Hi Naomi

Hydroxychloroquine can take up to 13 weeks to work but can sometimes work a lot sooner for some people. I took it many years ago, on its own, but can't now remember how long it took to work. To me the key here, given what you have said, is not so much the effect of HCQ on the long term control of the disease but your immediate need for relief from the symptoms of the disease, pain, stiffness and fatigue.

Pain needs to be managed adequately by appropriate medication separate to the DMARD. I have been on pain relief for 24 years at varying doses adjusted according to the efficacy of other drugs. There has never been a time when I have not needed some pain meds. Unless you are in drug-induced remission you will need pain relief. Surely you are taking pain meds and/or anti-inflammatories? If these are not dealing with the pain a visit to your GP is needed, there is so much available. Fatigue requires rest. In my experience it is the only way to get on top of it. You are fatigued because your body in its current state of ill health is saying you are doing too much. The HCQ will not work effectively, in my experience, if you aren't giving your body optimum conditions in which it can do what it needs to do.

As you have not tolerated other DMARDS I think you have to give this one a fair crack of the whip otherwise you risk another failure. You need time out from work, you need to rest when your body is tired and you need to be taking appropriate pain/anti-inflammatory medication. There is so much available these days that no-one should be in pain. The 'quick' fix is a steroid depo-medrone injection followed by 48 hours bed rest and an ongoing plan for pain management. An alternative to steroid by injection is oral steroids which will quickly bring things under control.

Giving up is an option but where will that get you? Nowhere! At some point you will have to address things in a logical way to ensure the pain is minimal and the fatigue is not allowed to get hold. The HCQ will then have a much better chance of doing its job!

Tough love, perhaps, but a harsh disease requires harsh measures. Been there, done it, and wear the joint damage. Don't let that happen to you.

Lyn x

hi Naomi,

i was put on Hydroxy about 6 months after i started on Methotrexate as that wasn't working for me up to the 20mg dose. i stayed on them both ( reducing Methotrexate down to 10mg ) for other reasons, for another 6 months. unfortunately the combination didn't work for me.

so i was then put forward for Humira an Anti -TNF which turned out into a long drawn out process re the funding, started on that in August and take it along with the above two.

so really i think you have to give it a good 6 months .. well it was that in my case.

i am fortunately now under control, but i do still get fatigued so i guess it goes along with the condition.

Lyn has give you great advice about pain meds, so perhaps a different combination will help you through this period,

i don't take pain killers so can't advise there.

hope you begin to feel better soon, although i know that it's a waiting game with each new drug.

Suzanne

Thank you Suzanne and Zena for your information and encouragement. It has been a great help. I am trying to be more patient about it all and to prevent myself getting stressed. I have been making sure I rest more, going for a nap in the afternoons every day and I think this is helping my physical symptoms. I know that when I get too tired my joints hurt even more. It's frustrating needing so much rest but I must accept this in order to fight against the RA (it's not good to see it as giving in). I send my best wishes to every one x

Hi Naomi
You were quick to send me encouragement and kind words so I just wanted to say chin up and I hope you will be feeling better very soon. If you remember I am also 'newly diagnosed' so can relate to what you are going through.
Take care and gentle hugs - Kim x

Hi Naomi

I'm on hydroxy and have been for nearly 5 years. I was also initially on 5mg steroids but have now got down to 3.5 mg and have started taking just 3mg once a week which I will increase (hopefully) to daily. It took 10 weeks for it to start working and I noticed an improvement in one wrist first of all. At one stage I thought it was disagreeing with me so my rheumy told me to stop taking it and see how I go. Three days later I couldn't even lift a spoon to my mouth so I went back on it again but I reduced the dose to 1.5 tabs daily instead of 2 and have been fine since. I found the introduction of amitriptyline made an amazing difference to me as well.

I hope you start to feel better very soon - B

i myself have been on enbrel injections now for one month along with 20mg mtx 50mg sulphazine 20 mg steroids but ohhh i feel so tired so i have some idea how you are feeling.So good luck for your future Valerie-R