Subject: Sulfasalazine OR Methotrexate?

Hi all,

I've just been diagnosed with RA and have been given a choice (but not much info) of which drug I'd prefer to take! either Sulphasalazine or Methotrexate. My Rhuematologist is pushing more towards MTX but I just wondered if anyone has taken both/either? I've read quite a bit on here about MTX side effects/benefits but haven't found any for Sulpha...

Any info would be greatly appreciated... I'm waiting for an appt. to meet with my Rheumy Nurse which could take about a month so I've got until then to decide!

Cheers
Tra
:)

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi everyone,
I too have just been diagnosed with RA . I was also given the choice between the two drugs. I opted for the Sulfasalazine only really because of weighing up the potential side effects, even the rarest ones, one being lung problems. That kind of clinched it for me and probably very naive of me too. This is all very new to me. I tried to push the rheumy to make the decision for me but she was very keen that it was my choice. She said that they were both equally effective. I started the Sulfa tablets almost 3 weeks ago and will have increased the dose to up 3 x 500mg tomorrow. So far i have tolerated the meds very well. If anything and it's quite fleeting is feeling just a tad nauseous. Again not really anything to groan about is a slight headache. Neither symptoms are a problem to me at the moment and i believe these will fizzle out as i get used to the drug. I hope this will help you towards a decision though everyone can respond differently. Best wishes, Heidi

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Subject: Re: Sulfasalazine OR Methotrexate?

hi every one, ive had all that the mex and sulf and hydra, all i take now is the emblel, and pain killers when really needed, i sussed the nhs out, they try you on all the stanard drugs first, in stead of giveing you the ant tnf, thats cause is very exspensive, their not stupid, i had to suffer in angony for three years, before i got it, im alot better now on the embrel, i just dont think its fair people have to suffer like this, when it all comes down to money.christine

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi all, again

Thanks so much for your replies ... they're all very interesting, and varied - as are we!

So I suppose it comes down to personal choice, trial and error. I may do some more investigating into the anti-TNF drugs first.

I just found out that a colleague and friend of mine has tried both Sulph and Meth, struggled for years with side effects/no effects, ended up on Meth and Embrel which she's now been taken off of because they think the Embrel caused her to have a severe attack of Raynaurds over Christmas - she's now back on Meth but in injection form and thinks she's doing okay at the mo! touch wood.

Anyway I've got a few more weeks to decide... thanks again, it's been really helpful :)

Take care
Tra
:)

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Tracy! I think as others have said it's personal choice and both drugs effect everyone differently with both effectiveness and side effects. I was diagnosed early Aug last year and given 1st depot steroid injection, put on mtx 15mg. Had awful side effects from mtx so split it half weds, half sun then Only side effect was the tiredness. You have to bear in mind though it can take up to 6months to prove effective in some people so perseverence is the key. After 6months my pain had worsened, CRP & ESR had risen and had new places effected so was put on to injections and given my 3rd depot steroid injection. With the mtx injections, again Only side effects are tiredness. Unfortunately after six weeks pain was so bad I was on morphine CRP was 38.8 & ESR was 31 so now on course of steroids and increasing my mtx shots to 17.5mg for 4wks then up to 20mg will go back 4wks after that because He then wants to start me on an anti TNF aswell as mtx If things still not good but not sure If I can have them as in remission from a brain disease and he's not sure If they'll they'll flare it up. I think whatever road you take it's all trial, error and perseverence. I hope you can make a choice and things start to improve for you! Go well Tracy XXX

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi We r all different, I was on MTX, didnt seem to work, then put on sulpha, made me very unwell, on it 6 months, hospitalised yet again, and was taken off it, now on MTX along with Enbrel, works very well combined...I tend to agree with Louise, work up the ladder...good luck

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi, I think the best thing would be to try the sulphasalazine first and then progress to Methotrexate if need be as the sulpha is less toxic than methotrexate. I took Sulphasalazine for about 12 - 16 weeks and then had methotrexate added to it. I found the combination of both made a MASSIVE difference. I was literally crippled before taking them both and had to have regular steroid injections but its so much more manageable now. I take 4 sulphasalazine a day and 20mg of methotrexate a week. You need to ask the doctor about taking folic acid when on methotrexate as it reduces the side effects, I take 5mg folic acid a day for 6 days a week (not on the day I take methotrexate - as methotrexate is just once a week). I also take 25mg of amitriptyline to help with pain and insomnia. HANG IN THERE with any of these medicines as it does take about 12 weeks for the medication to work and the side effects will (usually) subside after about 12 - 16 weeks. I glad I stuck with it as at first I felt really sick and had headaches and lost weight as I couldnt eat but for me it did all subside but you have to stick at it for about 12 - 16 weeks - it seems like a long time but for me it was worth it as the results are good. Hope this helps. Obviously we're all different how we react to medication but hopefully you'll go on okay.

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Subject: Re: Sulfasalazine OR Methotrexate?

hi,

i was diagnosed with RA last october,was put on sulpha first as was told it has less side effects then mtx,was ok for the first month then started feeling really tired,had a rash on my arms but nothing serious and got told i would adjust to it, a week later i went yellow,had awful stomach pains,vomiting,and couldnt keep awake,was taken into hospital and told to stop the meds straight away,my liver is still abnormal and now cant take any meds until the blood tests show its normal again,the ALT was 9 times highter then it should be, i think its rare to get a reaction like that tho so please dont let it scare you, just wanted to share my experience with it.

