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Type 1 Diabetes and Rheumatoid Arthritis (RA)
With type 1 Diabetes it is very important to maintain optimal control of your blood sugar. Some medications for RA can affect diabetes. The biggest offender is probably prednisone and other ......
Methotrexate and Nausea
Although methotrexate is generally very well tolerated, nausea is one of the most common side effects. This tends to occur most frequently 24-48 hours after the weekly dose is administered. There ......
Humira and tinnitus
Hi Rebecca, thanks for your question. I have never heard of anyone developing tinnitus (buzzing/ringing in the ears) after Humira injections. But, it could be related it if occurs everytime. It ......
How long for Orencia
We have safety data extending out several years with Orencia (abatacept). Many patients will continue to see improvments on this medication over time. No significant new or unexpected side effects have ......
Allergic reactions and serious infections from DMARDS
Most DMARD medications that are used to treat RA are associated with infections that can be severe. Patients with RA are also predisposed to increased infections becasue of their condition even ......
Efficacy of Plaquenil versus a generic Hydroxychloroquine formulation
The active ingredient of brand name Plaquenil and generic hydroxychloroquine are the same. In the United States, the manufacture of prescription drugs is highly regulated and the manufacturer is required, by ......
Is Enbrel made from fetal tissue?
Enbrel (etanercept) is not made of fetuses. However, the protein is entirely human and produced by recombinant DNA technology....
Concerned with increasing Methotrexate
Many patients complain of headache and fatigue when taking methotrexate so you are not unique. We recommend that all patients on MTX receive folic acid at a dose of at least ......
Efficacy of Sulfasalazine?
Many DMARD options are avaialble to treat RA including methotrexate, Arava (leflunomide), sulfasalazine, and biological agents. Many of these medications require time to work (which can be several months) and require ......
Combination of Arava and Methotrexate safe?
Certainly there can be additive toxicities of many medications. In the case of methotrexate and Arava (leflunomide) these can be effects on the liver and on blood counts. However, there are ......
Mixing other medications with Enbrel, such as cough medicine.
This should not be a problem to take cough medicine. But if you are having a persistent cough and you are taking TNF antagonists, it is important to have it evaluted ......
Can Rheumatoid Arthritis affect the eyes?
RA certainly can be associated with visual problems but a detatched retina is not typical. Inflammatory conditions involving the front part of the eye (episcleritis and iritis) are not uncommon in ......
Outcomes of Arava vs Humira for RA
I can discuss the clinical trials for these drugs, but the individual patient can do well ( or poorly) on either drug. In general, Humira and the other TNF inhibitors would ......
Pregnancy and Methotrexate
Current recommendations is to stop methotrexate for 2 menstral cycles before attempting pregnancy. Men taking methotrexate should stop for 90 days prior to atempting pregnancy....
Slow healing skin issues while taking Enbrel?
Although a few patients with well controlled arthritis have been able to taper Enbrel to every other week, most patients seem to require Enbrel at least every 10 days. I do not ......
Humira and Lupron Interactions?
There are no reports of problems and I so no reason why there should be any difficulties....
Possible resistance to Remicade?
It is possible that you have developed a resistance to Remicade. In some case this is due to your immune system making blocking antibodies against Remicade. Taking methotrexate prevents this. It ......
Methotrexate and Side Effects
Although infrequent, there are patients who do not tolerate methotrexate because of nausea or GI upset after each weekly dose. Sometimes switching to methotrexate injections help, but not always. Look at ......
Spondyloarthritis treatment
Unfortunately, our section on spondyloarthropathies is still under construction. Briefly, NSAIDs remain the first line of therapy. Sulfasalazine is often the next drug tried. Enbrel, one of the TNF inhibitors has ......
Will delaying treatment of RA cause deformity?
For the individual patient, it remains difficult to predict who wlll have aggressive disease and who will have a mild course. Thus, I can't predict what will happen if you wait, ......
RA and Methotrexate
Since methotrexate can take about 4 weeks to have an effect, when starting methotrexate, it is common to increase the methotrexate dose every 4 to 6 weeks, checking lab tests to ......
pamidronate in AS
There is some evidence that bisphosphonates (Palmidronate) may be effective in AS. However, I agree with you that there is much more published information on the benefits of anti-TNF agents in ......
Will Methotrexate and Prednisone cure Rheumatoid Arthritis?
