Re: methotrexate how long for effect?

[Guest guest]

, you may be weaning the prednisone too quickly. Reducing the amount of

prednisone, especially rapidly, can in itself cause pain. Is your physician

helping you taper your prednisone?

Are your hands and knees swollen?

Methotrexate has a onset of action of about 4 to 6 weeks.

http://www.hopkins-arthritis.som.jhmi.edu/rheumatoid/rheum_treat.html

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] methotrexate how long for effect?

> Hi I am 39, dx with RA 5 years ago. I did ok with nsaids and plaquenil

> for a while but had a very bad flare up this past december. My rheumy

> put me on oral methotrexate (now 15 mg) folic acid, prednisone and

> continued the plaquenil. I also continued relefan as needed, which is

> almost all the time. Initially I felt better after a few weeks but now

> my hands and knees are as bad as ever. I started to wean the prednisone

> last month.(now on 5 mg) I guess it was just the steroid that made me

> feel better. I have no side effects with the methotrexate but I don't

> think it is working and I want to get off the prednisone. I see my

> rhuemy thursday. Any advise or questions I should ask. Is it worth

> increasing mtx dose or should I ask about a different drug?

>

> Thanks

>

>

>

[Guest guest]

I've been on the methotrexate 4 mos now 2 months at 15 mg/week. I

took the prednisone down over a month. 7.5 then 6.25 then 5. I was

ok until I got to 5 every day. My dr wanted me to drop from 7.5 to

5 but I did taper it. When I started to taper I felt good but for

the past 10 days my hands and knees are killing me again. I would

just go back up but I'm seeing him thurs and I want him to see the

swelling. Has anyone found higher dose of methotrexate to be any

more effective or does it look like a new drug is in my near future?

>

> , you may be weaning the prednisone too quickly. Reducing the

amount of

> prednisone, especially rapidly, can in itself cause pain. Is your

physician

> helping you taper your prednisone?

>

> Are your hands and knees swollen?

>

> Methotrexate has a onset of action of about 4 to 6 weeks.

>

> http://www.hopkins-

arthritis.som.jhmi.edu/rheumatoid/rheum_treat.html

>

>

>

> Not an MD

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

>

> [ ] methotrexate how long for effect?

>

>

> > Hi I am 39, dx with RA 5 years ago. I did ok with nsaids and

plaquenil

> > for a while but had a very bad flare up this past december. My

rheumy

> > put me on oral methotrexate (now 15 mg) folic acid, prednisone

and

> > continued the plaquenil. I also continued relefan as needed,

which is

> > almost all the time. Initially I felt better after a few weeks

but now

> > my hands and knees are as bad as ever. I started to wean the

prednisone

> > last month.(now on 5 mg) I guess it was just the steroid that

made me

> > feel better. I have no side effects with the methotrexate but I

don't

> > think it is working and I want to get off the prednisone. I

see my

> > rhuemy thursday. Any advise or questions I should ask. Is it

worth

> > increasing mtx dose or should I ask about a different drug?

> >

> > Thanks

> >

> >

> >

>

[Guest guest]

Hi :

I am sorry that you are having trouble since

decreasing the Prednisone, it happens that way,

unfortunately. Prednisone is great, but you really

don't want to take it for too long, if we could take

it without all the side effects and risks, I would be

on it all the time because it takes the pain away so

well! Anyway, your doctor has a few of choices to

make (based on what I have gone through). He can

increase your Mtx doseage, add another medication on

top of the Mtx, change the Mtx to something else

pill-wise like Arava, or try you on a biologic like

Enbrel.

I did all of the above, and am now on Mtx witih Enbrel

and having good results. There might even be other

things that I am not aware of that he might try, and

perhaps others in the group will address those. I

wish you the best of luck on Thursday -

Kathe in CA

Kathe

" To ride a horse is to borrow freedom. "

__________________________________________________

[Guest guest]

Hi Kathe,

I haven't posted recently because I fell apart again, and then had

foreign guests arrive at the same time! But I've had a similar

problem. I'm now on my target dose of Mtx, and was weaning down off

the prednisone. When I dropped below 10 mg, I started feeling

worse. When I got to 8 mg (she's been having me go down by 1 mg per

week) I flared REALLY badly again. My doc has been away, but I

called her associate, who upped me to 20 mg of prednisone for 2

days, and then told me to stay at 10 mg per day until my doc gets

back and I see her the middle of next week.

Things got somewhat better after raising the prednisone back up, but

I've still needed pain meds almost round the clock, and even with

them I've been waking up in pain at night. I really don't think the

Mtx is working for me. Hopefully my doc will have some answers for

me next week.

On the good-news front, I brought the horses home Monday. Oliver

and the new guy (Dillon) are getting along great. A friend and I

took the two of them out for a trail ride yesterday for the first

time. Dillon acted like he'd been here all his life. He wanted to

lead, because Oliver believes in " moseying " on trail rides, and

Dillon clearly thought he walked MUCH too slowly. But once we let

Dillon go first, he was completely happy. He didn't even bat an eye

when we rode over the dam near our house with water rushing under

his feet. I think he's going to fit right in!

--- In , Kathe Sabetzadeh <lv2ryd@...>

wrote:

>

> Hi :

>

> I am sorry that you are having trouble since

> decreasing the Prednisone, it happens that way,

> unfortunately. Prednisone is great, but you really

> don't want to take it for too long, if we could take

> it without all the side effects and risks, I would be

> on it all the time because it takes the pain away so

> well! Anyway, your doctor has a few of choices to

> make (based on what I have gone through). He can

> increase your Mtx doseage, add another medication on

> top of the Mtx, change the Mtx to something else

> pill-wise like Arava, or try you on a biologic like

> Enbrel.

