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Methotrexate, Sulpahsalazine and Hydroxy Options
misty
#1 Posted : Thursday, April 21, 2011 7:47:02 PM Quote
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Hi,
Wondered if anyone had any experience or knowledge about the following. Was diagnosed with poly inflammatory arthritis nearly 3 years ago, which originally started with symptoms in my neck, which caused severe migraine like pain. However most other joints were affected after this, but have been on Methotrexate 25mg, Sulphasalzine and Hydroxy for over two years and have tolerated this well apart from feeling sick and some tiredness. My question is this, can it suddenly start to cause problems? For the past 3 weeks I have been getting the migraine type headaches again, with pain in my eyes, but at the same time my neck is clicking on moving and have some pain there. The tiredness is also becoming a problem.
Hoping someone can help.
Candy
dorat
#2 Posted : Saturday, April 23, 2011 11:00:22 AM Quote
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Hi Candy,

Yes, things can flare up even though the RA has been under control with the drugs. We can also get side effects to the drugs when we have taken them for years with no problem.
You should ring your rheumy nurse or see your Gp , maybe a steroid shot would calm things down.
Your neck sounds painful and it may be worth you seeing an out of hours GP if you can, especially if it gets any worse.

Hope you feel better soon.
Love, Doreen xx
misty
#3 Posted : Saturday, April 23, 2011 1:27:27 PM Quote
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Hi Doreen,
Thanks for that, and feel your advice to ring rheumy nurse is probably the way to go. Maybe also like you say the steroid shot would help and I know they have told me before to contact them if this is what I felt was needed.
Thanks again, it's good to be able to share.
Love
Candy
Lorna-A
#4 Posted : Saturday, April 23, 2011 1:41:00 PM Quote
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Hi Candy,

I'm Lorna, I like you have been on the triple therapy, although I was on them since the start of my RA. Maybe your dose of MTX is a little high with the rest, I am on 15mg per week and I get a tiredness the day after myself. Also the pollen is starting to affect people which could be the cause of your headaches. Best to get things checked out, but do not worry until there is something to worry about. The stress will make you unwell.

Take care Lorna x Smile
misty
#5 Posted : Saturday, April 23, 2011 8:00:40 PM Quote
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Hi Lorna,
Yes have wondered about the dose myself, but my last visit to rheumy showed my CRP had started to rise again a little, and did discuss injecting methotrexate. However I'm reluctant to go that way as I might have to admit to myself that this is real!!! Things seem to be easing a little today, but I'm tempted to miss the methotrexate this week to see what difference it will make to the headaches.
Many thanks for your reply. Enjoy the rest of Easter.
Take care
Candy
x
Sara-R
#6 Posted : Monday, April 25, 2011 5:55:22 PM Quote
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Hi Candy,
I'm on 15mg of the MTX since November and it gives me really bad headaches some days, others nothing, never seems to any pattern to it but it sounds like you should get yours checked out.
Sara
x
Rose-B
#7 Posted : Monday, April 25, 2011 7:18:21 PM Quote
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Hi Candy


Sorry to hear all your aches and pains returning. It does sound like the RA should be giving you a re think. A depo inject may help in the meantime. Give your RA nurse a call tomorrow to get sorted.

Try not to worry as that can make the situation worsen, however I am the Worlds worst worrier.

Good luck

Rose
misty
#8 Posted : Tuesday, April 26, 2011 2:39:52 PM Quote
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Hi Sara and Rose,
Thanks for replies. Well I have to say haven't given the rhuemy nurse a ring, but decided to miss the Methotrexate this week (very naughty, I know!!) to see if it made a difference. The heads are definately improved, but this was happening a little anyway. I may live to regret this decision, but do feel better, and a week of respite will be worth it. Famous last words eh!!!!
Thanks again
Candy
x
Sara-R
#9 Posted : Tuesday, April 26, 2011 4:22:12 PM Quote
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Don't worry about it Candy, I've missed a dose of MTX because of chronic runs one week and it didn't seem to make any difference. I think it stays in your system for quite sometime so is still doing the job, you'll probably still set off a gieger counter! I also think its the MTX which gives me the headaches rather than the rest of the cocktail.
Sara
x
misty
#10 Posted : Tuesday, April 26, 2011 9:20:17 PM Quote
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Thanks Sara, thats good to know, but sorry you get the headaches too.
Candy
x
Damned76
#11 Posted : Wednesday, April 27, 2011 6:18:01 PM Quote
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Hi Candy,

I got dreadful headaches when I was on the same combination. It wasn't the methotrexate causing them though, it was the Sulphasalazine. I think it's probably worth asking your rheummy nurse.

Julie x
misty
#12 Posted : Friday, April 29, 2011 8:56:45 PM Quote
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Hi Julie,
Thanks. Did you discontinue Sulphasalazine and stay on Methotrexate? Think if the headaches continue will have to contact rheumy nurse.
Candy
x
LynW
#13 Posted : Friday, April 29, 2011 9:52:46 PM Quote
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Hi Candy

Although missing a week of methotrexate will have given you a break (it stays in the system for about three months but to a lessening degree as time goes on) I wouldn't be too inclined to experiment yourself when you are on three drugs. From my own experience any one of the drugs could be causing the problem (each has your symptoms as possible side effects) and upsetting the balance between the drugs could actually make matters worse. The drugs prescribed are fairly finely balanced to give the right medication to tie in with your blood results; some people have higher mtx, some higher sulphasalazine etc.

It's possible, as Doreen said earlier, that the drugs are now becoming less effective and causing side effects. This suggests that they need reviewing. From this point it could quite easily turn into a flare so I would be inclined to seek early advice from rheumatology. They will look at the pattern of blood test results (these could be inaccurate if drugs are stopped even temporarily) and physically check your joints for inflammation and pain.

Headaches could easily be coming from your eyes and this can be a problem with hydroxychloroquine!! Definitely get it checked out soon Smile

Your neck also needs checking and may require X-Ray to look for damage. This also needs early attention because RA in the neck can quickly cause a lot of problems. You may be referred for physio to help strengthen the muscles and avoid further problems.

Good luck! ThumpUp

Lyn x
My son, Ian, completed the BUPA Great North Run on 15th September running for the National Rheumatoid Arthritis Society (NRAS). You can read his story at http://www.justgiving.com/ianlukewilson

Lorna-A
#14 Posted : Friday, April 29, 2011 9:56:24 PM Quote
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Hi Candy,

Don't worry about missing MTX for the odd time, it stays in your system for around 12 weeks. I missed it for the last 2 with travelling to Norway, it never does me any harm. Hope the headaches settle down for you, there is nothing worse.

Take care

Lorna x Smile
misty
#15 Posted : Saturday, April 30, 2011 8:33:29 PM Quote
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Hi Lyn,
Many thanks for reply. Well have to admit at the end of this week, my hands are feeling it, as well as my back, and the neck and head goes on, so not risking it any further and taking the Methotrexate again on Sunday. Looking at your post there are a few things to discuss with rheummy when I go again.
Once again thanks
Candy
x
misty
#16 Posted : Saturday, April 30, 2011 8:36:18 PM Quote
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Hi Lorna,
Thanks for reply. Did you have any symptoms at all with missing two weeks?
Candy
x
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