I am so sorry. When you say: "second orencia loading dose" you mean an IV infusion?

Maybe it's too much for you at one time because of your liver disease history? I have bene on Orencia for 8 years. before that, I was on MTX and Enbrel thennHunmira...alll without knowing that I had HCV. I was diagnosed by my rheumatologist because I had elevated liver enzymes. I waited 10 years after being diagnosed - keeping an eye on my liver enzymes and having biposies - while waiting for non-interferon treatment. I was cured of HCV 3 years ago and still on Orencia.

You have options. I would talk to doc about weekly self-injection instead of infusions which might be easier to handle. I also ask about Xeljanz which is a pill and requires no MTX.

I am on Orencia with a really super sensitive liver, which is ruining my life. I have had big issues with mthx, and little issues with Arava, but, never with Orencia.

I'm wondering if switching to a weekly needle might help. Those infusions can be very hard on the body generally. I had issues with Rituxan during the infusion, and Actemra. I've never had that from any of the biologics that I took weekly injections with. My rheumatologist figures the weekly shots are a better delivery system for Orencia. To say nothing of having to book appointments, be there on their time, rather than just popping into the bathroom for 3 minutes to push the plunger in!

That's two votes for self-injection vs infusions.

I do get infusions. She said my insurance would not cover self inject until I've had I think 6 infusions. It's so hard to get med approval it took me months to even get orencia. Is the self inject a pen or a vial & needle? Mtx shots didn't hurt at all I just can't take them. Enbrel shots were brutal. I still have a scar on my leg.

yeah US commercial group or individual or safety net insurance usually has a lot of rules. you are following the terms of your insurance contract and I am sure your medical office has done a lot of dummy claims and pre auth's on you so they can figure out what is covered versus what is not and the order therof. sometimes the doc's just know also from sheer volume in their office of similar insurance folks.

enbrel shots were brutal? I am (back) on enbrel and I use the pre filled syringe (NOT the auto injector) it's like injecting water. Were you on the auto injector with the enbrel - or the pre filled syringe? brutal? like you were allergic and the injection site blew up? or brutal like you did not like how it felt? I think you were allergic to enbrel no?

we used to have a woman on here RA sally who could not take any biologics and ended up on 2 dmards and ivig therapy (in canada) so maybe your doctor will end up with you on some regime that is super unique since you have a lot of allergies.

what do you think? what does your doctor think? I am sorry you are having so many reactions/allergies. It's demoralizing right cause you got all pumped up to start your new bio? Thoughts and hugs.

depot

Orencia may not directly affect the liver like MTX or some other meds, but it can increase your risk of infections, including those that affect your liver. As was mentioned above, a previously undiagnosed liver infection may be unleashed on Orencia. Whatever your prior liver issue was also may be triggered. I hope your rheum can figure it out for you and find a regimen that works and leaves your liver alone.