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Methotrexate?? & Doctors visit

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Posted 2/8/2008 2:32 AM (GMT 0)
I went to the rheumy Tuesday, the appt went well, I took my list of questions and problems with me and discussed the possibility of adding methotrexate (again). Asked about my lower back pain, she said it could be degenerative or caused by lupus and if I went on Mtx it would help if it was caused by lupus and wouldn't if it was degenerative . I am on Imuran and plaquenil and was nervous about going on Mtx too. The last time she told me she would take me off Plaq, but it helps me so much I am scared to do that so she said I could take all three. I really hope I tolerate it well and it helps with the joint pain I have.

I have a rash on my leg that 's been there for about 7+ years (yes I know I should have had it checked a long time ago scool ) she wanted me to get it check by a dermy before starting the Mtx, because if the rash was Psorias the mtx would help that too. I went to the dermy today and she doesn't think it's psorias, she thinks it something else and did a biopsy to make sure, will hear back from that in about 1 1/2 weeks.

Phew...... all of that to ask some questions about Mtx. What is your dosage, how is it taken and how does it make you feel and how well does it work for your joint pain? Do you still have joint pain?

I am also trying to see if my insurance will cover it.

Thanks for listening.... hugs and love to all.
Posted 2/8/2008 2:57 AM (GMT 0)
Hey Stacie...

I was put on methx about three months after my diagnosis (I've been on it since October, 2007). I take 15 mg per week. At my last rheumy appointment (January), he told me that if I have a hard time getting off my prednisone, he can increase the methx dosage - that I'm not at full dosage yet. I'm currently taking prednisone (9 mg) a day, plaquenil (400 mg) a day, and the methx every week (in addition to various and asundry other drugs...lol).

I don't really have any side effects from it...other than maybe being a smidge more tired for about a day.

I definitely would not drop the plaquenil.

I've seen other people on here to take the Imuran. What is that?

~Kim
Posted 2/8/2008 10:40 PM (GMT 0)
Hi Kim, thank you for the information. I'm glad to hear you didn't have any side affects from Mtx. Imuran is a lot like Mtx, generic name: Azathioprine is classified as an immunosuppressant medication. Azathioprine is used to suppress the immune system in patients who have had kidney transplants. Although its exact mechanism of action in rheumatoid arthritis, lupus, etc is not known, its effect in suppressing the immune system appears to decrease the activity of this illness. It is also used in Crohn's disease, it controls my GI problems very well because lupus attacks my GI tract (intestines).
Posted 2/9/2008 12:31 AM (GMT 0)
Hi Stacie, I don't use it so I'm no help at all. I just rarely catch up with you any more so I just wanted to give ya a big (((((((((STACIE))))))))))))).
I hope you get to feeling better soon! Let us know about the biopsy!
love ya
carol
Posted 2/9/2008 4:46 AM (GMT 0)
Hi Stacie, I don't use it either but like Carol, wanted to say hi. I sure do hope it works for you! And I'll check in to find out how your biopsy goes. I know that must be scary.

(((Hugs))))

Pat
Posted 2/9/2008 3:05 PM (GMT 0)
Hi Stacie! I used to take mtx for about a year and a half. At first I tried the pill form but had to progress to the injections each week so it would hit my system faster. Also, the pill form was really upsetting my stomach. The injection form made me nauseated, too, and that, coupled with the Relafen, made me nauseated almost 24/7 so we just changed my meds a few weeks ago because I couldn't take it anymore. (This seems to happen to me often - I do well at first and then progressively I fall back.) The mtx really helped my energy level and, at first, my joint pain. We eventually had to keep increasing the dosage every six to eight weeks, though, as it progressively became ineffective for me. I did notice being rather tired and weak on the day I gave myself the injections, but, this wasn't too bad for me as time went on. I also kept taking my plaquenil and I still do so. I am not sure the how effective the plaquenil is but I have taken 400 mg each day for almost three years now.

As for insurance coverage, the mtx is an older drug (it is actually a chemo drug) and it is very inexpensive. I would assume your insurance would cover it but I am not an expert on this.

That said, I would think the mtx is certainly worth a try. Everyone reacts differently to meds and this, with your plaquenil, might be the perfect combination for you! I will keep you in my prayers!
Posted 2/9/2008 4:06 PM (GMT 0)
(((( Carol & Pat ))))) thank you for your hugs and support, it really means a lot. I'm not too worried about the skin biopsy, the doctor already has an idea of that it is, just trying to verify. I just want the spot to hurry up and heal, it hurts!!!! I will let you know about the results, should be another week.

Audrey Ann, thank you for sharing your experience with me. I have a sensitive GI tract (thanks to lupus) so I am hoping the Mtx won't upset it. I am use to the nausea I get that sometimes with the Imuran. We have been tossing this idea of Mtx for a while now, up until now I was nervous about taking Imuran, Plaq and Mtx, seemed like a lot of pretty stout medicine but if it will help this joint pain I am willing to try. Thank you again... hugs to you!
Posted 2/9/2008 4:16 PM (GMT 0)
Hi Stacie,

   I have taken MTX in the past but, not with other Immunosuppressive drugs. I hope this works well for you.

   Just wanted to let you know your in my thoughts and prayers. Keep us updated and take care.

                                        ((Hugs)) Babs

Posted 2/11/2008 11:24 PM (GMT 0)
Thank you Babs, I will let you guys know what happens.
Posted 2/12/2008 12:31 AM (GMT 0)
Stacie,

I was terrified to try mtx. I was started on enbrel for RA, and it took me almost a year to decide to add mtx. It was the best decision I've made yet. Mtx is a wonderful drug for me, anyway. I could honestly ditch the enbrel, if I had to, and just take mtx. My joint pain would come back full throttle, but the mtx would keep it under control. Enbrel seems to be the icing on the cake. I was started on 7.5 mg/week, but mtx didn't start making a difference until I reached 15 mg/week, which is what I take now. Don't think I need to increase it more, although I do know people who take 25 mg and 30 mg/week--it just depends on how your immune system reacts to it. I wouldn't hesitate to take 3 dmards. I'm also on plaquenil, and I 've been taking it with the enbrel and mtx. I've only started decreasing it gradually to see if I can eliminate it altogether. Rheumy said I certainly don't need to take the plaquenil if I'm taking enbrel and mtx, but it won't harm me either--it's up to me.

One thing, when I started taking the mtx, for a day or two after I would have a slight stomach upset. I usually resolved itself within 48 hours and after a few months, that side effect disappeared altogether for me. I also used to experience fatigue for a day or two after my weekly dose. Again, that doesn't seem to bother me anymore. My body is pretty used to it now. Other than those two things, I've had no problem with mtx at all. Just be sure to take your folic acid and go in for your regular bloodwork.

Best of luck to you,
El
Posted 2/13/2008 12:51 AM (GMT 0)
Thank you El, I am relieved to know someone else out there is taking 3 stout meds with no problems. My rheumy gave me the ok today to start Mtx, so I start Friday night. I am anxious to see if it works for my joint pain. She wants me to stay on plaq for now, until I finish my bottle. She wants me to try to come off it again, I am a little nervous about it because it helps my fatigue A LOT! The last time I tried to come off it, it threw me into a terrible flare. I will just have to see how my body reacts to all this medicine and talk it over with her in April. I have to do labs every 2 weeks for 6 weeks just like with Imuran and I am already on folic acid. Thank you again for sharing your experience.... glad to hear your med combo works so well for you... I am really hoping for some relief. Hugs to you!
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