Date: 20.11.2012
From: Gillian
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Subject: DMARDS and Anti Inflammatory Medication
I have been on Sulfasalazine for just over a year now and every few months I had a depo steroid injection. This helped me but slowly I have got worse RA symptoms. The consultant has now added Methotrexate to the Sulfasalazine. I take Co-Codamol every day and Nortriptoline at night. I used to take Ibrufen when on just Sulfasalazine but my gp has said I am not to take Brufen now as I am on Methotrexate. I had to contact my gp today as I had a lot of pain. He again said no to Brufen but has given me Tramadol with paracetamol. My question is do any of you lovely people take anti-inflamatory tablets whilst on methotrexate. I am currently on 2 weekly blood tests. Thanks
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Date: 20.11.2012
From: Two hip replacement and still going!
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Subject: Re: DMARDS and Anti Inflammatory Medication
I take diclofenac three times a day and I'm on methotrexate. Before I was prescribed the diclofenac I used to take ibruprofen as my main painkiller.
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Date: 21.11.2012
From: Colin
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Subject: Re: DMARDS and Anti Inflammatory Medication
Hi Gillian think your GP & Consultant should be shot ( not realy ) , MTX is a good drug if you get on with it , 5mg folic acid six days a week should go with it & sorts most of the side effects no idea why they stopped your anti-inflamatory drugs , naproxen & diclofenac are better than Ibrufen & lot better than having to take steriods hope the MTX works soon , takes a bit of time to kick in
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Date: 21.11.2012
From: Gillian
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Subject: Re: DMARDS and Anti Inflammatory Medication
Thank you for your replies. I have to take Methotrexate 10mg on a Friday and on Saturday I have to take 5mg folic acid. just the one dose.
I took Tramadol last night and it did help but I felt very 'not with it' and I dreamt very vivid dreams.
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Date: 21.11.2012
From: Tony.
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Subject: Re: DMARDS and Anti Inflammatory Medication
Hi Jillian - I take MTX, and my consultant is insistant that I take naproxen along with it. He seemed unhappy that I said I feel that I don't need naproxen for its pain killing properties, and wants me to take it for its anti-inflamatory effects. Regards. Tony.
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Date: 21.11.2012
From: Gillian
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Subject: Re: DMARDS and Anti Inflammatory Medication
Isnt it strange the different opinion medical people have. The pharmacist said it was a big no to take anti-inflammatories. GP also said it was a big no. GP said I could have a slow release steroid injection but I refused as I only had one few weeks ago. I contacted the Clinical Nurse Specialist Rheumatology at my hospital and she said yes its fine to take brufen etc., as long as regular bloods are taken. Thank you for all your replies. Because I have been taking sulfasalazine for about a year now will the methotrexate kick in sooner?
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Date: 21.11.2012
From: Colin
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Subject: Re: DMARDS and Anti Inflammatory Medication
Hi Gillian
the national rheumatoid arthritis society has got a help line if you ever need it + loads of good information on thier website http://www.nras.org.uk/ 10mg Mtx is pretty low but they will increase it every few months as long as you get on it , up to 20mg or 25mg , some doctors start at 15mg but with 6 folic acid tabs a week dont understand why they dont want you on brufen , dont make sence at all
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Date: 21.11.2012
From: Gillian
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Subject: Re: DMARDS and Anti Inflammatory Medication
I went to the web site you suggested. Have added it to 'my favourites'. Thank you, its very interesting.
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Date: 22.11.2012
From: Paula-R
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Subject: Re: DMARDS and Anti Inflammatory Medication
Hi Gillian Have you been told that it is OK to split your MTX dose over two days? I have always been lead to believe that it needs to be taken the same day. I also took SLZ with it as well. I have just stopped taking SLZ because I am due to start Enbrel (tomorrow...gulp gulp). When I had MTX added and went to fetch the prescription from the chemist the computer flagged up that you shouldn't take anti inflammatories with MTX. I asked my nurse specialist and she said that the advantages of taking them both together out weighed the risks. I have been taking them together now for over two years and nothings happened to me yet. Paula
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Date: 22.11.2012
From: Gillian
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Subject: Re: DMARDS and Anti Inflammatory Medication
Hi Paula
I take 4 tablets in one go, on a Friday night. Then Saturday evening I take the folic acid. Over the two years did you have bloods done fortnightly or monthly. I have been on monthly whilst on just sulfasalazine but have been put back to fortnightly for a while to make sure I am not getting toxins. Did you get much relief or are you going onto Enbrel because sulfasalazine and methotrexate together did not help you? Hope tomorrow goes ok for you.
