of the disease is similar to what occurs in alcoholics and is potentially life-threatening. Methotrexate should not be used in any patient who has liver disease or who is an alcoholic. Drinking alcohol while taking methotrexate is not recommended because alcohol can increase the risk of liver disease.

When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your healthcare providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects.

For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action.

Regards,
Michelle McDermott, RPh, PharmD


First of all I don't think she answered my question- it's the same old story.

I don't know guys....do you think we can get of a pre-liver waiting list LOL?

Thank you! It is odd that it is the only warning label left of the bottle isn't it? I have labels that say it may make me dizzy, prone to infections, stay out of sunlight...