Re: ? on MTX or Enbrel first

[Guest guest]

Hello

I take Methotrexate. I was put on Humira and it did nothing for me, so i'm

back to the Methotrexate injections. It helps me quite a bit. One time I

thought i'd be smart and not take the injection for a week to see if I felt

better (I thought I was cured) and oh my.. I can't function without my

Methotrexate!! The pain got so bad!

Hope this helps.

Misty

callmeunoriginal <sjonesyg@...> wrote:

I was diagnosed w/PA in November after 9 months of pain/soreness in

multiple areas (I've had P on my scalp for a # of years). My rheumy put

me on prescription-strength naproxin for a couple months and told me

that he's going to recommend MTX when I see him next month if the

naproxin hasn't reduced my joint inflammation. Predictably, it hasn't.

In the meantime, I've visited my dermatologist to confirm the P

diagnosis; he said his recommendation would be to start out on Enbrel

since it has less side effects than the MTX.

Everything I've read suggests MTX first and then, if necessary, MTX in

conjunction with a biologic. Any ideas on/experiences with starting

with the biologic?

Thanks in advance for any input.

[Editor's Note: Many doctors recommend starting with MTX first since it has been

around for over 20 years and everything about the effect of long term usage is

pretty much known. Additionally, numerous studies have demonstrated that MTX

when used in combination with Enbrel, Humira or Remicade is more effective than

any of MTX, Enbrel, Humira or Remicade used alone. If nothing else, it is good

to know if your system can tolerate MTX since it would likely be added to your

drug regimen at some point anyway. Lastly, because MTX is off-patent, it is

decidedly less expensive than any of the other medications. For that reason,

health insurers often require you to have tried and failed on MTX (and maybe one

other DMARD), before they will approve your use of the more expensive Biologic

medications. Kathy F.]

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[Guest guest]

>

> Lastly, because MTX is off-patent, it is decidedly less expensive

than any of the other medications. For that reason, health insurers

often require you to have tried and failed on MTX (and maybe one

other DMARD), before they will approve your use of the more expensive

Biologic medications. Kathy F.]

>

I just started 7.5 mg of MTX weekly this week. It was $2.95 for the

month, and the Folic Acid 1 mg/day that was also prescribed was

$1.12. So it's definitely inexpensive!! However, the monthly labs

of CBC and CMP, and every-so-often ESR is what's going to be

expensive in the long haul!

I took the MTX Wednesday evening and so far have not had one single

side effect. I had Benadryl on hand but didn't need it for nausea.

I didn't get fatiqued (well more than usual) either.

I know when I started Mobic I had to have trials of Aleve and Relafen

before insurance would pay for it. At least now it has a generic so

they're more willing to pay.

C.

[Guest guest]

Hi ,

I am happy to hear you are doing so well with the MTX. I have been taking it

for about

5 years now and my side effects come and go, but for the most part the folic

acid and taking

it at night with a bit of food gets me by ok. I just want to tell of my

experience this month

when my liver enzymes were elevated a little for the first time, ever. My

doctor called and

wanted to recheck my blood in 2 weeks to make sure it was a true reading. I

tried to think

of anything " I " had been doing different in that time frame to make sure I

didn't have to quit

my meds for no reason. The only thing I could think of was I had began taking

Aleve a

little here and there for symptons of my fibro that were acting up. So I did

not take any

during that 2 weeks until the next test. Which, btw, was back down to normal,

for me

anyway. So I have gotten rid of the Aleve and am back to taking Tylenol, extra

strength.

I always have digestive problems, but they are more pronounced now also. God

bless,

Janet in Ca

-------------- Original message --------------

From: " momto23weeker " <momto23weeker@...>

> --- In , " callmeunoriginal "

> > I took the MTX Wednesday evening and so far have not had one single

> side effect. I had Benadryl on hand but didn't need it for nausea.

> I didn't get fatiqued (well more than usual) either.

>

> I know when I started Mobic I had to have trials of Aleve and Relafen

> before insurance would pay for it. At least now it has a generic so

> they're more willing to pay.

>

> C.

>

[Guest guest]

Hey Janet,

I saw that you said you have digestive problems. Is it worse when you take

Tylenol? I know that its not supposed to hurt your stomach but mine always

hurts worse if I take Tylenol if I have been having problems with it recently.

And it never helps me with my pain.

Just curious if anyone else has this problem.

Thanks,

Ann

cameronparkmom@... wrote: Hi ,

I am happy to hear you are doing so well with the MTX. I have been taking it

for about

5 years now and my side effects come and go, but for the most part the folic

acid and taking

it at night with a bit of food gets me by ok. I just want to tell of my

experience this month

when my liver enzymes were elevated a little for the first time, ever. My

doctor called and

wanted to recheck my blood in 2 weeks to make sure it was a true reading. I

tried to think

of anything " I " had been doing different in that time frame to make sure I

didn't have to quit

my meds for no reason. The only thing I could think of was I had began taking

Aleve a

little here and there for symptons of my fibro that were acting up. So I did

not take any

during that 2 weeks until the next test. Which, btw, was back down to normal,

for me

anyway. So I have gotten rid of the Aleve and am back to taking Tylenol, extra

strength.

I always have digestive problems, but they are more pronounced now also. God

bless,

Janet in Ca

-------------- Original message --------------

From: " momto23weeker " <momto23weeker@...>

> --- In , " callmeunoriginal "

> > I took the MTX Wednesday evening and so far have not had one single

> side effect. I had Benadryl on hand but didn't need it for nausea.

> I didn't get fatiqued (well more than usual) either.

>

> I know when I started Mobic I had to have trials of Aleve and Relafen

> before insurance would pay for it. At least now it has a generic so

> they're more willing to pay.

>

> C.

>

[Guest guest]

Ann,

I actually don't take that much Tylenol, so no, I can't say that is.

I blamed this last episode on the Aleve, and it is now getting some better.

I think the combination of fibro with PA is my biggest culprit, plus old age.

lol

As far as the nsaids are concerned, I took a lot of Advil with the celebrex,

and other drugs while I waited for a diagnosis and I am sure I ruined my

digestive system then. That was over a period of probably seven years. It

seems I always had a series of pain and colds, so I always carried Advil and

a non-drowsy cold pill for work time, and Benadryll or Advil Cold/ Sinus

for night time. Even when I went to the Doctor it seemed that the antibiotics

messed with my stomach, too. Now I eat a lot of yogurt. It seems to help.

Even though they say that Tylenol won't hurt your stomach, I think that when

it is combined with what we already take, I would not take any nsaid on a

daily basis. But that's my opinion. God Bless,

Janet in Ca

-------------- Original message --------------

From: Ann Lucas <annmlucas@...>

> Hey Janet,

> I saw that you said you have digestive problems. Is it worse when you take

> Tylenol? I know that its not supposed to hurt your stomach but mine always

> hurts worse if I take Tylenol if I have been having problems with it recently.

> And it never helps me with my pain.

>

> Just curious if anyone else has this problem.

> Thanks,

> Ann

[Guest guest]

>

> The only thing I could think of was I had began taking Aleve a

> little here and there for symptons of my fibro that were acting up.

So I did not take any during that 2 weeks until the next test. Which,

btw, was back down to normal, for me anyway. So I have gotten rid of

the Aleve and am back to taking Tylenol, extra strength.

> I always have digestive problems, but they are more pronounced now

also. God bless,

>

Thanks so much for the input. My pain killer of choice is ibuprofen,

but I'm already on Mobic 15 mg also. I was thinking " oh, no, what can

I take? " and was planning on asking the doc. I'll make sure to have

some Tylenol on hand.