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Date: 23.11.2012
From: Paula-R
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Subject: Re: DMARDS and Anti Inflammatory Medication
Hello Gillian Bit of a long story here. I changed to 20mg injeted MTX about a year ago (RA wasn't too good at the time), along with taking my 6 SLZ a day. I felt the best I had felt for a long time. I changed to injecting MTX because you get all of the dose, when you take MTX orally you loose some of it while your body breaks it down, if it is injected the full dose goes into your system. This was a last ditch attempt to get my RA under control before anti tnf's were considered. My liver function (alt) rose up to the dizzy heights of 257 so I had to come off all drugs until it got back to normal. Thankfully this happened after two blood tests. I noticed that while I was off all drugs I was sleeping better, hadn't had a good nights sleep since being diagnosed. I then realised that it was the SLZ that was causing this. One of the side effects in sleep disturbance. Another long story here but eventually was told to take only 4 SLZ a day instead of 6. Didn't work so now I am starting enbrel. Nurse coming today at 10.30....very nervous about starting it but when she rang me yesterday she said she would stop with me, they are suppose to stop for 30 minutes to see if there is any reaction, but because her next appointment isn't until 12 noon she will stop longer that what they are suppose to. I normally take MTX on a Wednesday and I wanted more than one day in between taking it and Enbrel. I spoke to my RA nurse specialist last Tuesday afternoon and asked her if I could take my MTX late that evening so it would bring it a day earlier. She said it wasn't wise to do this because it would mean that I had only had a 6 day break from my last injection. She told me not to take Wednesday and take it on Monday instead, so that's what I am going to do. That is why I queried what you are doing, if you are taking your last dose Saturday evening and then starting to take you next lot the following Friday you are only having 6 days break inbetween. I have been told it is OK to split the dose on the day that you take it i.e. half of it in the morning and then half in the evening. I did start to have fortnightly blood test at first and then went on to monthly ones. I did start on 15mg and when it was increased to 20mg I had to have fortnightly ones at first again for a while. I have been told that now my bloods have been stable for a long time I am now on two monthly test. Don't know if I am happy about that with me just starting Enbrel. Paula
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Date: 23.11.2012
From: Tony.
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Subject: Re: DMARDS and Anti Inflammatory Medication
Just to add my twopennyworth here, I started on MTX (1.5mg) in September and have since been on weekly blood tests. The dose wase increased on 4 November to 2mg, and still weekly tests (all my tests have been clear). On Monday I saw my specialist who has changed the tests to every 12 weeks.
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Date: 23.11.2012
From: rhona
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Subject: Re: DMARDS and Anti Inflammatory Medication
Hi Tony, Is it perhaps 15mg and 20mg you are on, i have never heard of 1.5mg or 2mg of MTX. I am on 25mg and i get monthly checks. It would be interesting to see how often others are checked. 12 weeks seems a long time if you are on MTX. unless things have changed since i was told.
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Date: 23.11.2012
From: bsk
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Subject: Re: DMARDS and Anti Inflammatory Medication
I agree with Rhona. I think I had monthly checks. as for anti inflammatories, there are certain drugs you can't take them with,like some anti depressants etc. You need to be sure your consultant has the full list of meds as they sometimes don't know what you are on.
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Date: 23.11.2012
From: Paula-R
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Subject: Re: DMARDS and Anti Inflammatory Medication
Boots handle all of my repeat prescriptions, they do the ordering and collecting and I just pop into town to collect them. This saves me the hassle of having to order them myself, fetch the prescription and then take it to a chemist. I find it to be a good service. All of my drugs are in their computer so if there is a problem with any drugs not to be taken together the computer flags it up like I said in my earlier post. Nurse as been and I have injected my first dose of enbrel. No problems at all at the moment (touch wood. Didn't feel a thing.
Paula
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Date: 23.11.2012
From: Tony
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Subject: Re: DMARDS and Anti Inflammatory Medication
Hi Rhona - yes it's 15 and 20mg - sorry! Isn't it amazing how different each person's treatment is to the next? One would think that with a NATIONAL health service all this sort of thing would be uniform. Still I guess it's down to the individual doctor/patient combination, and how advanced the RA is.
I'm quite new to all this (as I reckon you have all guessed!), and have a lot to learn.