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Subject: Re: Sulfasalazine OR Methotrexate?

Because jeff we have constant pain. In some cases have lost jobs homes relationships. Cant in some cases take care of ourselves people find it hard going to deal with these issues ona daily basis day inday out. We get comfort from each other and supporting one another......so if you dont have anything. SUPPORTIVE to contribute then please BUTT. OUT

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Subject: Re: Sulfasalazine OR Methotrexate?

"Because jeff we have constant pain."

All the more reason to look for something that works and won't damage your heart, kidneys, lungs etc. The info is all online. Just look. I'm not suggesting you all stop taking your medication this minute. All I'm saying is look for a safer alternative while you are on medication, and when you have found it, then stop taking the meds. For example magnesium is an effective arthritis painkiller, as is Rosehip--but not many doctors are aware of this. In fact Rosehip was studied scientifically for its pain relieving properties with RA patients. See:

http://news.bbc.co.uk/1/hi/health/6763017.stm

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Subject: Re: Sulfasalazine OR Methotrexate?

To be truthful, I haven't been diagnosed with arthritis yet. I say "yet" because I have to wait for the results of a blood test to confirm whether or not I have it. But I seem to have the symptoms of RA, although very minor. But my doctor is open to the idea that I do have arthritis, hence the blood test being arranged.

Once my arthritis is confirmed, I will refuse all drug related treatment for disease modification and pain control, as I've read about the horror stories involving the drugs for these. I will seek a cure using natural herbs and food supplements, and changing my diet. I have read (and am convinced) that both RA and osteoarthritis are curable. There are simply too many testimonies from people who have gone the non-drug route and reversed the illness for me to rationally dismiss these stories. You may say that I'm putting a lot of faith in this, and you are right. But I think most of you who are using drugs are similarly doing so based on faith.

I can understand why some of you are afraid to try non-drug treatments, as most of you have probably been on them a long time, and feel insecure about trying something new to you. I am not critical of you for taking this attitude. If I had been on drugs all that time I would be cautious as well. All I am saying is that the alternative route is not as crazy as most of you seem to think.

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Subject: Re: Sulfasalazine OR Methotrexate?

I agree that once the pain becomes intolerable you might be forced to take drugs. Though without coming off the drugs temporalily and trying a non-drug method you would not know if the non-drug method worked or not. If it did then that is good, if not then you could always go back on the drugs. All I'm saying is give it a try.

There is no proof that RA is not curable--they said that about scurvy too. If you do an internet search for "reverse rheumatoid arthritis" you will be amazed at the good news you will find.

Remember it is in the interests of the pharmecutical industry to convince you that there is no hope. That's how they frighten you into giving them business. See the following article about this. Please read it before responding to this post.

"Pharmaceutical fraud: How Big Pharma's marketing and profits come before consumer safety and wellness"

http://www.naturalnews.com/020345.html

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Subject: Re: Sulfasalazine OR Methotrexate?

I'm expecting real pain to come. I suppose we just have a different philosophy about the nature of illness and how to cure it.

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Subject: Re: Sulfasalazine OR Methotrexate?

Jeff,I was diagnosed with RA in 2008. The rhummy straight way wanted me to start on sulfasalizine and MTX, but I wouldn't even though I was in great pain, and could barely walk.
For the following 6 months I cleansed my body everyway I knew how. I researched natural medicines and herbs and had a strict regime of crystal form msm,magnesium, vit c, blackstrap mollases, cidervinegar, honey, meadow sweet tea,and used tumeric, and cinnimon in my food.
I also tried caledrex which was supposed to help RA.
As time went on my discomfort eased, and I thought I felt better in myself.Everyone that saw me said I looked well to, although every blood test I had which was fortnightly at the time because my esr and crp were so high, was climbing and climbing and no change I was still aneamic.
When my crp reached 82 and esr 103, I decided it was time to give in because I knew while they were so high my body was in distruct mode and I was not winning the fight internally anyway plus I still couldn't walk.
I started sulfa first, and nothing at all happened my esr and crp stayed sky high. After six months and no change, I was given mtx to take combined.
I decided that I would only take one lot, so weaned off sulfa and carried on with the mtx taking just six little tablets per week.
Within 3 months and no side effects,my esr and crp has dropped to near normal, I can walk much better and have no aneamia.The mtx had worked quickly and effectively.
My next step is to give my body time to settle more.I constantly monitor my ALT and ALK (liver function)and if there is the slightest raise above what it should be I lower my dosage of mtx and dont have any problems.
Once I have a full year of normal ESR and CRP tests I will stop the mtx, and go back to natural alternatives.
Looking back I think trying natural was a positive move, and taking the MTX was also a positive move.
So I do understand your philosophy as I have practiced what you are preaching so to speak.
I just hope first that you dont suffer like some on here or myself for that matter its not been an easy ride, and if it does come to it, I hope you remember to watch your blood because its the inflammation in my eyes thats the real danger whether taking meds or not.

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Subject: Re: Sulfasalazine OR Methotrexate?

