Medication Advice | Arthritis Information

Hi everyone, I need some help here. I am scheduling an appt w/my rheumy for next month because I need a check up but I have some issues, as all of us do,and am confused in general.

I am not sure if my MTX is not working anymore. I take 25mg/week along w/1000 mg of Naproxsyn daily. I have notice definitely within the last 6 to 12 months that my joints have been pretty active. It was hard for me to concentrate on my other joints when my worst was my left knee. I have since had a synovectomy on my knee in June and while it is still not great, it is better than before the surgery. Anyway, I have noticed now how active my elbows, jaw, shoulder, fingers, and toes are. The flares come and go, but I seem to have constant stiffness in the morning in my elbows, knee, and toes.

The kicker about all of this is I haven't been the best patient. At least a year and half before now I have been on and off my MTX and Nap. I was good the first 5 months of this year and making sure to take my MTX and trying to take my Nap daily. I had to go off my meds after my surgery and started taking them again in mid June. I am confused and just don't know if all this activity is from going on/going off my medication or if it is because my MTX is not controlling the RA. I am trying to be as aggressive as I can and I have a new rheumy so I want to go into this appointment with my guns blazing offering suggestions of what should be done and using his medical advice to figure out the best route. And of course I want your advice too. How long does it usually take for MTX to build up in your system and show results? Have any of you found MTX pill to be less effective then the injections? For those of you whom MTX no longer worked, where did you go from there?

Really, any help is greatly appreciated. What I hate the most is that I have lived 23 yrs with this and it isn't until recently that I am trying to educate myself on it and take a more aggressive approach to the disease. So I really thank anyone for the information.

If I remember correctly, it can take up to 12 weeks for the full effect of methotrexate. I'd say you taking it faithfully for 5 months without success is proof enough it failed.

When methotrexate didn't work for me, I went directly to Enbrel. However, I don't think I'd go in your appointment with "guns blazing." Be honest about how you feel and about your symptoms and wait for your RD to suggest what he/she feels is best. If you don't agree, you can always question them about their recommendation and talk about your suggestion.

The MTX could be still building up from your surgery as it does take 10 to 15 weeks to be fully working. Many times MTX is not enough--its not the MTX is not working its that the disease needs additional DMARDs to slow the monster. I need three, including MTX at a very high dose.

Me, the injections do work better and its better for your stomach and liver.

Be honest and try to a good patient until your visit.Hi and welcome to the forum. I notice from your sig line that you're also on gold shots, MXT, Sulfasalazine. Any one of the three, or all three may have failed. Your doctor may take you off gold, Sulfa and start you on Enbrel or Humira, along with MXT. Like Bird said you may not have been back on MXT long enough this time for it to start working or it's failed. Gather your info, make a list of questions, if necessary take someone with you for the appt. Make sure you have labs and if you haven't had xrays then they should be ordered. Good luck. Lindyjust coming in to wish you a good appointment w/ RD... and say taht I think birdgirrl and LinB have said it for me too.

It took five months for the MTX to kick in, but even then it wasn't effective enough. I found the injections much more effective and I'm feeling close to normal. However, the increased benefits also mean increased side effects for me and that has become a big problem, so much so that I'm seriously considering AP therapy. However, not everyone has increased side effects from the injections. Some have fewer. I'd try that before giving up on MTX completely. Thank you all for the advice, I really do appreciate it. I apologize though if my sig line is confusing, I meant it to just be a list of medicines I have been on. I no longer take Gold shots because that failed and I had to go to MTX. I no longer take the sulfasalizine but I really appreciate the advice of using more than one DMARD w/MT to increase the control.

For any that have already answered and are on multiple DMARD's, please can you tell me which ones you take so I might find out more about them?I took MTX for I guess two years before adding HUmira. It got to a point where 25mg wasn't enough anymore and since they won't increase more than that I had to add Humira. It was the best decision we could have made and I've had great success.

Definately be faithful about taking your meds. MTX isn't the type pf med you can skip or take whem you want. You HAVE to take it on schedule every week. It's an absolute must.

Good Luck.

I take Plaquenil 200 mg. twice a day (the generic) and .6 injection of MTX weekly. And cc is right. You cannot be hit or miss about your meds, especially the MTX. You have to be consistent. Am on Sulfasalazin, MXT and Humira and I'm in clinical remission after 11 years of searching for the right combo of drugs. Lindy ccsmith82,

Personally, I've tried:

Plaquenil alone (failed)
Plaquenil and Relafen (failed)
Plaquenil, Relafen, and Sulfasalazine (failed)
Plaquenil, Relafen, and Methotrexate (failed)
Plaquenil, Relafen, Methotrexate, and Enbrel (WOW)
Plaquenil, Relafen, and Enbrel (Worked)
Plaquenil, Relafen when "achey", and Enbrel (Current working treatment)

Here's a link to the Arthritis Foundation information for drugs. You'll want to look at the Biologic Modifiers, DMARDS, analgesics, and corticosteroids. That should cover all the drugs.

http://www.arthritis.org/types-of-drugs.php

kweenb2008-08-20 10:44:39Good luck to you. Hope you get the help you need.

Good to hear from Germany!!!

Jan in CA