Re: Methotrexate interaction

[Guest guest]

I've gotten so paranoid about drug interaction that I clear EVERYTHING with my pharmacist. My daughter takes anti-seizure medication which interacts with just about everything you can imagine so the child doesn't get so much as a tylenol unless our neighborhood pharmacist clears it. I actually took our prescriptions out of our neighborhood Giant because I was getting too many pharmacists and now use a small pharmacy exclusively for that reason. It has one pharmacist who owns the place and he knows my kids and their many meds and gives his opinion the second I walk in the door. My pediatrician has gone so far as to get a handheld PDR of sorts just so he can know the interactions when he is prescribing and he still tells me to check with Sanjay (our pharmacist).

I'm sure everyone is aware already but "herbal cures" also react most unfavorably when combined with standard medication often lowering or raising the blood levels and/or stressing the vital organs and blood cells beyond where they should be and often causing massive damage before any "interaction" is caught. I learned this the hard way by almost overdosing on simple herbal tea and Nyquil when I had the flu. I give my children NO herbs or herbal remedies at all because of this and quite honestly wouldn't touch them myself if you paid me. Especially after several people have nearly bled to death on the operating table after taking ginseng, ginko-biloaba and one other herbal , over the counter, non-regulated herb. They have also discovered that another "cure all" echinacea can be very dangerous to the liver when taken long term and also can cause dangerous reactions for those who are allergic to golden rod or other plants.

Anyway, just my $.02 for the day. Have a good one!

[Guest guest]

shouldn't the doctor have known that and not blame the pharmacist?

Pat & (1 year Systemic)

[Guest guest]

How awful. My thoughts are with you. I would think that ultimately the

physician is responsible for making sure that they order nothing that would

react badly with your other meds. I don't know how I would handle this - hang

in there - our thoughts are with you!

Val

Rob's Mom

In a message dated Mon, 3 Dec 2001 9:07:14 AM Eastern Standard Time, " Sevco,

" <sevcoca@...> writes:

>

>

>

>

>

>

>

>

>

> <SPAN class=820525813-03122001>My 4

> 1/2 old takes methotrexate and recently had a urinary tract infection. The

> pediatrician prescribed bactrum. The UTI cleared up. She had her

> standard monthly blood work this week and her liver enzymes are elevated and

her

> white count is low. The rheumatologist called and said she should have

> never been prescribed the bactrum because it contains sulfur which interacted

> with the methotrexate and made her absorb too much methotrexate. I have to

> skip her shot this week and have blood done again this week. I was so

> upset. The methotrexate is starting to really work and I just hope this

> does not prevent us from having to use it. The pediatrician blamed the

> pharmacist and said the pharmacist should have caught this. I had the

> bactrum filled at a different Giant Eagle (large food chain store) than where

I

> got the methotrexate filled and I found out that there systems are not

> linked. If I would have got it filled at the other one I usually use, the

> system would have flagged it. Do you believe it? Even more

> disturbing is that I only got the very first methotrexate script filled at

Giant

> Eagle as a mistake b/c due to my health insurance, I have to have all

injectable

> prescriptions filled using the health plan's mail order pharmacy so the

> interaction would have have been caught that way either. I learned that I

> need to check with the rheumatologist. The pediatrician obviously knows

> nothing about methotrexate and did not bother to look it up. I hope this

> terrible lab results can reverse themselves. </SPAN>

> <SPAN class=820525813-03122001></SPAN>

> <SPAN class=820525813-03122001>Take

> care,</SPAN>

> <SPAN class=820525813-03122001>Chris</SPAN>

>

> FYI

>

> FIRST ONLINE CHAT

> SESSION WITH PHYSICIAN AND PATIENT WHO STUDIED A NEW RHEUMATOID ARTHRITIS

DRUG

>

>

> -- RA Patients Eager to Get Information About

> First-of-its-Kind Treatment --

>

> INDIANAPOLIS, December 3, 2001

> - Two million rheumatoid arthritis (RA) patients in this country will be

able

> to learn more about a new, first-of-its-kind RA medication called Kineret

> (anakinra) during an hour-long chat session on Arthritis Insight.com with an

> investigator and patient involved in the drug's clinical trials.

