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Currently on remicade now they want to add methotrexate

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Crohn's Disease
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Posted 5/12/2011 10:42 PM (GMT 0)
I was diagnosed with crohn's of the large and small bowels in april 2010. I have tried budesodine, prednosione, pentasa and am currently on remicade. I have been having joint pain since january. My gi sent me to a RA doctor who wants to start me on methotrexate on top of the remicade. My gi thinks this will be benifical for my intestines as well as I am now flaring and the crohn's has since moved to my rectum as well. I am scared to start this as I recently had a seton placed to help with a abscess/fissure/fistula (started as a fissure, thumbed into an abscess abd the stein made it a fistula). The surgeon says the problems are from inflammation due to crohn's more so then from infection. And thinks starting methotrexate would be fine. I an just scared cause I dont really know if there is active infection our not. Plus methotrexate and remicade together increase your chances for the really bad side effects of both.

Anyone been on these 2 drugs together?
Posted 5/13/2011 12:55 AM (GMT 0)
I've been on both since February with no problems. I may be experiencing a side effect from the Remicade and if I am it's something that started before I began the Methotrexate. I was also off of Remicade for a year and went back on it which has an increased risk of side effects.
Posted 5/13/2011 1:39 AM (GMT 0)
I have a open abscess wound, and I'm on prednisone, and humira and I started imuran two weeks ago.
There is no infection right now from abscess wound just inflammation and soreness because of the location and having to go to the bathroom all related to my crohn's.

I would treat the crohn's because that will help in the healing process of the abscess, I would trust the doctor.
Posted 5/13/2011 1:50 AM (GMT 0)
I was on MTX for 9 months (25 mg shot) once per week before I started Remicade. It acts like a barricade for the antibodies. One went with the other for me. Good luck to you, and I hope you have great success with Remicade.


Julia
Posted 5/13/2011 2:52 AM (GMT 0)
Can you use sulfasalazine w/Remicade? It might help the joints more. Also, I think I've read here that some people have joint pain as a side effect of the Remicade.
Posted 5/14/2011 5:57 PM (GMT 0)
I was on both for 8 years - no problems except tonsillitis 3/4 times a year and being in schools and universities I was in contact with lots of people and germs all the time so not too bad going really, wasn't ill any more often than any of my friends! The only thing I didn't like about the methotrexate was feeling nauseaus and spacey the following day but doing it at night helped that. I was on the methotrexate before for arthritis and crohns and then remicade was added into the mix for a boost. Apparently taking methotrexate with it slows the build up of antibodies to the remicade and reduces reactions and side-effetcs, meant that I had 8 years of almost complete remission (odd flare every 2-3 years that was shortlived) until I did eventually react.
Posted 5/14/2011 7:01 PM (GMT 0)
Doctors 'double-down' on these types of medications all the time, Ive been on methotrexate and humira at the same time and i'm starting cimzia in the next few weeks once this tuberculosis type infection is gone after this month long round of IV antiobiotics I have to give myself(then a year of by mouth). But I dont know per se if your getting more risk of infection, you already have a big risk with one. And alot of times using two helps quite a lot, I have to say that methotrexate is the single one drug that I have gotten the most benefit out of besides prednisone, and Ive tried remicade, 6mp, methotrexate, humira, imuran.

I dont think you really have anything to be scared of. I think its just your mind over thinking it. which a lot of people tend to do with these medications jsut because the side effects are TALKED about. well tylenol has tons of side effects, its just no one talks about them, if we did, lots of people would not want to take that.
Posted 5/22/2011 8:56 AM (GMT 0)
Thank you everyone. You have helped ease my mind. I will be starting MTX next few weeks. I hope it helps as I am having a flare up.
Posted 5/23/2011 1:26 AM (GMT 0)
@lilcrohnie - you're from the UK and you were on Remicade for 8 years?? That makes me mad. I'm sick of everybody else from the UK seemingly having no troubles with getting long term Rem/Humira, while all I get told by doctors is how expensive it is. (Yes, I know it's £1000 per infusion). Wish I was at the same hospitals as you folks, tbh.
Posted 5/23/2011 5:04 PM (GMT 0)
When I first got it they literally had just been given the budget for it, as I was one of the departments severest and most unresponsive cases (5ASA allergy, steroids don't work and actually make things worse for, 9 months treatment with immunosuppressants MTX, unsuitable candidate for surgery as disease to widespread) meant that I was literally amongst the first couple of patients to get it. The hospital I'm at also has currently only 8 patients on Humira. You have to tick a hell of a lot of boxes and your case has to be approved by a budget panel. When I got put on Humira, Remicade had caused me to stop breathing and I was in such a severe flare my organs were struggling and the attack on my joints was severely disabling me, they didn't have a choice but to get me on it as soon as possible - but even then I had to make it past the budget panel still. Its no easier at my hospital, they'll only put you on Remicade or Humira if there is literally nothing else that can be done for you.
Posted 5/24/2011 1:46 AM (GMT 0)
Which can I say is why I'm terrified when this new healthcare bill fully kicks in in the united states...I dont want a budget panel telling me what i can use
Posted 5/24/2011 3:06 AM (GMT 0)
Seriously, about the insurance thing. Not to change the subject of the thread but the insurance denied coverage stay because they said it wasn't medically necessary, even though I had surgery while there. And I only get 6 months of Humira at a time and then I have to get it reapproved.

To make this a relevant post buddyr503, did you make a decision?
Posted 5/24/2011 11:23 AM (GMT 0)
tsitodawg, I dont have private health insurance, which is really why I don't really get denied anything. Which is another problem actually with medicare and medicaid. The only thing Ive been denied is my oxycontin because they put me into that crap humana-walmart plan making you think your getting something cheaper when those drugs are mainly already on the 4 dollar list at walmart. The reason they denied it is because they have a 'evaluation' type of fee and the makers of oxycontin are not willing to pay for it so their medications have to be preapproved, humana actually told my doctor this, which is why in his qaurterly newletter he recommended people stay away from this plan but of course they stack me into it.

I get a letter saying I can stay in my current plan as long as i dont send them anything back, so i dont, then i get a letter saying they've put me into this humana walmart plan i was like what but i didnt send anything in?

Sorry Its off post.

Also when I had blue cross blue shield when most of my more severe stuff was going on I never was denied. even when remicade went from $2100 a infusion to $7600 in only 4 or 5 infusions times
Posted 5/24/2011 12:49 PM (GMT 0)
CrohnsPatient,

When you were on BCBS, what was your out of pocket for remicade? I'm still waiting on my first bill.
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