I've been taking metho (8 x 2.5mg tablets per week) and hydroxychloroquine (2 X 200mg tablets per day) for 3.5 years without any side effects. As I am starting to have more pain days than painless days I have just been advised to change to leflunomide.

I've been told to reduce the metho by one 2.5 mg tablet per week, keep taking the hydroxychloroquine and start taking one 20 mg tablet of leflu per day. This means I will be taking all three drugs at the same time but when I read the insert for leflu it states that taking it with other DMARDS is not advisable and reading around the subject I've discovered other information that states that taking this combination is controversial.

At present I am living and working (volunteering) overseas where health care isn't as developed as UK and rheumatology care is very limited. It's because of this that I'm very concerned about starting the leflu in case the medical care/advice is incorrect.

Does anyone have any experience of taking this combination of drugs? Has anyone else gone through the process of switching from metho to leflunomide and how was it done?

Many thanks in advance for any advice that can be given.

triple therapies like this one are really common in rheumatology and some results show they are as effective as the anti tnfs

the key issues on the drugs is risk of infection first
leflunomide and the mtx can give you tummy issues

basically any dr needs to know you are immuno supressed.
thats the key bit of information

I WOULD
if you can
take the first few doses and see how you go before you go anywhere with iffy medical care

make sure you are fully insured.

Hi vmoss,

I'm Lorna, I have had RA for just over 4 years now. I was on the triple therapy when I first started. My combination was Methotrexate 15mg per week, Hydroxochloroquine and Sulfazasalizine. They were introduced in stages and then after about 2.5 years I had to stop taking the Sulf as I no longer needed it. I keep really well now and I am still on the MTX and Hydrox along with Folic acid once a week.

Hope this is a help to you, Take care.

Lorna