None of the available therapies "cure" rheumatoid arthritis. The medications help the symptoms and in the case of drugs such as methotrexate, they prevent the joints from being damaged from the ......
Use of ETANERCEPT with AS
Look on this website for a discussion of etanercept in RA. Just as in RA, etanercept has been well tolerated and very effective in AS patients. Look in the Arthritis News ......
Stomach problems with Plaquenil
You might try starting at 1/2 a tablet and work your way up slowly. Also, generic plaquenil (hydroxychloroquine) is often associated with more GI side effets than the name brand....
Effects and use of methotrexate
Make sure you read the section on methotrexate (Mtx) on this website. Overall, Mtx is very effective and well tolerated. In fact remains the "gold standard" disease modifying agent for RA ......
Psoriatic Arthritis
First, find another rheumatologist. He/she needs to carefully review your situation. In general, we have been seeing remarkable improvement in the skin and joints with the TNF inhibitors. Enbrel is formally ......
Taking remicade
Although both Remicade and Enbrel are TNF inhibitors, there are many patients that respond to or tolerate one drug but not the other. The obvious thing to do from a treatment ......
Dealing with the pain of RA /Progression of RA
This is an improtant topic to discuss with yuor doctor. It is important to treat RA not only to reduce the symptoms but to prevent joint damage and future joint deformity. ......
Endometriosis and Enbrel
Endometriosis is not an infection but is due to uterine linig tissue that is present outside of the uterus. I do not know of any reason why Enbrel would be a ......
RA and Endometriosis
I am not aware of any problems with lupron and methotrexate....
When will I get some relief from my Rheumatoid Arthritis
You may get relief from the prednsione fairly soon, usually within the first few days. Methotrexate takes 4 qweeks to have an effect. Hydroxychloroquine can take from 6 to 12 weeks. ......
Skin reactions...
If I understand your question correctly, the answer is no. It is not possible to spread hives from a drug rash to one's partner or for that matter anyone else by ......
Remicade use for Adult Onset Still's Disease
There have been studies using the TNF inhibitors, Enbrel and Remicade, in patients with Still's Disease who have had poor success with traditional treatments. However, neither drug has received FDA approval ......
RA - when/why are x-rays ordered
This is a good topic to discuss with your rheumatologist. Over the past several years, there has been increased emphasis on the prevention of joint damage particularly since we have new ......
Side effects of Methotrexate
Rheumatoid nodules can ocur more frequently with methotrexate and these nodules can be in the lung. However, you still need a careful evaluation (usually by a lung doctor) to make sure ......
Enbrel and uveitis
Although there are case reports of uveitis being treated with Enbrel, there are also cases like your son where the uveitis developed on Enbrel therapy. There are not very many good ......
Effect of Humira and Methotrexate on Lungs
It all depends on what this "lesion" is. Humira and the other TNF inhibitors have not been associated with solid tumors like lung cancer. There have been reported cases of lymphoma, ......
methotrexate and alcohol
The key here is moderation. Different doctors have different views, but I tell patients not to drink alcohol on a daily basis and to limit themselves to 2 to 3 drinks ......
Pneumonia shot??
RA patients should get a pneumonia shot, particularly those on a TNF inhibitor such as Enbrel or Humira. It is impossible to get pneumonia from the shot and thus there is ......
Dermatomyositis
You need to talk with her doctor. In general, the risks to your daughter and thye baby would be very low if she was not taking azathioprine while she was pregnant ......
Re: enbrel 25 mg
The issue of cancer and the TNF inhibitors (Enbrel, Humira, Remicade) is being watched very carefully. Although there have been some patients who have developed cancer while taking these medications, the ......
Surgery and Enbrel
Unfortunately there is very little information on TNF inhibitors and surgery. The obvious concern is whether there is an increased risk of perioperative infections with these drugs, or if these drugs ......
Enbrel in a 78 year old woman/ Is it worth risk?
As you know, it is impossible to make clinical assessements without seeing her, but let me make some general comments. In terms of benefits, I have been amazed that many patients ......
Remicade and surgery
There is not a lot of good scientific information to tell us exactly what to do. In my practice, I stop methotrexate 1 week prior to surgery and restart 2 weeks ......
Patient with RA on Remicade and in need of a knee transplant
It is not really known. There may be an increased risk of infection post-op with patients on Remicade and thus it seems prudent to stop the drug prior to surgery. How ......
