I was wondering how much time they give you on a drug, me MTX. to decide it isnt workign and will try another med? my rheumy told me she wants me on enbril but due to insunrance we have to start with mtx. I have had my ninth shot, and still on prednisone,unable to decrease it. i dont feel any better,than before i started.I have an appintmeent with her may 24th. i called and asked if i could increase the mtx, she said she wanted to see me beore she did that. I am on injections .4ml? = 10mg oral?
kel
depends on the medication. MTX takes 6-12 weeks to be effective but it needs to be at the correct dose. 10mg of MTX is really low, starting dose is 7.5 mg (.3ml). Most people with RA need at least 15mg (.6ml) for it to be effective.
I do believe in the effectiveness of the biologic meds but you should not be kept underdosed just to say you've failed MTX so that you can move on to them
MTX has been a great medication for me; but 10mg doesn't do anything. Like Buckeye mentioned it takes a higher dose to be very effective.
Why these doctors are letting folks suffer through and get strung out on predisone when they could increase that dose is beyond me!
You could likely put off being on Enbrel for another year if they'd adjust that dose.
These biologics are not magic like some seem to think. Don't skip over good medications in an effort to get on these medications. They'll be there when you need them.....but don't use them until you have to. Exhast the medications you are on before going that route.
My insurance required that I try MTX for 3 months first. It did help with swelling but not the pain so we added Enbrel.What amount did you get up to before you were prescribed Enbrel Bonny?
I think I got up to 17 or 17.5mg before I was prescribed Humira. Even after I started Humira we still tweeked both meds many times before finding a dose that was best.
It's so frustrating that's for sure!
Sounds like your RD is being conservative. You may have to insist on increasing the dose and adding Enbrel. A letter or call from your doctor to the ins. co. may prompt them to authorize Enbrel at this stage. Also, sounds like your Dr. should increase the MXT. I started on 12.5 and after 3 months went to 15 another month and then to 17.5 and that seems to be my magic dose at this stage along with the Remicade.
Be insistent that you want to start tapering off Pred. and you can only do that if the dmards and bios are working. I've tapered from 35mg. a year ago to 9mg presently and hoping to be at 7.5 mg in a couple of months. It's possible but then my RD plays around with my dosage until we have the right combos.
Good luck
THANKS GUYS. I WILL INSIST ON INCREASING MY DOSE OF MTX. ON MY NEXT APPOINTMENT. MAY 24TH.
KEL
I started on 7.5 MTX with the 10 mg. Prednisone. I didn't get relief until my MTX was pushed up to 20 mg. I'm still on the 10 Prednisone too, and I'd love to get off of that. I'm going to ask the rheumy about it on my next appt. However, even with these two meds at this dose I'm still red/puffy and definitely not myself when it comes to energy and being able to do things.
I wonder if the other drugs would bring a little more relief? Or also wonder what happens if I get to get off of the Prednisone? Hhhmmm .4ml of mtx is really low and conservative. I had to bump to .8 and add humira for any relief. I am going to be off the pred next month!!!!! Well, at least when I go in June 5th for a flare re-check I'm going to beg to get off of it!! LOL!
Wow. My RD initially prescribed Enbrel without mtx (or pred). After 2 months, at my prompting based on what I read here, he added mtx 7.5 mg oral. After a month of that, he upped it to 10 mg. A month later, he decided that wasn't working and has just switched me to Arava. Sounds like I never even got a real dose of mtx.
Next month, if there's no improvement on the Arava, he wants to switch the Enbrel (still at 50 mg/ml sure-click per week) to Rituxan. I'm beginning to think, from what I read here, that he isn't really giving these meds a real chance. I asked at my last appointment about upping the Enbrel, the mtx, or both, and he didn't want to do it. And he didn't want to try Humira next, saying if Enbrel didn't do it, Humira probably wouldn't either.
This all sucks!
that is a really low dose of MTX..
My insurance basically wanted me to stay on each med for 4 months to give it a real try.. plaquinel alone did nothing, MTX alone does nothing, MTX with Enbrel worked for about 3 months, then MTX and Humira worked for about 4 months then MTX and remicade seems to be the right combo.