> I did all of the above, and am now on Mtx witih Enbrel

> and having good results. There might even be other

> things that I am not aware of that he might try, and

> perhaps others in the group will address those. I

> wish you the best of luck on Thursday -

>

> Kathe in CA

>

>

> Kathe

>

> " To ride a horse is to borrow freedom. "

>

>

>

> __________________________________________________

>

[Guest guest]

Hi :

Hi fellow horsey person! Sorry to hear that the Mtx

is not working for you. What doseage are you on?

Yea, it's hard to give up that Prednisone, because it

is such a good pain/inflammation med. But if you are

having to be on pain meds too, even with the Pred

increase, then you definately need to talk about

options to Mtx with your doctor. I think that

generally insurance companies want you to try most of

the less expensive meds like Mtx or Arava, before they

let you go biologic, but I hope that your doctor does

give thought to keeping the Mtx, but adding Enbrel.

That combo is working very well for me, and is holding

my RA really well. Some flares, but not everyday like

I was for a while. You know, there is always pain,

but pain I can live with, since beginning the Enbrel.

Still also take Ultracet, but actually that is turning

out to be more for the FM than the RA! but I guess it

helps with both really.

Yeah! Great to hear that you have your horses back

home with you, and that your new guy is doing so well.

I absolutely love having my guys at home where I can

keep an eye on them. I sold my little mustang/quarter

mix, Leo, whom I loved dearly, but it had gotten to

the point that he was now too much for me with the RA

and FM, so he was just sitting in his corral. He got

a wonderful home, a great new owner, and I cried my

head off. But I still have my good old boy, Shekar,

and I actually went for a ride on Sunday (after a

month off), and really, really enjoyed it. Nothing

too strenuous, just a trail ride, but did lope for

maybe 3 to 5 minutes! That's enough for me right

now!lol. I am definately just a moseyier, but Shekar,

although 20, has the heart and mind of a 10 year old,

and can be quite exciting at times - luckily he was

very good that day and took care of his momma.

I hope that your doctor visit goes well, and many more

rides are in your near future - wish we lived close so

we could ride together! Hang in there -

Kathe

Kathe

" To ride a horse is to borrow freedom. "

__________________________________________________

[Guest guest]

I'm on 15 mg of Mtx, so I know we COULD go up a little higher. But

considering that I'm getting little to no benefit from it now, I'm

not sure the side effects are worth it. I'm sure glad the doc is

back and I have an appointment next week!

I took Oliver out for a trail ride again yesterday. No one was

around to ride Dillon, so he stayed home. He called for Oliver as

we headed out the driveway, but didn't get overly upset about us

leaving. I've realized that riding actually hurts less than walking

(go figure) so as long as my hands are OK on any given day, riding

doesn't seem to be a problem.

Even though Oliver is VERY soft in the hand, when my hands are

really bad, even just holding the reins between my fingers hurts.

The OT suggested I get some fat rubber reins, and that has helped

somewhat, particularly in terms of keeping the reins from just

sliding through my hands. Dillon can be a little luggy, so I may

have to put something a little stronger in his mouth than the

eggbutt snaffle he currently wears, at least until he learns not to

lug down on my hands.

On the good news front, even though I had to take some Tramadol when

I went to bed, I didn't wake up in pain during the night, and even

though I'm stiff this morning, my hips are only mildly uncomfortable

rather than really painful. But why? I've been awake at night with

pain, and dragging myself out of bed every morning for 2 weeks, and

now, when I'm not doing anything different, today I feel better.

Who knows!<g> And, of course, today is Mtx day again, so tonight,

whether the RA is leaving me alone or not, I'll be sick from that

again! :-/

--- In , Kathe Sabetzadeh <lv2ryd@...>

wrote:

>

> Hi :

>

>

> Hi fellow horsey person! Sorry to hear that the Mtx

> is not working for you. What doseage are you on?

> Yea, it's hard to give up that Prednisone, because it

> is such a good pain/inflammation med. But if you are

> having to be on pain meds too, even with the Pred

> increase, then you definately need to talk about

> options to Mtx with your doctor. I think that

> generally insurance companies want you to try most of

> the less expensive meds like Mtx or Arava, before they

> let you go biologic, but I hope that your doctor does

> give thought to keeping the Mtx, but adding Enbrel.

> That combo is working very well for me, and is holding

> my RA really well. Some flares, but not everyday like

> I was for a while. You know, there is always pain,

> but pain I can live with, since beginning the Enbrel.

> Still also take Ultracet, but actually that is turning

> out to be more for the FM than the RA! but I guess it

> helps with both really.

>

> Yeah! Great to hear that you have your horses back

> home with you, and that your new guy is doing so well.

> I absolutely love having my guys at home where I can

> keep an eye on them. I sold my little mustang/quarter

> mix, Leo, whom I loved dearly, but it had gotten to

> the point that he was now too much for me with the RA

> and FM, so he was just sitting in his corral. He got

> a wonderful home, a great new owner, and I cried my

> head off. But I still have my good old boy, Shekar,

> and I actually went for a ride on Sunday (after a

> month off), and really, really enjoyed it. Nothing

> too strenuous, just a trail ride, but did lope for

> maybe 3 to 5 minutes! That's enough for me right

> now!lol. I am definately just a moseyier, but Shekar,

> although 20, has the heart and mind of a 10 year old,

> and can be quite exciting at times - luckily he was

> very good that day and took care of his momma.

>

> I hope that your doctor visit goes well, and many more

> rides are in your near future - wish we lived close so

> we could ride together! Hang in there -

>

> Kathe

>

>

>

> Kathe

>

> " To ride a horse is to borrow freedom. "

>

>

>

> __________________________________________________

>