HealingWell
Search Close Search
☰

on methotrexate, need a new med, WHICH ONE!?

Support Forums
>
Crohn's Disease
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 10/31/2010 7:07 AM (GMT 0)
im under 21 years old, beenn taking methotrexate (25mg/ 1 ml) every week in shot form. im having a flare up now and i will probably be switching medications.

my choices look like remicade, imuran, or humira

i want the least amount of side effects and to be able to drink alcohol while on this medication!!!!

which one should i pick?i think me and my parents are leaning towards remicadE
Posted 10/31/2010 7:42 AM (GMT 0)
Any reason why you can't stay on the methotrexate and add in either pred or one of the anti-TNFs like Rem or Humira?

Ivy.
Posted 10/31/2010 2:13 PM (GMT 0)
I think Ivy its because he can't drink on the MTX. JeffB you do know that alcohol and CD don't really mix. I am not sure alcohol is receally a good idea with any of these meds. I finally gave up alcohol myself because feeling so bad the next day wasn't worth it anymore. And the strongest med I take is Asacol and my Crohns is considered mild. JMHO
Posted 10/31/2010 11:15 PM (GMT 0)
Imuran, Remicade, or Humira are all powerful. In fact, I'm not sure why you were prescribed methotrexate, to begin with - this med is usually tried only when the others have been tried and failed.

It seems to me quality of life should be considered, too: since you can take Imuran (aka azathioprine) by mouth, it is more convenient and so it might make sense to give that a try. BUT it might take a few months to fully kick in, so you might need to combine it with Entocort or prednisone in the beginning months.

Just curious - why were you considering Remicade over Imuran?

Posted 11/1/2010 2:25 AM (GMT 0)
Methotrexate and Imuran/AZA both primarily reduce the activity of B cells (a kind of white blood cell).

The biologics (Remicade, Humira, Cimzia) primarily affect T cells.

Some people respond well to one, some to the other and some need both kinds. And of course sometimes people respond differently to 2 different drugs even though the drugs do pretty much the same thing.

If you responded really well to MTX then it may make sense to switch to Imuran. However it takes up to 4 months to figure out if Imuran works for you.

You could bridge this time by taking something like Entocort but alcohol can increase side effects like dizziness.

You may be fine on Remicade or Humira and there are no warnings about interactions with alcohol for them.

If you are going to drink to excess (more than 2 drinks a day) then you need to realize that you are risking much more than the other people around you. Mainly you are taking a chance on damaging your liver badly. Because you have Crohn's you are at higher risk of problems with your liver to begin with. There are very few symptoms of liver damage until the damage is very advanced. So it's hard to tell when you're making yourself sick.

You really can't live without a liver sad so it would be good if you could keep this in mind when you start drinking so you can take steps to stay in control.

Alcoholic drinks of all kinds stimulate the intestines and may make symptoms like diarrhea and cramping worse. Drinks high in sugar are worse than ones that don't have much sugar (i.e. carbohydrates).

What is your doctor recommending? I assume your doctor understands that you want to be able to drink socially. If not, I would make sure he does.
Posted 11/1/2010 7:19 PM (GMT 0)

It appears the new Fad in the world of meds and crohn's is adding a bio to the methotrexate mx dose.  I also take the same amount of methotrexate as you do and just started Cimzia two weeks ago. The MTX helps me alot but not 100%. Ask your doc about adding any one of the bio's he likes. For me, remicade worked great until I developed antibodies and I hurt bad from head to toe.  Here's hoping Cimzia along with MTX helps.

As far as drinking, it's not good to drink especially on Metho. but I have one occassionally and in moderation should be ok. Just make sure the dr. keeps a check on your liver which he should be doing anyway!  Good Luck.

Steve

 

Posted 11/1/2010 8:17 PM (GMT 0)
I loved Remicade. In fact, I know that alcohol is sort of a no no with CD but I'm in my twenties and was able to eat salads and drink socially on occasion with no problem on Remicade. If you start imuran it's actually really important you don't drink at all while adjusting to the med because it can act on your liver.

I am on humira now and I have to watch my diet/skip alcohol more often than I ever did on Remicade.
Posted 11/2/2010 1:31 AM (GMT 0)
I've been on immuran-not worked for me, humeira-not worked-major flare-up-lost nearly 20kg-no toleration of any food-vomiting after mealtimes-was very ill-thought i was finished, put on iv steroids, major recovery, at home again, enjoying life again with 2year old son and my wife, on iv mtx now along with humeira, taking a social drink, doing ok.
Posted 11/2/2010 2:07 AM (GMT 0)
Glad your health is improving, Brendan. And welcome!! :-)
Posted 11/2/2010 4:07 AM (GMT 0)
Thanks everyone for the input!

