Prednisone & Methotrexate | Arthritis Information

 

Would appreciate hearing testimonies of those who have used methotrexate to help wean themselves from prednisone and was is successful in controlling the pain which was covered by prednisone.

I am down to 8 mg of prednisone and am in intense pain constantly. Rheumy wants to start the methotrexate to help control the pain.

It has side effects also but not as critical as prednisone.

Has anyone used plaquenil?

Do you all find that if you exert some then wham the pain is worse.

I decided to weed wack for 45 minutes- I have been paying for it for days now.

Karen,

I have been on pred for about 1 1/2 yr. started at 30, got down to 6.
am having a huge flare up sed rate 63, got it down to 23  3 months ago.

can just about walk, i am in deep trouble,

dr allways wanted me to do the methotrexate  so i went to him yesterday,  said to myself, i am going to do everything he tells me to do,.  He gave me a shot of the methotrexate, and uped my pred to 30 for 1 week, he said. just took the 30 this morning,  but I am so weak and achy, do not know if it is from the methotrexate or not , but i will wait it out  and do what he tells me to do

I do not know how you did the weed wack for 45 min, I can just about take a shower, this is getting scary.

Will keep you posted

Take care    Georgiana
Georgiana,

I sure hope the new prescription helps you. You have been in such pain for so long, it's not right. You probably don't want to be on prednisone much longer??? But if it helps the horrible pain, and the side effects aren't too bad.... do you get bad side effects from the prednisone? I had mild osteopenia before I had PMR, so know that the steroids didn't add much to the bone loss, and I was taking fosamax the whole time I was on prednisone.
Are you able to take fosamax or some other med for osteoporosis prevention? Hope to hear that you are doing better soon.

Reni
Hi Reni

You are so right, I do not want to be on the pred. much longer, and I hope this time I will start to feel better.  This is really taking a toll on me.  I do not have very bad side effects from the pred., a lot of sweating, and when I take a larger dose, my eyes feel dry and achy in the morning, then it seems to go away, of course who knows what it is doing to my bones.  Dr. is going to give me shots of Boniva, as I had trouble with the pills, so I think that is a good thing, to get the Boniva

Thanks for caring................Georgiana

My rhumy started me on Methotrexate about two weeks after I was on 20 mgs of prednisone and started taking less prednisone.  I have glaucoma and she didn't want me on prednisone for any length of time.  I started 20 mgs of predisone on Dec. 18.  She says it takes a while for the methotrexate to start working.  I think she said something like a couple months to be fully effective.

I am now on 2 mgs of prednisone and I have stiffness.  I mowed the yard the other night...and I suppose that made it worse.  I have to lift my legs into the car, whereas I didn't on a higher dosage of prednisone.   So maybe without the methotrexate, I would be in worse shape.   I will go down to 1 mg of prednisone next week for two weeks and then the first part of June go to the rhumy.

Last time she said then we would try to wean me off the methothrexate.  I don't know....I have a feeling things will not get better.  I know though I can live with how I feel now.  Not the best, but at least I won't be on the prednisone.   I felt so good on the 10 mgs of prednisone, wished it wasn't such a bad medicine.

I am tired when I get up in the morning.  Takes a lot to get started.  So I couldn't tell you if the methotrexate helps or not.  I think it might.   Mary

Hello All,
I started on 15mgm prednisone Dec 05 then methotrexate  10 or 20 mgm , I think, orally.  Then we upped the meth. to 30mgm. Then changed to methotrexate IMI. I am not sure of the time gaps, but I do remember rheum said that the meth. took about 6 weeks to kick in. He thought that perhaps i was not absorbing the meth  orally so that is why we changed to injection.

The methotrexate  30mgm has stayed constant for at least a year, then because I was getting so much fatigue and all my blood tests for anaemia , vit deficiencies were OK we lowered the meth. to 25mgm and I am still on this.
I am now down to 4mgm prednisilone, but there have been times when I was lowering the prednisilone had a bad week or 2 and we had to go back up for a while again. But have been slowly whittling away at it

Just because you go on methotrexate, it does not mean you then just come off prednisone. It is just hoped that your body can cope with less.  PMR still seems to run its course, but it is how much of these drugs we need to cope.

I have only had 2 alcohol drinks for 18mths. And I was a glass of red wine every night girl, and a beer on weekends.
It is really important to have monthly liver function tests while on meth. and I do not feel that you should stress your liver any more.

Side effects.......I thought increased fatigue. Nothing else.

 But today i am off to my GP as my husband feels I have sleep apnoea. I do have a deviated septum and have snored for many years, but did not want to do anything about it as i did not think it was a problem as my husband has been such a deep sleeper. My yoga teacher last night, felt that if I clear my breathing it may help me to heal my body. So lets hope another little thing can be fixed.

I live in Sydney, and have a lot of confidence in the decisions my rheum makes, and I feel he is up with latest treatments. He keeps very fit, so he has a great understanding of how PMR is knocking me about and how fit I was prior to this.

hope this gives you some hope Hugs to all  Zali  

Zali...My rhemy called and had me take another liver test just last Monday.  I haven't had a call about a change in medication yet though.

I don't know what they look for in the tests.   She said the enzymes were higher.  About three years ago, I had high alkaline phosphates and someplace I read that many who have PMR have higher APs.