- JEFF - Your views/opinions do matter - however - I pray to the good lord that you don't have RA - If you do - come back to this site in a years time and give us an update. For now, plz let us be. You, like most others who do not suffer do not & cannot for one second understand the constant pain both physically and mentally. I feel your optimism, but when you have tried so many different treatments for so many years without any real success - life does become truly difficult. We are not asking for sympathy or help - we just want to share our stories and take comfort in each other. I hope all who read this agree. Keep up the battle gang!

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi, i had to reduce my dose of sulphasalazine after it did the same to my bloods. the really annoying thing is that i was doing really well and starting to feel a real improvement in my symptoms when i was taking 6 a day but had to come off it for a week then go down to 4 tabs a day. i certainly wasnt feeling the affect of low white cells. i think that most of the drugs for RA do affect our blood or liver or kidneys to some degree but the regular blood tests are there to make sure it never gets too bad. ive been having weekly bloods for the last 12 weeks and its been a giant pain in the ar*e, but hopefully after tomorrow its going to be monthly. woohoo
good luck
nic x

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Subject: Re: Sulfasalazine OR Methotrexate?

Ive been on Sulfasalazine since about September and im not sure the dosage is right yet and doesnt help the specialist giving me cortezone injections that dont work.

My last appointment he did it again and didnt even consider putting my dosage up from 2 in the morn and 2 at night.

However the Dr had to put me on Tramadol which is I believe is one step away from Morphine & Naproxen and is doing wonders for the pain, however even after taking it for 2 weeks I missed a dose for 48 hrs and I had sever withdrawel symptons (wont be doing that again).

My concern is if I need to raise my sulfasalazine is that might have to reduce my Tramadol which will make me sick and unable to work.

The other side is the specialist keeps me on the same dosage and keeps me taking the tramadol which I dont think is the best option.

What are peoples views on dosage of sulfasalazine and is increasing a solution for "burning" wrists which the dr says is nerve related (hence the tram)

I didnt go for Methotrexate as wanted to drink, however a dr friend of mine says his brother is on methotrexate and drinks.

Is there a big difference in the 2? Is one better than the other.

I currently have blood tests ever month which is a pain but not convinced the drug is working unless its one of those to think how bad I would be without it.

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Subject: Re: Sulfasalazine OR Methotrexate?

I have been on sulfasalazine for 12 weeks just had another blood test and it shows stage 1-2 kidney disease.Im absolutely devastated.I dont know yet if med's caused it or i was going to get this anyway.Waiting for a phone call from my doctor as i write now

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Marlene,
Thanks for your reply.I can't believe this is happening.I have had pain in the right kidney area for a while been to hospital for ct, but they found nothing.I was still put on this medication.As far as i know my tests were fine 3 weeks ago,although not sure they done kidney function test.All i can do now is wait for my gp to phone today.Im told that wont be till around 1 oclock.It is awful,the waiting.My son knows something is wrong as well.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Patricia,
Thank you for support x

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi. I have been in sulphasalazine for 2 + yrs now. It has worked fine for me with just a few issues with my bloods to start with but this sorted it self out. I had no side effects worth mentioning so I was lucky.
Unfortunately they have now stopped working and I have been put on mtx.
I am a little worried about these tablets because of all the reported side effects in particular some sites have mentioned memory problems, speech problems, and infertility.
Does anyone have any experience they can share about these tablets, as I am seriously considering stopping them.
I should mention that although I tend to get all of the pains associated with RA I don't get a lot of swelling except in my hands occasionally, so luckily joint damage is not a big risk at the moment.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi, Ive been taking 20mg of methotrexate and 4 sulphasalazine a day for 2 years and have hardly any problems. It took about 4 months to get used to the medication as I felt really"off" for a while, sickly and headache etc but it is worth sticking with it - as I say it took 4 months roughly before it all worked and my body got used to it but I live a relatively normal life now.

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Subject: Re: Sulfasalazine OR Methotrexate?

hi, i started on sulfasalazine and it worked well for about 4 years then my knees got bad and i was put on methotrexate, i didn't feel any improvement with the added methotrexate after being on it six months i was in severe pain and then i was put on hydoxychloquine which really made a difference, i am still on all 3 medications and i have had R/A for over 10 years but i dont think the methotexate makes any difference, i am now in agony as i think they have all stopped working, i phoned the rheumy dept in tears as they said they can't give me an earlier appointment, i have had 3 steroid jags over the last two months and my feet are so sore i can barely walk, i also take 600mg lodine but it's not very helpful, i feel its unfair to wait another 2 months to see a consultant when i am in so much pain. Good luck to all of you suffering from this painful disease.

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Subject: Re: Sulfasalazine OR Methotrexate?

Thanks for your reply, i went into the hospital on friday and was given an all over steroid injection and was told it would keep me going for 2 months until my appointment in December but i really don't feel any benefit from it. I don't know whether to phone again and ask for another injection.

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Subject: Re: Sulfasalazine OR Methotrexate?

Addendum, I was born in the UK but live in California, US I came here for my health. I was in a wheel chair I no longer am, unless there is a lot of walking (over 1 mile)

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Subject: Re: Sulfasalazine OR Methotrexate?

What a stupid comment to make.

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Subject: Re: Sulfasalazine OR Methotrexate?