>

> The

> chat session will take place on Monday, December 17, from 9-10 p.m. ET.

> Anyone who wishes to participate can log onto

http://www.arthritisinsight.com and

> follow the directions on the screen for the chat session.

>

> Participants

> will be able to ask questions of Dr. Stanley Cohen, a clinical associate

> professor at the University of Texas Southwestern Medical Center in Dallas

and

> a clinical investigator in the Kineret trials, and Rashel Cruz-Woessner, who

> was diagnosed with rheumatoid arthritis at the age of 29 and took Kineret in

> the trials.

>

> Since more than 300,000 patients taking current RA drugs

> still suffer from the signs and symptoms of their disease, new treatment

> option like Kineret are critical. Many patients are eager to learn more

> about it, as the drug was approved not too long ago by the U.S. Food and

Drug

> Administration on November 14, 2001.

>

> Approximately 2.1 million

> Americans have RA. It is the most serious and disabling type of

> arthritis striking people in the prime of life (onset usually occurs between

> 35-45 years of age). One-quarter of patients have severe disease that

> will lead to significant disability and, in some cases, death.

>

> RA is

> an autoimmune disease, meaning that the body's immune system does not

function

> properly and attacks healthy joint tissue as it would foreign cells. It not

> only affects joints but also often damages internal organs, such as the

heart,

> lungs and eyes. In fact, life expectancy for RA patients is 5 to 10

> years shorter than that of the general population; the most common cause of

> death is heart-related.

>

> Arthritis Insight is a not for profit

> organization formed by and for people with arthritis. Their goal is to use

the

> internet to provide timely, accurate information and emotional support to

the

> hundreds of millions of people with arthritis and their families around the

> world. The organization's motto is: " Knowledge is power...support is

> essential.

> # # #

>

> Contact: Tina Underwood, 330-633-1941, tina@...

>

>

>

> For

> links to websites about arthritis and JRA, visit:

> http://www.geocities.com/Heartland/Village/8414/Links.html</TT>

>

>

>

[Guest guest]

My 4 1/2 old takes methotrexate and recently had a urinary tract infection. The pediatrician prescribed bactrum. The UTI cleared up. She had her standard monthly blood work this week and her liver enzymes are elevated and her white count is low. The rheumatologist called and said she should have never been prescribed the bactrum because it contains sulfur which interacted with the methotrexate and made her absorb too much methotrexate. I have to skip her shot this week and have blood done again this week. I was so upset. The methotrexate is starting to really work and I just hope this does not prevent us from having to use it. The pediatrician blamed the pharmacist and said the pharmacist should have caught this. I had the bactrum filled at a different Giant Eagle (large food chain store) than where I got the methotrexate filled and I found out that there systems are not linked. If I would have got it filled at the other one I usually use, the system would have flagged it. Do you believe it? Even more disturbing is that I only got the very first methotrexate script filled at Giant Eagle as a mistake b/c due to my health insurance, I have to have all injectable prescriptions filled using the health plan's mail order pharmacy so the interaction would have have been caught that way either. I learned that I need to check with the rheumatologist. The pediatrician obviously knows nothing about methotrexate and did not bother to look it up. I hope this terrible lab results can reverse themselves.