How does one know when and if PMR has run its course?  Was the ache in my lower back which has been there for the last five or six years part of it...I wonder?     Mary

Starbright, I am guessing about it running its course, but know that just because you want to lower the prednisone , it can not necessarily happen if your pain and limitations increase. Most of the data about PMR says 2 yrs and as we read on this site, some a lot longer.

I thought, when I was first diagnosed....OK lets go about fixing this!   NO quick FIX!   For me,  I have found that it is about relieving the pain, doing what I can on the day to cope, using the advice of the rheum., using massage , acupuncture, and looking at other things that may be affecting my health.

Good luck, but I would be very surprised if your rheum said to decrease the prednisone when you have to lift your legs out of the car. Been there, done that. But not now.

Ask your rheum, what the blood test means and how it compares with previous tests also.     Hugs zali  Hi all

Had a shot of methotrexate at the dr's offica the other day, and I think it has made me more fatigued, I think Zali said that also, I really can not afford to be more fatigued, almost in bed all the time now, so this is no way to live.

Should i tell th dr. i do not want the methotrexate?  What would any of you do? I am on 30 of the pred. right now. Would appreciate some advise

Georgiana
Georgiana,

I really wish I knew what to tell you. When do you see your dr. again? If it's not for a while, I would certainly call and talk to him or his nurse, and mention the fatigue and being in bed almost all the time. It's awful when you just can't function, either because of the PMR or the meds or a combination. As Zali said a few posts earlier on this thread, the methotrexate takes a while to kick in. I seem to remember my rehumy telling me the plaquenil also took a couple months to kick in. I didn't thin it was doing a thing until I quit taking it, and then I started to hurt again. I guess it did help, but just a little. Not as much as I would have liked it to. Maybe methotrexate works better. My rheumy at that time didn't want me on methotrexate except as a last resort. Is the 30 mg of prednisone helping at all right now? Seems like it should, unless your sed rate is way up. Did you have that checked when you got your meth. shot; seems like you would have.

Keep us posted. Sure wish I was there to help you out.

Reni

I start on 1 mg of prednisone on Monday.  I can only keep my fingers crossed.   Maybe it is the Methotrexate that is keeping the pain away.  I went to the eye doctor and the pressure had raised to 22 in my left eye and was 14 in the right.  Usually both had been around 14.  I do have glaucoma and have had it now for about 20 years.

I can live with the way I am now...I just have to get off the prednisone because of my glaucoma.  I took a test from a traveling health group and it showed my pressure to be 17 and 14.  So maybe it is going down.  I have another appointment in July as a followup.

Probably, I will remain on the Methotrexate.  I suppose as long as my sed rate is high, she won't try to lower it.   I believe it to be high because I do have trouble lifting my legs into the car.  Yesterday, I fell out of the car, I had my left out and on the ground and then my right leg didn't lift high enough and I don't know what happened by I ended up in a heap on the ground.  I'll have to be more careful,  I could have really broke something with that incident.

Two years sounds like a long time, but I think I had it before last August.  Unless there are no lesser degrees to this condition.

Hugs to you all... Mary

Georgiana,

 I so feel for  you , sometimes this PMR just really gets to you. There have been many times when I just  cried. And just couldn't get off the floor,when I thought that maybe if I did a stretch or two, it might help.....  especially in the first year.
 I have been on the methotrexate for 15mths.
 PMR is 17mths since diagnosis.
The fatigue is a little worse in the 24hrs after meth.
The fatigue is worse when PMR is worse.
The fatigue is worse if i do not get a good night's sleep.
The fatigue is worse if i am up late.
The fatigue is worse if the pain is worse.

2 months ago I felt that I was improving and the only problem was the fatigue, so rheum lowered meth from 30mgm to 25mgm.

The fatigue improved prior to lowering the dose, when I had a holiday at my sisters, with no responsibility for meals, dogs, housework, my parents, my grandchildren.

For me , it is just the daily living that I used to do with my hands tied behind my back, that increases the fatigue with PMR.

It is a real cliche, but eat well and do not stress your liver with alcohol, while on meth.  I am feeling better, down to 4mgm prednisilone.    thinking of you Georgiana   love zali I am new to this forum and not sure how it works, but I have a question. I have had PMR/GCA for over three years now, and have been tapering down on the pred, from 60 mgs at the start to 8 mgs recently. Now at 7 mgs but feeling a little achy for the first time since I began tapering. So here's my question. Is there some achiness associated with the withdrawal of prednisone that has nothing to do with PMR?. That is, am I running into the PMR again at 7 mgs, or could it be that the PMR is gone and I am just experiencing withdrawal symptoms as I taper down?? My doctor isn't much help on this issue, and just responds to the clinical model, that is, if it hurts, go back up on the pred. Thanks! Hi Pmr Guy...congratulations on getting down to 8mg!  I started off at 30mg last Oct and, after a  long gradual process I finally made it to 5mg as of last week. I have not been pain free since I was at 12.5 but over time I do believe it is better.  I supplement with 200mg Motrin in the morning and in the evening.  Every time I drop to a lower dose there is increased achiness, stiffness, pain and fatigue...but I persevere because I truly want to get off this stuff.  Eventually things settle down to the regular levels of symptoms until the next decrease.  So...to answer your question, at least from my experience, I think it is a combination of withdrawal and lingering pmr.  As long as your sed rate is normal and there are no gca symptoms...and if you want to get off this med in a reasonable length of time...it may be worth it to just bite the bullet and endure the achiness for a while...BUT I would certainly go by whatever your dr thinks is prudent.  Good luck to you!
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