Rheumatoid Arthritis Support Group

Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...

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KiddoGal 12/13/2009

I am indecisive on to whether increase my methotrexate by two pills ( I am on 4 pills per week - 2.5 mg each) or leave things the way they are. My doctor has not insisted I increase the mtx, but gave me the option. I have been on Enbrel for 6 months, and mtx for four and one half months. I have weaned down to 2mg of Prednisone. I have no fatigue and no pain. I work full time, and get up each morning with no problems. I can move fine, I bowl once per week, walking and climbing stairs are no problem at the moment. My right hand between the first and second knuckles is slightly swollen about 60% of the time, and sometimes warm. My knees are warm about 50% of the time, but barely swelling, if at all. I feel like I could totally wean myself on the prednisone now, and I would still basically feel the same. My doctor says to "get the optimum benifit" and hopefully stop all swelling and warmth would be to increase the Mtx. My delima is to increase the mtx, risk liver issues, hair falling out, other side effects, etc. or just go as it is for the time being. I hate to increase the mtx, but I undertand warm joints/slight swelling means the RA is active and possibly doing damage. Just want some feedback, what you might opt to do in this situation?

KiddoGal 12/13/2009

one more thing....RA doc said I could increase the mtx by adding to more pills per week, totalling six pills per week.

Caspiana 12/14/2009

hummm...that is a tough one. Does the dr. think you risk damage by not increasing the dosage? If increasing the dosage means a greater chance of not getting any damage then maybe he has a point. I was told that if I still have any pain or swelling then the disease is still active. I really don't know what is best although I would be hesitant to increase if it was me IF I was feeling good. Sorry this is probably not very helpful. Take care.

deleted_user 12/14/2009

I was just talking to my husbands bosses wife at our Christmas Party. She also has RA (lives in OC and looks just like you) and is taking only 3 MTX. She is having a bad time and is afraid to increase her dose. I think her seeing me gave her the incentive to try increasing her dose.

Two could make a difference. At 4 I had some relief. At 6 I had complete relief from morning stiffness, swelling. My doctor still wanted me to increase it to 7 a day. I was increased 1 pill every 4 weeks until I was up to 7. I got off Prednisone when I was taking 5 MTX. I have never needed any other meds. No side effects at all. I have not lost one hair. My blood test are taking every two months. He said my liver is good. I was a heavy heavy drinker prior, so I am shocked. If your doctor is monitoring you good, I wouldn't worry. Let him do his magic on you.

KiddoGal 12/14/2009

Thank you Cinnamint and Caspiana for your input. Yeah, it's a tough one....like today, I feel good, no swelling and just the slightest, slightest, bit of warmth. However, sometimes during the day I tend to have a "hot flash" in which my swelling in my hand (between the knuckles) increases. Drives me nuts too! Then 30 minutes later, I am fine...strange! Yes, I do think the doctor feels I could be having damage being done because the joints are warm at times...I tend to have very little side effects at 4 pills, and things are managable with that dose. Hate to start having more side effects...ahahaha. oh, well. I will have to mull this over more. I do want off the prednisone completely though. I am leaning towards an increase. ugh. Tonight is my mtx pill night too so I will decide tonight.....thanks again!

deleted_user 12/14/2009

Can you opt to try one pill more or even two pills short term? That way instead of fearing what "might" happen with the increase, you can actually judge if it is "worth it" to you?

Please keep us posted

Tort

deleted_user 12/14/2009

I take 6 with no problems. I still have some swelling. Although, I am not sure MTX does anything for me since I still am on 10 mg of prednisone.

Consider upping your mtx does one at a time and see if that makes a difference.

But, of course, do what you feel comfortable with. I can't wait to find the right combo so I can wean myself of prednisone too!

KiddoGal 12/14/2009

yep....thought about just upping it by one pill and seeing if that makes everything better....gotta get off the prednisone!

KiddoGal 12/14/2009

I took five pills tonight and all my hair immediately fell out!! JUST KIDDING!!!!...will let you know if I see more improvement.

deleted_user 12/14/2009

Yep, getting off the prednisone is probably a reasonable goal as it causes so many health problems in the short and in the long run! You might want to talk with your doc about the long range impact of continued inflammation and swelling. It might be that the increased dose of MTX would not cause as many problems as you think. Sometimes an increased dosage actually minimizes the side effects! Why not try "titrating" the dose, going up really slowly until you get the desired benefit?? Hope you continue pain free!!!

deleted_user 12/14/2009

" I took five pills tonight and all my hair immediately fell out!! JUST KIDDING!!!!..."

Thanks for the giggle Kiddogal!

blessings,
Missy

KiddoGal 12/14/2009

Yep, got to keep the sense of humor as best we can!

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