Visited my GI today, and we have decided to end MTX and start Remicade.
I have to do a bunch of tests and x-rays before I can start.
First infusion should be within a few weeks.

Anybody care to share their personal experiences with Remicade? Thanks!
Posted 11/2/2010 2:18 PM (GMT 0)
My personal experience with Remicade is it worked great the three years I was on it.  At the beginning my dr told me it only worked for every 4 out of 10 people.  Anyway, I developed a restriction that led to a third bowel resection and all meds were stopped after the operation.  MISTAKE.  6 months later crohn's returned and got back on Remicade and this time it did not work. Every joint in my body hurt like heck, stopped the Remicade and the pain went away.  My thoughts are if your lucky enough to have good results with the med, do not stop it no matter what, keep taking it. It's also fair to say that I was on 6mp and entocort months before I started Remicade and continued all three until the surgery. Needless to say this is one he** of a disease that can be a fight for the rest of our lives for now.  Work hard to keep a positive attitude.

Good luck

Steve

Posted 11/3/2010 10:19 PM (GMT 0)
Thats funny that your GI put you back on Remicade after you had stopped taking it. It seems like its a known fact that you cant stop and start Remicade, so yes I am aware that once I'm on it, I'm on it. But I am very young and hopefully there will be a miracle med or a cure next time i switch meds
Posted 11/3/2010 11:34 PM (GMT 0)
I was on remicade and immuran, none of them worked for me, doc reckoned I developed antibodies towards them.
Posted 11/7/2010 4:35 AM (GMT 0)
Ahhh Remicade the miracle drug. And....the not so wonderful drug. I'm young like you, only 20 years old.

I was put on Remicade after I got fistualas and a massive abcsess while on 6MP. Worked great for me! I loved the drug! Healed me up very well. Lo and behold, 5 months later I am diagnosed with cancer. There's a major grey area with Remicade and cancer. Some doctors will tell you that Remicade actually causes cancer while others will just say you got the cancer because you were immuno-suppressant. Even though it might have caused my cancer, I desperately want to go back on Remicade due to severe complications of being off it.
Posted 11/7/2010 5:37 AM (GMT 0)
Oh, RiddleMe, how horrible!

May I ask what sort of cancer it is? How's your treatment going?
Posted 11/7/2010 5:53 AM (GMT 0)
Hi ivy6! Eh, everything happens for a reason! :) I think: keep your chin up, it could be worse!

It's thyroid cancer. In relation to other cancers, thyroid cancer isn't bad at all, but it still isn't fun at all. Treatment is actually very good in relations to the cancer! I underwent radioactive iodine back in June and the cancer has been cleared. It'll just be follow-up blood tests and ultrasounds for the next few years. In general, doctors say if the cancer hasn't come back in 5 years, you're relatively safe. Unfortunately, until that 5 year mark, I'm not allowed on any immuno-suppressants because of the risk of the cancer coming back. Because of going off the Remicade, my abcsess and fistuala and all the peri-anal goodness flared right up. Now I have an ileostomy. At the moment we're experimenting with different drugs, trying to find something to clear up the peri-anal area. So, at the moment everything with the cancer is great! But life is currently on hold because of the peri-anal part of the Crohn's.

Thank you for asking!! :)
Posted 11/7/2010 6:33 AM (GMT 0)

jeffb123 said...
Thats funny that your GI put you back on Remicade after you had stopped taking it. It seems like its a known fact that you cant stop and start Remicade, so yes I am aware that once I'm on it, I'm on it. But I am very young and hopefully there will be a miracle med or a cure next time i switch meds

Actually, it is not a fact at all. I was on remicade for 5 1/2 years at the max dose and frequency when I switched to cimzia because of antibody buildup. I tried cimzia for a whole year before my G.I. decided to let me go back on remicade. I have been back on it now for over a year with a lot better results than last time. I am still on the same dose(10 mg per every 4 weeks) but now I am premedicated I.V. with cortisteroids, benedryl, and zofran. There are some people that have tried to go back and had reactions but it is not a fact. More and more is being learned about remicade and more people like myself that have exhausted all other medicinal options are going back on remicade. Good luck with it and I think that you will probably end up like it even more than the methotrexate.
✚ New Topic ✚ Reply