Dose of methotrexate given with Remicade

Been taking weekly injections of methotrexate for the past 4 weeks. I was having terrible osteoarthritis from the remicade. It’s really helped. Been taking 0.6 mg. This week i started with the swelling and arthritic joint pain at the fifth day. Is 0.6 a small dose? I’m not sure if i should just wait it out before complaining to the doctor .

Faith

Faith,

Previous steroid usage and immune diseases can impact cartilage repair and regrowth which directly correlates to osteoarthritis. Remicade CAN cause joint pain as a side effect. Methotrexate assists in the pain symptom relief/resolution by relieving inflammation markers thus causing less pain (among other things). So while Remicade may not have causation to your osteoarthritis it does correlate into your symptoms and pain. Simply put... Remicade has this far not been proven to CAUSE osteoarthritis but it can impact osteoarthritis joint pain you may be suffering from AND the way it impacts each person is different.

You also have the issue that you have developed antibodies to Remicade. When some people have that happen their joint pain can increase. My GI and rheumatologist have both stated that for some people if you lower the antibodies the joint pain will lower too.

It's the chicken and the egg theory.... It just keeps circling because for every person it can be different. Sigh.... I wish that for all people that it was A then B then C. Instead we have to search for our own resolutions sometimes. A "mean" or a "norm" can help guide decisions but it's not set in concrete.

Personally, I would call your GI and your rheumatologist to discuss the side effects you are currently experiencing and if you are able to change that dosage now or if you should wait. They know your medical history a little better and could help guide you.

It takes on average 12 weeks for it to build up in your system. My doctor's refused to do any increases until after the 12 weeks....the one time I wanted to increase it. But your doctor may decide that it's in your best interest to increase your dosage. My dosage, even when taking the shots, was always labeled as mg and I started high and tapered down so my experience in increasing dosages may not be pertinent nor helpful. My current dosage 15 mg delivered one time per week. It's been as high as 30 to 45 mg if I remember correctly. I don't know what measurement your . 06 is so I can't make a recommendation.

I'm a firm believer... If you are in pain you should contact your doctors and seek assistance.

Please let us know how it goes.

Clo

if Mtx is indeed helping things it proves this is not ostearthrtis. MTx cannot suddenly regenerate catrilage tissue overnight.

Clo, for your comment
"Remicade has this far not been proven to CAUSE osteoarthritis but it can impact osteoarthritis joint pain you may be suffering from AND the way it impacts each person is different."

id be very interested to read the peer viewed research papers and articles where you obtained this info....please provide links to such peer viewed research papers and articles

Faith,

Hang in there and listen to your doctors.

I am assuming you are in the U. S. That's where I am located. I can tell you that my rheumatologist, hand and knee surgeon all have indicated that it's in my best interest to continue with MTX for use in treating my Osteoarthritis. You may have a doctor with a different opinion or you may not respond as I do.... Nothing is guaranteed. I just hope that it helps you.

I did see my 3 doctors this week and all 3 of them were in agreement and they all stated that they believe MTX helps with OA inflammation thus lowering pain levels. There were studies quoted but I am going with my individual experience. You will want to research and decide on your own, along with your doctors.

I too experience difficulties right before my next dosage....

I'll be out if pocket for awhile... So I won't be responding on HW. I wish you the best of luck.

Clo

Immune-mediated arthritis is not the same as osteoarthritis, although you can conceivably have both at the same time.

Interestingly my dog is on a canine biologic for osteoarthritis (librela). My vague understanding of the mechanism is that it blocks the pain receptors without much altering the progression of the joint degeneration (except for allowing more normal biomechanics, so in that sense it may reduce wear and tear on other joints). It has been transformative for her quality of life and I dont know why there isn't an equivalent for humans (perhaps there is something in development?).

Faith,

Took my MX last night... Thought of you.

How's it going? Is it getting better? How bout with your infusion reactions? Have they improved?.

We are in the mountains. Last time I was up here my phone wouldn't work at all.... Imagine my surprise when it worked this time. Knock on wood it continues... Lol... So will check in on HW to see how you are doing.

Clo

Faith -- there's a manufacturing delay for methotrexate injection. Maybe check to see if you can take oral?
https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=912

Clo,
Just got a prior approval for the other pharmacy. So hopefully i get it this week . Seems the heat here is really bothering me this year. Have the AC down to 73.
Thursday infusion! Let you know. Thanks for the website.
Enjoy the cooler weather 😊

Faith