As far as I know, Methotrexate, Sulfasalazine, Planquenil are all medicines that 'help' to relieve RA in one way or another. But surely, they only reduce the pain?!! The silly question - what happens if you just put up with the pain? Do you just seize up?
I'm new to RA. I am, however, 76 - and am 'afraid' of taking any more medicines (I am taking Prednisone for PMR at the moment).
Looking forward to your comments.
C.
Methotextrate is the gold standard treatment for RA. However it is also used with PMR, partlcularly if the RA is what is called Late Onset RA and then the metho really helps.
Talk to your medics and get them to explain it all to you - you should have a contact number for a Rheumatology Nurse and also a Methotextrate Nurse contact details. Don't be afraid discuss it with those who can allay your fears.
Hi, RA is a systemic connective tissue disease, and serious auto immune disease, which means it is not just the many joints and tendons this is about, but the many organs in the body such as the heart and lungs, that are hugely effected by what could be fatal inflammation taken over by systemic fungal, bacterial, or viral infections. If you were to stop the medications, inflammation takes over, as a cancer does, and the disease takes over systemically, which can lead to very serious all over body sickness, and very swollen lymph nodes, from massive infection or cancer itself. Infections such as these with a greatly compromised immune system from the RA, spread quickly and profusely, and is very dangerous for those with auto immune diseases. Please talk to a specialist who can explain this and the importance of RA treatment!
Hi Lodger! No chance of a Rheumy/Metho nurse over here (Germany) and its my rheumatologist who is trying to put me onto Metho or Sulfasalazine, he's a 'get off pred asap' man. But I can't see that the above mentioned medicines won't harm you just as much as pred does.
However, I really must think carefully. C2Anna has pointed out what CAN happen if I just ignore them. Drat!!!
Thanks Anna. I have some real thinking to do!!
Hi Constance, it all depends on what your diagnosis stage is as well. You say you're 76; is the RA new or is this a late diagnosis? Do you have joint deformation? Have you had xrays? Methotrexate (MTX) is a DMARD drug which means Disease-modifying antirheumatic drug. They have many of them, but MTX is prescribed the most. I personally don't care for it as it makes my symptoms worse. But you should definitely find either a DMARD or bilogic that will curtail your inflammation. Prednisone is OK in small doses for a short time, but the long term effects for long term use are horrible, so please be careful with prednisone. I won't touch the stuff.
Make sure to get more info from your doctors. They should be able to explain everything to you about this disease and about your diagnosis of it.
', so please be careful with prednisone. I won't touch the stuff'.
You would if you had GCA and it was that or loss of vision.
Pred is a most powerful drug, but because it has been around a long time all its side effects are known.
Many Children and Adults would not be living without this drug and they take it for life.
Sorry to but in to the conversation - but Constance isn't on pred for her RA - she is on it because she has PMR. DMARDs don't work to change the disease process in PMR - the only thing they can do in PMR is to allow the same result to be achieved with a lower dose of pred and even that is disputed. She does have RA as well though - hence the question.
Used properly in PMR it isn't a horrible drug - it gives us our lives back and nothing else does. PMR in many ways is like RA without the joint damage - but it can be just as painful and disabling without any treatment.
Eileen, would you add any of the above medicines to pred?
Meant to add - I only have RA in hands and ankles at the moment. (Not sure whether hips are now PMR or RA)!! Time will tell!
I'm delighted I'm down to 5mgs pred - long may it last!
Me? For PMR? Probably not - but I have got the PMR and the pred under control. Used properly I don't believe that most people need anything else to manage PMR. But it is how it is used that is important.
Having RA is a different kettle of fish altogether - but I'd also want another opinion and proof that it was RA and that it was causing damage. It doesn't always do so in LORA.
Oh - I forgot to say that most doctors would accept 5mg as a very low dose that could be continued over long periods. I'm at 5mg, my doctors are perfectly happy. So am I.
I would think it depends on how severe your RA is as to whether you sieze up or not. I had all of my RA immune supressing meds stopped 4 months ago due to complications caused by a more recent chronic condition. I'm currently taking tramadol and a short (one week) course of naproxen to try to combat the constant debilitating pain. I can't take long term anti-inflammatories because I had a mild heart attack 10 years ago, which rather ironically was caused by anti-inflammatories. Not sure what my GP is going to come up with after I've finished the naproxen on monday...a minor miracle I hope! I've had RA for 12 years with multiple joints affected...hands, wrists, shoulders and knees being the worst, and yes I have more or less siezed up at least during the mornings, evenings and night time. I'm not too bad during day time but even then life ain't much fun and my good wife has to do a lot to help me. My consultants are trying to come up with some form of effective treatment, but to be honest and realistic I don't hold out much hope.
