Re: Methotrexate - stopping

January 4, 2002

Many times people are weaned off of mtx because they aren't sure if the mtx is

effective, so they will decrease it and see if they feel any worse. So I guess

if the mtx is working, and it's discontinued, it may cause a flare.

I read Susie's question as to asking if it was similar to steroids or

antidepressants where they MUST be tapered or there could be serious problems

such as withdrawal.

I've looked for any sites that say there are any serious effects from stopping

mtx abruptly, but so far I come up with nothing. I'd like to know since I

abruptly stopped it once, and may do it again if my liver enzymes go up again.

a

[ ] Methotrexate - stopping

Hi everyone,I can only speak from what I have seen done up here. Three girls

have just started taking either Enbrel or Remicade along with Methotrexate and

they were told that if they do well on the new drug,they will start weaning them

off the Mtx. Because I can't take Mtx I asked the dr. if that meant I would not

get as good a result taking Enbrel alone. He said no that was not the case atall

and he repeated the same thing,that if the patients do well,their drs would try

to wean them of Mtx. Now you have me wondering. I had my 6th injection today

but I can't honestly say it is working fantastically. However,I will be patient

and see what happens when I see my rheumy in March.

Hugs

June

January 4, 2002

Here's an excerpt from a Healthtalk discussion:

" Audience:

I started taking methotrexate, and it did help a lot. A year ago I

started taking Enbrel. And that's been helping. You said that

methotrexate is taken in conjunction with Remicade and not with Enbrel.

I was wondering, now that I'm on Enbrel, should I stop the methotrexate,

or is it okay to continue both?

Dr. Markenson:

It appears as if Remicade, when it was tested, was found to be safer and

more efficacious when used with methotrexate, and as such it came out,

and that's the way we consider we should use it. When Enbrel was first

tested, it did not have to be used with methotrexate at all, and it

turns out to be a very effective therapy when used without methotrexate.

However, I have many patients who like yourself, have had rheumatoid

disease for many years, who are on methotrexate and not doing 100

percent and may need a little more. We've added Enbrel to their regimen,

and it's actually been gangbusters. We've found that the combination of

the two in that setting is actually synergistic.

I think what's reasonable is if you're feeling good, you should ask your

doctor to start to taper or maybe decrease the methotrexate slowly. You

know your disease better than we do. It should never be stopped

abruptly, but it might not be a bad idea if you're feeling good to ask

him to try to taper the methotrexate. There's no question that of the

two, methotrexate has the potential for more serious eventual side

effects than Enbrel does. "

Source:

http://www.healthtalk.com/rain/101001/09.html

I've read before that quitting MTX cold turkey can throw you into a

nasty flare which is what a reasoned.

[ ] Methotrexate - stopping

> Hi everyone,I can only speak from what I have seen done up here. Three

girls have just started taking either Enbrel or Remicade along with

Methotrexate and they were told that if they do well on the new

drug,they will start weaning them off the Mtx. Because I can't take Mtx

I asked the dr. if that meant I would not get as good a result taking

Enbrel alone. He said no that was not the case atall and he repeated the

same thing,that if the patients do well,their drs would try to wean them

of Mtx. Now you have me wondering. I had my 6th injection today but I

can't honestly say it is working fantastically. However,I will be

patient and see what happens when I see my rheumy in March.

>

> Hugs

> June

January 4, 2002

Good sleuthing . Here's another one:

http://www.acad-ophthal-int.org/VirtualMeeting/faqs.htm#8

Actually what I meant to say to June is when on several DMARDS and the doctor

wants to discontinue one of them, they usually will taper it to avoid a flare if

the med is working and the patient just doesn't realize it's working until it's

stopped. Hope I make sense. I'm flaring and taking more pain meds than normal,

and my brain and my fingers aren't in sync LOL!

We always hear of mtx being abruptly stopped for various side effects, but maybe

it depends on how high the dose and how long it's been taken. For someone not

on it a long time, maybe it's not a problem to abruptly quit. There really

isn't much written about it except the doctor's opinions that we found.