I've been prescribed lefludomide, which was horrible. It didn't do me any good at all, and caused loss of feeling in fingers, drowsiness, balance problems and a dull pain in the right kidney area. Ultimately, I changed to MTX which was even worse. Add to the above an intense need to scratch an itch, to the point where I bled badly and obviously ran the risk of serious infection. Against medical advice, I stopped taking it (17.5mg once a week). The itching eased off, but didn't disappear altogether.
Next week, I go to see about starting on sulfa, which I will try for 6 months or so to see how it goes.

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Subject: Re: Sulfasalazine OR Methotrexate?

Ok please do not listen to Jeff ..belter .. But obviously just not experienced the real pain of this condition and doesn't know any better,I still get people saying to me have you tried cod liver oil lol
I've been on sulphersalazine for 15 years now has worked great,came off due to stomache props .. Absolutely crippled now never had it in my knees and feet before do now! I so regret not pushing my reumy to get me on something else straight away demards are a lifeline lots of studies have shown the sooner you start the better they work ,unfortunately they are often only used after a year or 2 of pain

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Subject: Re: Sulfasalazine OR Methotrexate?

This thread is over 4 years old! You might be better starting a new one.

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Subject: Re: Sulfasalazine OR Methotrexate?

Its good to carry on with old threads as it will help someone with people's comments over the past years and give better understanding how everyone is coping.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi everyone,

I've just removed some comments as they are getting personal and it's going to put people off using this forum if they think they may get unkind comments coming back.

Sorry if it seems heavy handed but this forum is meant to be a supportive and nice place to be!

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Subject: Methotrexate side effects

I was put on methotrexate in january 2015 and build my dose up weekly to six x 2.5md tabs.
In february I started to feel ill, extremely tired, fluish, nausea and vomiting and loss of appetite. My dr has stopped the methotrexate as my liver readings were extremely high. I havent taken any now for 3 weeks but still feel really ill. Is this normal?
When should I expect to feel better?

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Melissa

I am fairly well read on arthritis flare triggers - and immediately thought of the obvious hormonal link from your post.

There is a lot out there with research backing it up - so am surprised you doc says don't know.

The hormone Progesterone - falls a lot at the beginning of a menstrual cycle. I was aware from previous reading that low progesterone causes a lower regulatory immune response.

So when there is more progesterone we get a more regulated immune response to environmental triggers - see these links they explain it well

http://www.nature.com/nrrheum/journal/v10/n12/fig_tab/nrrheum.2014.144_F2.html

http://www.nature.com/nrrheum/journal/v10/n12/full/nrrheum.2014.144.html

http://www.womensinternational.com/connections/inflammation.html

The article above says - "too many carbohydrates causes overproduction of two hormones: pro-inflammatory eicosanoids and insulin. High levels of these hormones then cause the body to produce more cortisol (the stress hormone), which furthers inflammation."

http://www.purdue.edu/newsroom/releases/2013/Q3/researcher-finds-way-to-convert-blood-cells-into-autoimmune-disease-treatment.html

Above link is the article that originally sparked my interest!

Here is an excellent forum where they are discussing your issue in more detail - Danger, some doctors do not know the full effects of hormone replacement therapies - as this thread explains the body can convert some hormones in to bad stuff when other factors are out of whack .

http://www.raypeatforum.com/forum/viewtopic.php?t=826

Interesting about your earlier diagnosis too - as I am quite sure from the recent research that osteoarthritis (especially in younger people) will prove to be inflammatory - like RA but less detectable. In this article is compares Osteoarthritis with Alzheimer's - both being continuous low grade inflammation.

http://med.stanford.edu/news/all-news/2011/11/osteoarthritis-results-from-inflammatory-process-not-just-wear-and-tear-study-suggests.html

So the way I see it is that Huntington's Disease is to Alzheimer's - as RA is to Osteoarthritis.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Paul, If you find taking the 6 sulphasalazine don't make any difference after another wee while I would consider taking something else to help. I also take sulphasalazine and have done so for around 15 years now. I also take Plaquenil (hydroxychloroquine) and it is meant to be one of the safer drugs. You could ask to try them if you are not keen on the methotrexate. I also believe stress does play a part in the symtoms, hard to avoid stress but sometimes the joints can settle down a bit when things are more relaxed.
Hope you feel better soon.

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Subject: Re: Sulfasalazine OR Methotrexate?

That's great, Paul, 3 weeks isn't a long time. I had a fall back in February and broke my femur so they gave me a half hip replacement, I'm 61 and I'm just getting back to normal. I think I would have been better getting a full hip replacement as I was left with a difference in leg length but as it happened in Dubai I had no choice in the matter.

Sometimes a support on the knee can help or even an ice bag to reduce the swelling.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Fraser, It might be an idea to reduce the sulpha. to 3 again for a week or so and see if the itch settles any. I would also look to see if the sulpha. and the other meds you are on are suitable together, although I guess this has been checked out. If this doesn't help I would speak to the rheumy team about this. Good luck

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi, I am 41 and was diagnosed 4 years ago. I'm really nervous about medications and have been on plaquenil for the past 4 years. My left elbow has now "locked" and will not straighten. I think I have been trying to "hide" my pain but somedays I can barely wash my hair (right shoulder). I am a dental hygienist and have cut back to only one day of hygiene per week and am now doing reception the rest (major pay deduction...) Yesterday i had a cortisone injection in my elbow after being on prednisone for 2 weeks. Not sure what to do next......suggestion from my rheumatologist is methotrexate or sulfasalazine. I feel lost. She brought up lymphoma as side effects of both medications and said we RA people are more susceptible to it also even without medication. I am really happy to have found this forum. Any advice would be great.