So to sum up - metotrexate and enbrel worked great for me prior to the complications brought on by my other health condition and I'd give my right arm, under anaesthetic of course, to be able to take them again.
I'm new to RA. Hands and ankles affected. They are stiff, swollen and painful, but the pain is bearable, that's why I don't want to start taking extra medicines. As you have probably read, I have PMR and must take prednisone. I think I'll just saunter on for the present. See what doctor suggests!
Thanks for your reply. C.
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If you can get by without extra meds then all well and good. As with most people, I hate taking meds, especially the strong immune suppressors I was taking for my RA, though as previously mentioned - I'd go on them now in a heart beat if I could. Unfortunately for me,they, enbrel especially, played a significant part in me getting septic arthritis in my hip, which ain't much fun I can assure you... I needed surgery and 6 weeks of strong antibiotics to clear it up. I now run a high risk of getting sepsis if I go back on immune suppressors, though my rheumatologist is tinkling with the idea of putting me on long term antibiotics plus a low dose of an immune suppressor, probably methotrexate, which as you can imagine I'm not keen on doing one little bit. If I don't go on this treatment then it looks like like I'll have to soldier on for the rest of my days (I'm 64) like I am or probably even in a worse state in time...talk about a catch 22 situation!!
I have no idea what PMR or GCA are. All I know is I have had many friends who have taken Prednisone for many different issues and years later, they're still dealing with the effects from it. I'm sure many people get along fine with it. I was just stating my own fears of it due to the horrible effects my friends have had that I have witnessed. And there's a long list of them (both friends and side effects). I wasn't trying to tell anyone to not take it. If that's what it sounded like; my apologies.
PMR (polymyalgia rheumatica) and GCA (giant cell arteritis) are related forms of a vasculitis (inflammed blood vessels). PMR causes rheumatic symptoms and can progress to GCA, GCA can lead to irreversible blindness if untreated - and the only management option at present for both is pred.
Whatever the unpleasant side effects there are few as bad as loss of vision. My granddaughter is on high dose pred for severe brittle asthma - without it she would be dead because she doesn't respond well in a crisis to the other drugs. The pred reduces the incidence of attacks.
Pred used unwisely can be bad, I won't deny that, and is often unpleasant but there are instances where pred is a lifesaver and, in our case, prevents disasterous longer term effects of our illness. Believe me, we wouldn't be taking it if there were a better alternative! We do have great problems though with patients on forums and who come to support groups who are terrified of taking pred because of the stories they hear. We are often in the position of explaining the whole story - not just to patients but also to doctors who are also scared of big bad pred which leads to them trying to force reductions of dose in patients who are not able to reduce, either because it is too soon or because they need just a low dose to maintain their relatively good health. There are two sides to every story - pred too.
Hi Constance66322, all those drugs methotrexate, sulfasalazine and hydroxychloroquine are DMARDS, (disease modifying anti rheumatic drugs that supress the immune stystem, they arent painkillers. Prednisolone is brilliant becasue its a steriod BUT you can only use it very short term because its very potent and can cause very bad side effects. You could try normal over the counter pain relief like paracetemol or even co-codamol but the co-codamol you can only buy 8/500 not 30/500, the 30/500 you can only get on prescription from the GP. You could try ibuprofen from over the counter or speak to your GP when you next see him and ask for something like Naproxen which is a stronger anti inflammatory or you could ask about stronger pain relief BUT all have there own side effects, the stroner you go with painkillers the more chance you are of getting constipated and the higher you go with anti inflammatorys the more chance you get of bleeds of the stomach ad ulcers etc but you can get a stomach protector like omeprazole or lansoprazole to help with that. I take Naproxen 250mg with 30mg of lansoprazole and just 500mg paracetemol as and when and it helps me. Go and speak to your GP and have a good chat with him/her and see what they say. All the best, Matt
Hallo Matt. A little of my history. I have had Polymyalgia Rheumatics (PMR for short), for 3+ years. For this illness one has to take steroids (in my case Prednisolone). I was on high dosages, fluctuating between 20 - 40, and once - 60 mgs. Now, I am down to 5 - 6 mgs, but I must keep taking Pred.
I have Co-codamol (prescribed - 100 tablets!!!), omeprazole (stomach ulcers and acid reflux). Can you see why I am loathe to take any more medicines?
Thank you for your interest and reply. I do appreciate it.
Have a good weekend (suffering in a heatwave here in Germany).
Greetings from Constance