I asked my RD for a stronger med (something more than Naproxen) at my last appointment and he recommended diclofenac (pain and inflammation) and plaquenil (to slow the RA's progression). I really wanted to try Enbrel, but he felt that the other two drugs were best. He also stated that metho would be a better option than Enbrel. I just don't understand why he would select metho. I have read about the side effects and they scare me more so than that of Enbrel. What do you guys think?
Well, so far I have taken the diclofenac and plaquenil for 2 weeks and the relief comes and goes. it is always worse at night and when I wake up. I will see my RD in a month so I am really praying that the meds work. I just refuse to try metho and he refused to allow me try Enbrel.
confused but hopeful..........Most doctors won't even prescribe a biologic without trying methotrexate
first. Some insurances require that step. Also, most people take both the
biologics (Enbrel, Humia, Remicade) with the methotrexate. Arava and
methotrexate are very similar. I have taken both. Arava freaked me out a
bit cause it gets into your liver salts. It takes 2 years to get out of your
system. Methotrexate took 3 months(I went off it to have my son).
They are scary sounding meds. but most people don't get the bigtime
side effects. They also take months to work.
Good luck to you. I know that all this is very overwhelming. I was
diagnosed at 19-that age where you know everything and are invincible.
I questioned everything that came out of my dr.'s mouth. I am not sure
how much she like it but I learned alot. Make sure you have a dr. that you
can talk to and bounce ideas off of.
Becky
I noticed you've only been on the Plaquenil for two weeks. When I started on the Plaquenil, it took about two months before I started noticing improvement.
I was just diagnosed this spring. My Rheumatologist put me on Mtx - the lowest dose he could - and I took it for about 2 or 3 weeks and I became so sick on it. I had massive stomach cramps, mouth sores (the folic acid he prescribed didn't help that), diarreah, etc. I was literally either on the toilet or rolled up in a ball in bed from stomach cramps, no appetite. Awful. I finally called his service on a Sunday afternoon, he called me back and told me not to take anymore mtx and keep my next appt. w/him. From there he put me on Enbrel and I've been pretty ok w/that. As I've said in previous posts, my fatigue is the thing that is getting me. I've also started having muscle pains which I thought might be due to excercising (very little bit of excercise cause I hate it!) but he said muscle pain is common in RA. Good luck to you and push for Enbrel.I have learnt over the past two years that the progression of the disease can be worse than the side effects of the drugs. I too posted that I was scared of mthx and know that some people can't tolerate it but there are lots who can and it certainly helps, it's usually in combination with something else, i.e. Plaquinel or something. It also definitely takes a few months to work before you see any relief. Also I always take the meds on a full stomach. Good luck
I have been on MTX for two weeks with no side effects (knock on wood.) My hands are definitely improved.
It is difficult to tell how much the MTX has worked on my feet. I also have OA in my feet so they hurt...most of the time. Plus I am having an issue with one knee and I am walking to compensate for the pain.
Most insurance companies require that you start on less expensive meds before they will pay for the biologics like enbrel, humira, remicade , etc. At least with me, the doctor started me on prednisone, added plaquanil, then MTX, and finally enbrel when all the others together didn't put me in remission. Some meds need to be taken along with MTX. You have to be patient because it can take months for some of the drugs to take effect.I was diagnosed last Dec. - started MTX in March - gradually increased the dose. Still wasn't getting anywhere. Added Arava a month ago, and I have to say (knock wood), I'm doing pretty well. The side effects are scary, but you should be closely monitored. They'll check your blood fairly often.My doctor had a bit of a different approach. She believes in very early and aggressive treatment and wanted me on a biologic drug asap. She started me on several pills after the first appt. But not Mtx - some of my liver tests weren't great, so she couldn't go that route. I can't remember which drug was first, but it didn't do much of anything. So she tried Plaquenil and Sulfasalazine, with daypro for the inflammation. The results were good, but not as good as she hoped.
So after only 4 months she had me on humira. I don't know what she said in her letter, but I had it within a week of her writing the insurance company for approval! God bless her! The sulfasalazine was dropped after I showed severe anemia. Doing fine 14 months later on Humira, Plaquenil and Daypro.
Good luck with finding the meds that work for you. We're all different, but I've found it so helpful to hear what combos others are taking.
I've been on MTX 6 years with very few side effects. I had some nausea in the beginning and fatigue around the time I take it. Twice they have taken me off of it because of my liver. But once they take you off, the liver returns to normal. That's why they do such close monitoring.
I would give the MTX a try because everyone is different. It does take awhile to work and the biologics work best with MTX added. MTX has been around for a long time now and has worked well for many people.
It might not work for you, that's true. But all of these medicines carry scary side effects. One just has to face up to that. Not getting treatment can be far more damaging.
MTX really has helped me.
Thanks again!
It took 3 months for me to see improvement with Plaquenil but it helped with the morning stiffness alot. I was started on MTX a month after the Plaq was begun and it took care of the rest of my problems after being on it for 2-3 months. I have some low level queasiness a day or two after I take it (I take 12.5mg) but that is it and that is WAY better than RA. I have never had mouth sores or hair loss. I tolerate it quite well. We are all very different and the only way you know how you will react to it is to try it. It is a very effective drug and has been around a long time...way longer than the biologics. That's my two cents. Good luck.