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Subject: Re: Sulfasalazine OR Methotrexate?

Thanks Lucy. I know I need to do something. I am just super scared. I really appreciate you responding to my message. She has given me a week to decide. Some days I feel like I am ok. Then I get a flare up. Today I feel pretty good, so it makes me take a step back and say, "maybe I don't need these harsh drugs yet". So frustrating. The biologics like Humera and Remicade are not covered medications in Canada. They only start with Sulphasalazine and methotrexate. I am already on plaquenil. I am seeing a naturopath in March.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Lucy. I was on prenisone for 2 weeks to try to get my elbow back to normal and I felt great! Then I just had cortisone on my elbow and it is straight again and I still feel good! I am sleeping and I have zero pain right now. Could the elbow be just a gym injury (it really flared up after i was doing lots of weights) and maybe is better now. I am bucking the medication as much as I can, so you can see. Again, I feel good right now - maybe the prednisone cleared up some inflammation and is staying in my system? I am happy to hear you are doing well on your medication. What is your biggest side effect, if any?

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Subject: Re: Sulfasalazine OR Methotrexate?

I was diagnosed with RA four months ago and been on sulfasalazine for three months with no side effects. My CRP has always been less than one prior to diagnosis and now and luckily i've not had too much pain at all. That was until this weekend when I guess I had my first bad flare up, burning pain in many joints for about two hours at night and increased stiffness the next day but OK now. Do you think the sulfasalazinr isn't working or should I give it longer? Any thoughts? Not due to go back to rheumy nurse for 5weeks. Thanks sara

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Subject: Re: Sulfasalazine OR Methotrexate?

Thanks Lucy, what else do you take? I think the flarecup scaredvme and madevme realise I have been quite lucky so far.how do they decide if it's not working enough?

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Subject: Re: Sulfasalazine OR Methotrexate?

I have been taking MTX for a year or so but have not coped well with side affects so will be trying sulf hopefully in the next few weeks after my next hospital appt. Can anybody on Sulf confirm if the monthly blood tests are still needed (for liver function etc). I have a bit of a phobia when it comes to injections so wonder if there is any other way to check liver function other than by taking blood?

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Subject: Re: Sulfasalazine OR Methotrexate?

Thanks. Yes, every month it is a nightmare which is made worse by the fact that my local surgery always seems to be running late by half an hour or more, which gives me more time to think about what is about to happen. Of course the more tense you are the more difficult it is to draw blood which makes for a more painful and drawn out experience, only making my next visit even more dreaded (and so on)... I thought that after a few visits that my phobia would subside but if anything it has only gotten worse.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Shaelyn, I get a lot of cracking and creaking in my joints. I try to eat healthily if I can and have started taking milled flax seed on my cereal each day and trying tumeric/curcumin capsules.both are meant to be anti inflammatory.

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Subject: Re: Sulfasalazine OR Methotrexate?

I still have not taken my sulf or meth as i have not decided yet.

Sara, My right shoulder is cracking almost at every move and the pain wakes me up at night...i sound crazy but does this mean i need to start taking something soon? :( I am terrified. The lymphoma side effect is scaring the pants off me. Does anyone have jaw arthritis?

Wayne, that is so hard if you have anxiety for needles. I don't like them but I can tolerate. Weekly though, I am not so sure. I am a hygienist and see people very nervous daily for needles. Some will take ativan....however to have to take "another" medication as often as getting the blood work would be hard too. I take it before flying and it helps lots with no side effects for me.

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Subject: Re: Sulfasalazine OR Methotrexate?

Has anyone tried medicinal marajuana? it is not legal where i live for everyone and meeds a prescription. many doctors do not prescribe it. My issue is I can't sleep at night due to my shoulders aching in the night. ?? I'm starting to think I need to start some methotrexate....

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi David, you are doing the correct thing always let your rheumy nurse know if you feel things are not right with your meds. Only you know how you feel and your nurse will confirm if your meds need changing.
Tiredness is all part and parcel of this disease unfortunately. Do you have any pain medication?

I hope you get some answers soon. Good luck with it all.

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Subject: Re: Sulfasalazine OR Methotrexate?

I've been on sulphasalazine for 13 years. I'm on 4 a day plus Naproxen if needed. I've gone from being almost crippled with pain to leading an almost normal life. My knee joints are the worst and hurt all the time and my feet have given me problems so have had insoles made to support my feet and ankles. But I've not had a flare up for 10 years. I know my limits regarding exersice. I walk my 2 dogs daily and go to Zumba class once a week. I have a pretty active job but I do have understanding and supportive colleagues who help me out when I'm having a bad day. I would love to be totally pain free but I don't think that will ever happen. But while I can use it I will!!

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Robert, sorry to hear you have had to stop your meds. I take Sulfasalazine and I have no side effects so far. I take 3x500mg twice a day.

Try some heat pads or a good old fashioned hot water bottle on that neck.

I hope you can either be back on your meds or something different very soon and you can resume your Rugby again pain free.

Good luck with it all. Please come back and let us know how you are doing. xx

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Subject: Re: Sulfasalazine OR Methotrexate?

