what was your first med? | Arthritis Information

I'm wondering how doctors determine which medication to try for newly diagnosed patients. My doctor has recommended plaquenil, which I'm getting a second opinion on. Is there a standard way to treat this? In other words: plaquenil first, then enbrel, then MTX? How does that work for the newly diagnosed? What was your first line of treatment and why did your doctor pick that specific medication as opposed to others? Thanks for any info. Love and gentle hugs, Juliah

The first medication I started on 11 years ago was sulfersalazine...and then added plaquenil as well. When I was first dignosed I was a complete mess...and I was on predisone for a while too. That seemed to get me on my feet faster than anything.

All these years later I'm on MTX and Humira...I think they just have to start somewhere; and they try the less powerful drugs first; just to see if they can get by with these.

Lovie38487.3862847222I was diagnosed with RA almost two years ago. It hit quickly and fiercly. I was started on Bextra first. This did nothing. Then he put me on Sulfasalazine, which helped for a couple of months only. I was having to boost this with doses of Prednisone, which works well, but the side effects are terrifying. He then prescribed Methotrexate once a week along with 4 Folic Acid daily, which helped for several months, then I was having to boost that with regular doses of Prednisone. The Prednisone helps a great deal, but drove my Chloresterol way up, as well as the fact that I could not sleep, stayed hungry, and put on a good deal of weight. I am now on Enbrel and 10 mg. Methotrexate. He is slowly taking me off Methotrexate and I am doing great with the Enbrel injections twice a week. Yours must be very aggresive, because my doctor explained to me that they like to start on the bottom end of the scale and work up the scale only when they see a particular medicine is not helping. Your doctor seems to be working toward not allowing joint damage to occur, which is good. All too many doctors wait until joint damage has occured to come in with the "Big Guns." Hang in there and read all you can about RA. EDUCATE yourself as much as you can.

I agree with Mtgirl's statement: All too many doctors wait until joint damage has occured to come in with the "Big Guns."

My first doctor prescribed Feldene for me and I was on that for two years, all the while, you could see my fingers were becoming distorted. Both the two doctors I've had since that one said it's too bad I wasn't on something stronger to help stop the progression earlier.

I was on Plaquenil at one point, but it made me ill so didn't stay on that too long. It does sound like your doctor is doing a good job of trying to stop the progression with prescribing Plaqenil, Enbrel and Methotrxate for you right off the bat. I wish mine had done that.

Sue

1.I started of on Celebrex and it didn't do a thing.

2.I then went onto Mobicox and that pretty much did nothing as well.

3.Next was Naproxen and losec and that seemed to be going well for a while.

4.Sulfasalzine was added.

5.Plaquenil added.

6.Mtx pill form and folic acid was added.

7.Prednisone was added.

8.Mtx injection form and prednisone removed and this was real great for a long time.

9.Started to get worse so Arava was introduced, but made me sick to my stomach so went off it.

10. Sulfasalazine removed, Enbrel added. We'll see what happens from here I guess...My blood work shows that my CRP is real low now (hopefully it stays like this for a few years

I think my doctor was good about my treatment. In the beginning stages, she started me off with less harsh drugs and as soon as she thought the disease was on a rise, she immediately started to prescribe aggressive drugs. This is good because I don't have too much joint damage because of her decisions.

This is the usually the order that drugs will be prescribed (but it would depend on everyone's individual cases):

Non-steriodal anti-inflammatory drugs (NSAIDs):
ie:Naproxen

Corticosteriods:
ie:Predisone

Disease Modifying Anti-Rheumatic drugs (DMARDs):
ie: Plaquenil, Sulfasalizine, mtx

Biologics:
ie: Enbrel

Hope that helped!

Jalebi38488.3369328704

I have had arthritis for 24yrs and nowdays I take Enbrel, Imuran, Celebrex and Prednisone. The very 1st med that worked for me was Methotrexate.

Barb

nOW beat THAT!!! i'M STILL deciding whether to complain about her or not.

Marie

I was started on prednisone before I got the RA diagnosis because my hands and fingers were very swollen. Once I got the diagnosis the rheumy put me on MTX,plaquenil and folic acid along with the prednisone. Developed an allergy to plaquenil and had to stop after 2 months. It was 15 months before I was put on a biologic because the other meds alone were not doing the job.

That's an interesting point. Do those with RA have a shorter life expectancy? And if so why?

I have never heard anyone say that we do and I've had it nearly my whole life. I'm 35 and was diagnosed when I was 3.

I can't remeber all the drugs I have taken excpet for a few. Gold shots for years when I was a kid. Still got a sore spot on each butt cheek but haven't had a shot since I was 12 or so. I was told that the Gold will show up in my lymph nodes when I have my first mamogram. The fun never ends!

Then it was all sorts of this and that: Penecillimine, Narprosyn, Daypro, MTX with folic acid, Arava, Enbrel, etc. Luckliy I have been on steroids just 6 times in my life and for a short period of time.

I've been happiest with Enbrel, Arava and Naprosyn. Hated MTX and the gold shots.