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Date: 23.11.2012
From: rhona
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Subject: Re: DMARDS and Anti Inflammatory Medication
That's not a problem Tony, we are all here to help each other if we can. I have found this site to be a great help to me. You are right about the different treatments we all have, it would make it much easier if the same treatment worked for everyone. I would just get them to confirm that it is 12 weeks for blood tests as i thought everyone got checked monthly. In fact i will start a new thread on this if you don't mind. Take care.
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Date: 23.11.2012
From: bsk
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Subject: Re: DMARDS and Anti Inflammatory Medication
Tony, you should have a Mtx book which the nurse should put all your blood results in. This is to take to gp or pharmacy or whoever. You can compare blood results from month to month.
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Date: 23.11.2012
From: Gillian
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Subject: Re: DMARDS and Anti Inflammatory Medication
Bsl, I wasnt given a booklet when consultant put me on methotrexate three weeks ago. Should I be asking at my gp surgery or perhaps ring Rheumatology to ask about one?
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Date: 23.11.2012
From: rhona
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Subject: Re: DMARDS and Anti Inflammatory Medication
Hi Gillian. I have a yellow card that i got from my rheumy nurse and when i get my blood done at the doctors i phone for my blood results a few days later and record them on my card. It has a bit for Hb, WCC, Platelets and ESR, i also take a urine sample each time i go to the surgery and that is noted.
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Date: 23.11.2012
From: bsk
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Subject: Re: DMARDS and Anti Inflammatory Medication
I think it might be different in Scotland as we have a booklet here Rhona. Gillian, you should have been allocated a specialist nurse when you were put on mtx and they issue the book and blood forms. I got about 3 month's worth of forms at my appt with her,all post dated, plus book plus info leaflet. Nurse got very grumpy about me asking for my results to put in my book but I used to have to take my blood results to the hospital pharmacy before they would issue the methotrexate.
I used to go for blood test and ring rheumy nurse the next day for results. You can get liver problems or low white blood count on mtx so it is vital they know. The booklet is useful as you can compare from one month to another and it also keeps the results all together.
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Date: 24.11.2012
From: Paula-R
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Subject: Re: DMARDS and Anti Inflammatory Medication
I think they go longer inbetween your blood tests if the have been stable over a set period of time. I was given a MTX booklet when I was first put on it, I take it every time I go and have a blood test done and the nurse puts the results in from the one before. I always keep my booklet in my handbag and when I go away on holiday so if anything happens there is a check list of my blood test, I am sure that I was told to do this. I was told that the pharmacist is suppose to ask to see this booklet when you pick up your MTX from the chemist to check that you are having your bloods checked because the drug is so toxic. I have only on one occasion been asked if I have had my bloods done and they did not want to see my booklet. Paula
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Date: 24.11.2012
From: bsk
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Subject: Re: DMARDS and Anti Inflammatory Medication
I got my Mtx from hospital and they wouldn't dispense without the booklet!
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Date: 24.11.2012
From: Trevor Engand
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Subject: Re: DMARDS and Anti Inflammatory Medication
I was prescribed Mtx with Diclofenac and blood tests weekly, then fortnightly and eventually monthly. They told me toavoid Ibuprofen too, something about liver function - it was 5 years ago so my memory has faded on it.My favourite Dmard was leflunomide - with Ibuprofen. good luck.
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Date: 30.01.2013
From: linda
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Subject: Re: DMARDS and Anti Inflammatory Medication
Is anybody know how soon MTX can kick in? I have been start my MTX with 10 mg since Aug. 2012 and increase to 15 mg from Oct. 2012 to now. I still have swelling knees. my new rheumy ask me to stop my MTX, he said MTX doesn't work for me. so please let me know from your experience with MTX. should I quit MTX? it's about six month now.
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Date: 30.01.2013
From: bsk
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Subject: Re: DMARDS and Anti Inflammatory Medication
Hi Linda, you might get more response if you start a new thread.
Mtx didn't work for me. It was good to quit as it meant I was closer to getting onto the anti tnfs. You have to have tried 2 dmards before you get moved onto the other drugs.
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Date: 30.01.2013
From: Colin
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Subject: Re: DMARDS and Anti Inflammatory Medication
hi Linda , been on MTX for years + sulfhasalazine which is not so good but we are all different , Mtx should kick-in within a few weeks would ask them to add another drug like sulfhasalazine so they can fast track you onto a anti-tnf drug .
btw what is your blood test showing for CRP & ESR & ask them to drain your knees & put steriod injection into them , works realy well sometimes
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