Am 52, just been diagnosed with Psoriatic Arthritis. Negligible psoriasis through life and few sore toes and a sore finger. Told to take Sulfasalazine by Rheumy. Terrified of the idea of the expected side effects which feel totally out of proportions to symptoms and going straight from full health and no contact to medics to pill dependency and regular blood tests. Hate the idea of reducing my body's immunity and this orange urine business is just plain disgusting. Oh and I like the sun. Can't take Mtx as like the odd glass of wine. Very depressing, feels like a life sentence.

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Subject: Re: Sulfasalazine OR Methotrexate?

Thanks Lucy getting to me is precisely what is happening. Not sleeping been off work on counselling and thinking of not taking the pills. This orange thing is a big thing disgusting and filthy. Incidentally do you have to have urine tests as well
or something?

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Subject: Re: Sulfasalazine OR Methotrexate?

Thanks Lucy I don't think that there is much choice only alternative is mtx which can't do as I drink. Whilst not adverse to giving up now is not the time in fact am drinking like a fish with stress. Have heard orange colouring can wreck clothing do you get that? Guess what having yet another sleep free night another day off work coming up.

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Subject: Re: Sulfasalazine OR Methotrexate?

Plaquenil (hydroxychloroquine) is meant to be one of the safer drugs with less side effects so you could ask for that. It is quite scary having to take drugs but I find the alternative is worse and there are side effects with every drug even the ones you buy over the counter but it doesn't mean that you will necessarily get them. I've never had a problem the sulpha staining my clothes. The alcohol can cause side effects too, Ian, so I try not to worry too much about it all. I know it isn't a nice thought taking drugs and having a disease but life can be a bitch at times, but we have to try and cope the best we can and make the most of it. Good luck with whatever you decide.

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Subject: Re: Sulfasalazine OR Methotrexate?

I was diagnosed with psoriatic arthritis about a year ago. I am taking sulfasalazine at the moment but have a review next month to discuss changing to methotrexate as they don't think the sulfa is working. At first it was just in my fingers but now affects both my wrists. I couldn't drive this morning as the pain was so bad. Not sure what to do about the possible change in meds as I really don't want to go on methotrexate - not sure I have much choice however as the pain gets so bad.

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Subject: Re: Sulfasalazine OR Methotrexate?

It's a bit horses for courses, Ian. I've been through a whole load of drugs which either didn't work or gave me unacceptable side effects. Other people do really well. It's very hard to make a decision about which one to take and I've been reluctant to start some of them.

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Subject: Re: Sulfasalazine OR Methotrexate?

I've been taking incapsulated a variety of 30 different fruits, vegetables and berries for the past 8 months and my arthritis is hardly an issue anymore. This is because of all the nutrients and berries reduce inflammation. Hope this helps everyone.

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Subject: Re: Sulfasalazine OR Methotrexate?

Yes, please share your info Adam, I am very interested in using diet to help reduce inflammation and would value some advice. I would also be interested to know if you have any dietary foods/drinks that trigger your arthritis.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hey Jeff, if it was as easy as taking magnesium or rose hips to cure rheumatoid arthritis! I've tried every healthy alternative before I had to give up and go for the pharmaceuticals. I don't like the big Pharma companies any more than you do. But, pain and continued joint inflammation have made me try the Humira and methotrexate. I have too much to do to end up crippled or in a wheel chair.

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Subject: Re: Sulfasalazine OR Methotrexate?

Back again :-)

Well the good news is my WBC is up to normal levels again, so apparently it had something to do with the drugs.

The bad news is the doc doesn't want me to go back on Sulfasalazine. They want me to try something new out. What that is I do not know yet.

I'm just hoping for something good and that it comes quick :-(

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Subject: Embrel and the right drug for you

I agree that the anti TNF is probably the treatment that has the strongest success. I agree that we seem to have to jump through hoops before we are prescribed it and try all the cheaper ones first. My own experiences over many years has shown that everyone is so different that every patient needs to be looked at individually and checked out thoroughly for everything that might cause complications in your disease. I think you go through different mindsets depending on how long you have had to live with RA. At the beginning, with a little bit of denial, I was happy to try the least toxic drug and persuaded myself I was ok with it because I was terrified of the others. Sulfasalazine was my drug for a year. It affected my liver then and I had to switch to Methotrexate. My liver quickly returned to normal after I stopped Sulfasalasine. I found myself a consultant on the NHS who I have a bit of confidence in and a super support nurse. I was unable to tolerate Methotrexate tablets but the injections were absolutely fine. They did me for another couple of years and then all of a sudden, it was like the script changed overnight in my consultant's office. I had accepted the bad days and the tiredness as a necessary part of the OK days on Meth, then suddenly I was told that I could not tolerate it any more. It was not working well enough for me and I qualified for anti TNF drugs! It was like winng a trophy to the 'people who will feel the best club!' I tried Humira first and it was good for the RA but changed my immune system too much so that I had strange skin and blood vessel problems and an instant lung infection. I tried Embrel and BINGO, it works well for me. I've been on it for 2 years. Lately however, I have had some problems: lung infections, vocal chord cyst that has to be operated on, bronchioectsasis and an MRI scan has shown some inflammation in my sigmoid colon. My bloods are good. I can do more than before and my stamina is much better. We have a huge garden and land so I have to be active. I would be interested to hear from anyone with similar experiences or any helpful advice? So far Embrel has had the best control of the RA, but I do not know whether the other problems would have occurred anyway or whether the Embrel has caused them?

