I don't know anybody that this drug has worked for.

Biologics can effect your liver, but most aren't as hard on your liver as MTX - at least that is my understanding. Hopefully, this move to Plaquenil is a step to placate your insurance company so you can move to biologics.

Agree with Kim....Plaquenil is [to me] a psychological pacifier.....for short term.

Biologics don't have the harsh effects on the liver as MTX can have [I've used MTX since the early 90's and never had abnormal liver function test results].

It's not necessarily the doctor's protocol. It's usually the insurance protocol. Somehow insurance company employees seem to think they're a lot smarter than MD's. [Anything to save a buck, right?]

I'm not understanding why the MTX was reduced. Is your doctor afraid of using MTX? This is a board certified rheumatologist, right? [If a family doctor, they often get scared of using MTX and won't prescribe it.]

If it was me, I'd call the doctor, tell him/her you want to discontinue the Plaquenil and increase the MTX to where it was before.

I don't advocate lying or stretching the truth, but you may have to overdo the complaining about pain part in order to get what you want.

Reducing MTX due to liver. Went from 8 pills to 6 to 4 over 18 mo.

Aha! Then increasing the MTX is NOT what YOU want to be doing.

Looks like you'll have to be your own best advocate and demand a biologic.

My guess is that Plaquenil is the solution for many people, and for those people, having found relief from a relatively mild prescription, there's no particular benefit to visiting an online support group, especially one where they'll be told that Plaquenil won't work! My rheumatoligist told me that for about 30% of the people in her practice, it's very effective, so much so that her biggest challenge is getting those people to come in for regular checkups, since they think they're 'cured'. She said a percentage of people will never need anything else, and some will at some point find that the Plaquenil alone is not effective.

Interesting. My rheumatologist told me he never prescribes it because in his 30+ years of rheumatology he's never seen it help.

I was on it for twice, 1 year, each time. . It did nothing for me, whatesoever. In fact, I now know it is much harder on the eyes, than I was led to believe, and you can get Plaquenil eye damage up to 5 YEARS after you go off of it. So, another 3 to go for me.

I have only met one person it helped. It took a year, and she has extremely mild RA. Taking you off mthx, which might be necessary, and putting you on a drug that takes 6-12 months to work, if it does, makes no sense to me.

Even Arava as a second choice would be better. Oh, and it does affect the liver, but in a different way than mthx does. So, I am on both, I take Arava 2/3 days, and mthx 17.5 mg injections (Pills are never the way to go! Injections are much easier on the liver.)

And yes, I am affected in my liver, I had to go off mthx totally 9 years ago, after being on it 8 years, and it working perfectly with a biologic! Those were the days! Those screamingly high liver enzymes were the reason I had to go off!

So, I understand the frustration. Definitely forget the Plaquenil, demand a biologic, which will work with the little mthx you are on. And go to injectable mthx. Another thing I cannot understand! Why put you on a pill that doesn’t work, damages your stomach and affects your liver, when an injection is so much superior!

I had great results with plaquenil. I still take it as part of a cocktail. It wasn't enough on its own.
I am trying rituxin now. I hope it works. It is my last gasp drug. No biologics worked for me without side effects.

I will soon be starting on my first biologic (Humira) and doc has already said she will probably put plaquenil back in the mix. I probably won't know if it is doing anything or not.

nerot - I am so sorry to hear the drugs are failing you. Fingers crossed for you and rituxin.

I can't take methotrexate; in fact, the only similar drug I can take is plaquenil. I definitely noticed a difference when I went off it for about a year. It can cause major eye damage/ blindness if someone is on it too long and it's not monitored by your eye doctors. I had been on it probably 6 years.

I've had great result with plaquenil. I've been on it for about 6 years.
Now I take a biologic with it / embrel.
YES. Doctors have to go by protocol of ruling out the DMARDS before going to a biologic. This is mandated by the biologic and / or insurance companies bc they are so so expensive. Insurance will not cover them until it is a MUST go to. And most insurance companies are the ones that decide WHAT biologic you are on. I was on Orencia but my new insurance said they would only cover Embrel. So I'm on Embrel now. But it's doing fine.
Best of luck to you.
Ginger

Just to add a note about Plaquenil. As I said before, it didn't work at all for me in 2000 & 2015.

My liver enzymes have been climbing up, and my rheumatologist has me cut back to 12.5 mg, or half a diabetic needle. My hands, wrists and thumbs were flaring badly. I was losing hand function. So I phoned him and asked him if he would put me back on Plaquenil, and he did!

So I am on Cimzia every 11 days, 12.5 mg mthx, and 200X 2 daily Plaquenil the funny thing, the Plaquenil started helping me within a few days. I went on it mid-March, and I haven't had a flare since.

Of course, COVID-19 did not exist when this thread started. And there is a lot of argument whether Plaquenil works prophylactically. But I figure, better safe that sorry. I'm already taking zinc with Biotin for my hair, maybe it will help?

Except that we aren't getting hardly any new cases for hundreds of miles, so that is probably a bigger factor.