Take care,

Chris

FYI

FIRST ONLINE CHAT SESSION WITH PHYSICIAN AND PATIENT WHO STUDIED A NEW RHEUMATOID ARTHRITIS DRUG -- RA Patients Eager to Get Information About First-of-its-Kind Treatment -- INDIANAPOLIS, December 3, 2001 - Two million rheumatoid arthritis (RA) patients in this country will be able to learn more about a new, first-of-its-kind RA medication called Kineret (anakinra) during an hour-long chat session on Arthritis Insight.com with an investigator and patient involved in the drug's clinical trials. The chat session will take place on Monday, December 17, from 9-10 p.m. ET. Anyone who wishes to participate can log onto http://www.arthritisinsight.com and follow the directions on the screen for the chat session. Participants will be able to ask questions of Dr. Stanley Cohen, a clinical associate professor at the University of Texas Southwestern Medical Center in Dallas and a clinical investigator in the Kineret trials, and Rashel Cruz-Woessner, who was diagnosed with rheumatoid arthritis at the age of 29 and took Kineret in the trials. Since more than 300,000 patients taking current RA drugs still suffer from the signs and symptoms of their disease, new treatment option like Kineret are critical. Many patients are eager to learn more about it, as the drug was approved not too long ago by the U.S. Food and Drug Administration on November 14, 2001. Approximately 2.1 million Americans have RA. It is the most serious and disabling type of arthritis striking people in the prime of life (onset usually occurs between 35-45 years of age). One-quarter of patients have severe disease that will lead to significant disability and, in some cases, death. RA is an autoimmune disease, meaning that the body's immune system does not function properly and attacks healthy joint tissue as it would foreign cells. It not only affects joints but also often damages internal organs, such as the heart, lungs and eyes. In fact, life expectancy for RA patients is 5 to 10 years shorter than that of the general population; the most common cause of death is heart-related. Arthritis Insight is a not for profit organization formed by and for people with arthritis. Their goal is to use the internet to provide timely, accurate information and emotional support to the hundreds of millions of people with arthritis and their families around the world. The organization's motto is: "Knowledge is power...support is essential. # # # Contact: Tina Underwood, 330-633-1941, tina@... For links to websites about arthritis and JRA, visit: http://www.geocities.com/Heartland/Village/8414/Links.html

[Guest guest]

Hi Chris

The rheumy is right-- bactrim should never be given to a child on methotrexate. But the elevated liver enzymes are reversible. We've been thru a few bouts of liver enzyme elevations in the last few years. Once we had to discontinue methotrexate for several weeks because the counts were so high, but the other times we just lowered the dose for a while. And we had more frequent lab work done to make sure things were improving. My daughter continues to take methotrexate and has no liver damage at all in spite of the years-- nearly 7-- that she has been on it. Hang in there--- And try not to worry too much. It sounds like the rheumy is on top of things and will do what needs to be done for your daughter. Let os know what happens.

Liz

FYI

FIRST ONLINE CHAT SESSION WITH PHYSICIAN AND PATIENT WHO STUDIED A NEW RHEUMATOID ARTHRITIS DRUG -- RA Patients Eager to Get Information About First-of-its-Kind Treatment -- INDIANAPOLIS, December 3, 2001 - Two million rheumatoid arthritis (RA) patients in this country will be able to learn more about a new, first-of-its-kind RA medication called Kineret (anakinra) during an hour-long chat session on Arthritis Insight.com with an investigator and patient involved in the drug's clinical trials. The chat session will take place on Monday, December 17, from 9-10 p.m. ET. Anyone who wishes to participate can log onto http://www.arthritisinsight.com and follow the directions on the screen for the chat session. Participants will be able to ask questions of Dr. Stanley Cohen, a clinical associate professor at the University of Texas Southwestern Medical Center in Dallas and a clinical investigator in the Kineret trials, and Rashel Cruz-Woessner, who was diagnosed with rheumatoid arthritis at the age of 29 and took Kineret in the trials. Since more than 300,000 patients taking current RA drugs still suffer from the signs and symptoms of their disease, new treatment option like Kineret are critical. Many patients are eager to learn more about it, as the drug was approved not too long ago by the U.S. Food and Drug Administration on November 14, 2001. Approximately 2.1 million Americans have RA. It is the most serious and disabling type of arthritis striking people in the prime of life (onset usually occurs between 35-45 years of age). One-quarter of patients have severe disease that will lead to significant disability and, in some cases, death. RA is an autoimmune disease, meaning that the body's immune system does not function properly and attacks healthy joint tissue as it would foreign cells. It not only affects joints but also often damages internal organs, such as the heart, lungs and eyes. In fact, life expectancy for RA patients is 5 to 10 years shorter than that of the general population; the most common cause of death is heart-related. Arthritis Insight is a not for profit organization formed by and for people with arthritis. Their goal is to use the internet to provide timely, accurate information and emotional support to the hundreds of millions of people with arthritis and their families around the world. The organization's motto is: "Knowledge is power...support is essential. # # # Contact: Tina Underwood, 330-633-1941, tina@... For links to websites about arthritis and JRA, visit: http://www.geocities.com/Heartland/Village/8414/Links.html