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Subject: Re: Sulfasalazine OR Methotrexate?

I have AS EMBREL only work advise from
Many professionals the rest no , methotrexate is very toxic so any immunosuppressive drug however caution on EMBREL lower the immune can activate cancer as I remove my thyroid for cancer , nasty staff , all those is blood disorders , immune issues go easy on TNF BLOCKERS give some brake

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Subject: Re: Sulfasalazine OR Methotrexate?

lois you are not the only one ,

Debra , the problems with raised liver enzymes can be controlled with increased folic acid , will help with other side effects from MTX , the drug is alot more effective than sulpha or AP which helps with mild RA , know some people dont like using MTX but it is very effective for th majority of RA sufferers ,

one drug I would recommend is Leflunomide , found is very good after coming off MTX & taking it along with Sulpha & a biologic + steriods

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Subject: Re: Sulfasalazine OR Methotrexate?

Debra

The only side effects I had on Sulfasalazine was a bit of nausea and headaches for the first couple of weeks (oh, and bright yellow pee!) the nausea and headaches subsided and I had no more side effects after that. Sulfasalazine just didn't work at all for me unfortunately so I'm now on a combination of Sulfasalazine and methotrexate (apparently they can work together if not on their own?!) I feel crap on the methotrexate, it's still early days so I hope things get better. Good luck to you you sound like you've had along road with it ❤️

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Alana, Sorry to hear that you were having breathing problems but it's good that you went to a lung doctor and were told everything was fine. The steroids should help you a lot and i hope you don't have to be on them too long. Do you have a rheumatology nurse that you can call for advice? Do you swim? perhaps swimming would help your lungs. Good luck and i hope you feel better soon x

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Jackieo, welcome to the forum. Glad you have found it helpful. Good luck with the methotrexate.

Take care

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Subject: Re: Sulfasalazine OR Methotrexate?

My advice is that disease names are labels to link to symptoms - underlying causes of RA and AS (Hla-b27 positive) are similar - the difference being the Genes you carry - which interplay with the antibodies that are generated due to presentation of foreign protein antigens.

I have read of cases where both conditions have been diagnosed - so I guess these individuals carry genetic susceptibility for both conditions.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Dave

I just stumbled on this on the use of Sufasalazine and it's modus operandi in HLA-B27 Reactive Arthritis.

It appears that Sufasalazine either has an effect on gut bacteria or impacts the immune response to gut bacteria !

Antibodies to Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis in ankylosing spondylitis: effect of sulfasalazine treatment.

https://www.ncbi.nlm.nih.gov/pubmed/7869314

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Subject: Re: Sulfasalazine OR Methotrexate?

Lol had someone tell me to take cod liver oil the other day! So annoying :(

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Subject: Re: Sulfasalazine OR Methotrexate?

My mother rheumatoid arthritis (RA) started two years ago at the age of 49; and her life was not the same. it started with traveling joint pain. she went to many doctors, it took a year to diagnose, and the only reason my motehr was diagnosed was because she have nodules and they removed one and it came back as RA. she have been in pain every day.(RA)is a horrible disease,she have been on one pill a day of diclofenac. If she don't take it, by the third day she can hardly move and she feel like she have the flu.My friend David ossy told me about Perfecthealthherbalmedicinehome, who cured his uncle of same disease (RA). I contacted this herbal home and purchase the herbal medicine, then they sent me the herbal medicine through courier service, when i received the herbal medicine my mother applied for 4 weeks as prescribed and she totally cured of (RA) within 4 Weeks of usage,now she can walk properly,no joint pains anymore, thanks to perfecthealthherbalmedicinehome.It is important not to give up.. Contact Perfecthealthherbalmedicinehome via:
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Subject: Re: Sulfasalazine OR Methotrexate?

Hi- I was diagnosed 6 months ago with RA and started on Mth-came off it after 2 months as it seemed to be making the RA worse immediately after dosage. Put on sulfasalazine and am on 2nd week of tablets x2.I am really struggling with The side effects! headache, ringing in ears, feeling sick to the point where you cant eat or sleep. I dare not stop the drug as my knees are so painful I am struggling to walk and trying desperately to hang on to my job.I find myself crying most of the time and often feel suicidal.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi Jo - Methotrexate interferes with Folic Acid synthesis (as this is controlled via gut bacteria, which are disrupted by MXT antibiotic effects).

Ask your doc - but might be the reason if you are not tasking enough.

Here is a thread from a lady that had same hair loss and what she tried.

https://patient.info/forums/discuss/tips-for-avoiding-hair-loss-on-methotrexate-301201

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Subject: Re: Sulfasalazine OR Methotrexate?

Hello, I hope it's OK to resurrect this long thread. I was diagnosed with RA way back in 1999 but only found this forum a week or two ago and have been slowly reading through some of the posts including this entire thread.

When first diagnosed I was determined to try to control the RA with means other than conventional medication and surgery and tried all sorts --nutritional approaches, shiatsu, Chinese herbs-- some of which helped a little but not in the long term. Then I did go on some medication, naproxen, co-codamol, also steroid injections, and then had two knee replacemnets in 2011. But I still resisted the DMARDS, so afraid of what I'd read about side effects, possible organ damage, and suppressing the body's immune system.

Then this past September the RA moved into my hip, where I'd never had pain before (since the knee replacements, the pain was mostly in my feet and ankles, also my shoulder). And it had never been so bad, I could barely move especially in the mornings and it took me literally hours to go from bed to being able to leave the house. My GP re-referred me to rheumatology (I had sort of fallen off the radar as things had been fairly stable and I didn't want more meds) but it took ages to get an appointment. Meanwhile they were investigating my weight loss and anaemia in case it was anything life-threatening (ie cancer-- doesn't seem to be, touch wood).

In the meantime my GP prescribed MST (slow-release morphine) --an absolute god-send-- and prednisolone, and the pain has decreased quite a bit (before that I was on tramadol which did nothing for me).

Anyway, I finally had my rheumy appointment today and have been prescribed methotrexate.

Some of the posts upthread about being so scared of these pills and the side effects ring so true to me. I also can't help irrationally feeling like a failure for not being able to cope without these harder drugs.

And it's good to see some of the other posts in this thread too, eg Shae who was so scared then finally took the M. pills and didn't experience any side effects after all. And Angela back in 2011 has given me hope saying

"Within 3 months and no side effects,my esr and crp has dropped to near normal, I can walk much better and have no aneamia.The mtx had worked quickly and effectively. "

And reassurance with "Looking back I think trying natural was a positive move, and taking the MTX was also a positive move. "

I don't know who from this thread is still around but thank you. I am planning to take my first weekly dose tomorrow --if I am brave enough-- in case there are any immediate ill-effects, as I don't work on Tuesdays. Fingers crossed and it is really good to find people facing some similar problems and worries and fears, not to mention the physical pain.

[Sorry for long-windedness on my first post!!]

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Subject: Re: Sulfasalazine OR Methotrexate?

hi it is very quiet , some in the UK post on Arthritis Care forum , as for Methotrexate , just make sure you get enough Folic Acid to help with the side effects , mg six days a week & you will be fine

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi River, It has got very quiet, not sure what's happened to everyone. It hasn't helped when we get so many of the silly posts taking over our site advertising fake diplomas.

I also felt worried about starting methotrexate but they do regular blood tests to check for any liver problems etc so try not to worry too much and i hope it helps you.x

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Subject: Re: Sulfasalazine OR Methotrexate?

Hello lucy, yes I saw some of those posts, I'm surprised they don't just get deleted.

Yes that's true about the blood tests. To start off with I am having them every two weeks, then monthly. So they do keep an eye on you, that's true. Thanks for the good wishes, I hope you are doing OK yourself.

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Subject: 481812

hope I don't get too many of those symptoms!! Haven't started meds yet as have only had one meeting with the rhuemy just waiting for results of everything and have an appointment on 20th feb. I too like a couple of glasses of wine on a night so hope I don't start on the methotrexate. Pain around body and knees have been helped by the steroids and co-codamol but wrists and fingers are still painful. The worst is the thumbs. Find I cant do most things as they are too painful.

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Subject: Re: Sulfasalazine OR Methotrexate?

I rang up to get my prescription renewed today, as instructed, having not noticed any side effects from the methotrexate. (I've just taken my third weekly dose today.) To my surprise the folic acid dosage has been reduced from one tablet daily apart from the day I take the methotrexate, to one tablet weekly (not on the day of the methotrexate dose). I rang up to make sure this wasn't a mistake but apparently it was correct. I'm really not sure why the change has been made given I haven't seen the rheumy again, and I just hope I don't start noticing side effects as a result...

Sorry to hear of your experience, Ruth, and hope a solution can be found.

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Subject: Re: Sulfasalazine OR Methotrexate?

Thank you, lucy. I was started on a much higher dose, as I say, and didn't understand why it has been reduced so much. But if one 5mg tablet a week is normal I suppose it must be OK. It just makes me nervous given I have been so afraid of the side effects to begin with.

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Subject: Re: Sulfasalazine OR Methotrexate?

I would ring your rheumy nurse , I was on one 5mg folic acid tab/week for years but had problems with raised ALT (blood ttest for Liver inflamation)& when raised to six tabs a week my ALT when back to normal , I never had any other side effects & was on it for 18 years

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Subject: Re: Sulfasalazine

Can i take morphine when on sulfasalazine, im in terrible pain all over, been on them now 2 weeks so just getting going. Thanks

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Subject: Re: Sulfasalazine OR Methotrexate?

Mick asked " Can i take morphine when on sulfasalazine, im in terrible pain all over, been on them now 2 weeks so just getting going. Thanks"

Oh I am so sorry to read this. Please get in touch with your rheumatologist or his staff to get it sorted Mick. NOBODY should have to suffer terrible pain. Sometimes it cannot be taken away but at least it should be able to be alleviated. Maybe consider taking to the Dr about combining plaquenil with the sulfa. It wont work for everyone but did for me. Otherwise a short course of prednisone (7/10 days) to help you have a rest from pain and to get some new meds started. Good luck.

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Subject: Re: Sulfasalazine OR Methotrexate?

Hi , everyone
I started taking Sulf 3 days ago , was prescribed it in April but was to afraid to take it
Just wanted to ask anyone that I have had terrible diarrhoea after day 2
Is this normal please

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