Moving from Enbrel to Humira
Remicade, Enbrel and Humira are all inhibitors of tumor necrosis factor (TNF) which causes inflammation. See our section on RA treatments. Remicade and Humira are monoclonal antibodies against TNF. Remicade has ......
long term prednisone vs methotrexate for pmr
This depends on how well you tolerate prednisone and if you have other conditions (diabetes, high blood pressure, osteoporosis, herat disease, obesity) that might be worsened with prednisone. In general, if ......
Leflunomide
In the RA patient population, we have not seen an increase incidence of TB with leflunomide or methotrexate. Thus most rheumatologists do not screen for latent TB with a PPD prior ......
methotrexate toxicity
Talk to your rheumatologist and look at our RA treatment section on this website. Arava (leflunomide) or one of the TNF inhibitors (Humira, Enbrel, Remicade) might be appropriate....
Enbrel plus methotrexate - family planning
Methotrexate can affect DNA replication and thus there is potential to cause birth defects when taken by men or women. In men, methotrexate should be stopped 3 months prior to attempting ......
methotrexate during pregnancy
A review article by M.E. Lloyd et al (QJ Med 1999; 92:551-563) titled "The effects of methotrexate on pregnancy, fertility and lactation" concluded the following about MTX and pregnancy:1.MTX demonstrates significant ......
Remicade and Toxicity
Increased infusion reactions can be a sign of Remicade toxicity or to be more specific, a sign that your body may have developed antibodies against Remicade. However, it is somewhat unusual ......
Availability of injectable Methotrexate?
The shortage of injectable MTX has been terrible for my patients who do not tolerate oral MTX. The explanation is a manufacturing problem that apparently will be solved over the next ......
Methotrexate for Rheumatoid Arthritis
There is no minimum level. The critical question is why is the hemoglobin low (anemia). Methotrexate at the doses used for RA rarely is the cause of anemia. However, if the ......
Blood Pheresis as an alternative RA treatmemnt
That's an impressive list of previous consultants although I would argue that a very prominent institution has been left off your list. Having not seen you in person, it is hard ......
TNF meds causing CNS disorder
There have been several reported cases of RA patients on anti-TNF drugs developing multiple sclerosis like problems. Usually the diagnosis is made on MRI scan showing demyelinating lesions in the brain ......
Methotrexate and future pregnancy
Three months or at least 2 ovulatory cycles off of MTX is recommended before attempting pregnancy. Although some rheumatologists are concerned that MTX is not as effective if stopped and restarted, ......
Enbrel and seizures
I am not aware of any reported association of TNF drugs and seizures. The neurologic problems have been multiple sclerosis like problems and an unusual problem called Guillian Barre Syndrome....
Humira/Remicade For Chronic Low Back Pain?
The trials are with anti-TNF agents in acute sciatica not chronic back pain. TNF has been shown to be present in acute disc herniation and steroids (prednisone)is most effective in acute ......
Tamoxifen and Methotrexate
I would not be overly concerned and would recommend ususal methotrexate monitoring....
How long to be on MTX before tapering off?
As you've gathered, there is no clear answer. Rheumatoid arthritis symptoms can vary widely over time and thus it is difficult to tell if patients continue to require medications. The general ......
Arava and Methatrexate
Yes. Your doctor may consider one of the new TNF drugs (Enbrel, Remicade, Humira). See the info on this website....
Storing of Remicade
It should be stable at room temperature. For others, this also applies to Humira and Enbrel....
Methotrexate and vertigo
Neurologic complaints-- dizziness, headache, difficulty concentrating, are infrequent but can occur. Often, these complaints occur soon after the weekly dose. With repeated doses, these problems often get better on their own. ......
Methotrexate and pregnancy
It is correct that you have to stop methotrexate. Enbrel may be enough to control symptoms. Use of prednisone for the period could also be used to control symptoms....
Having Hepatitis C and Rheumatoid Arthritis
Treatment decisions are complex for patients with RA who are Hep C positive. Since many patients with Hep C have joint pain or have joint pain associated with therapy for Hep ......
Effects of Methotrexate treatment on Kidney
The main side effect of methotrexate is liver toxicity. In the past, liver biopsies were done on patients with long term usage of methotrexate. However, after careful review of all the ......
Remicade infusions for severe polymyalgia
No because prednisone is so cheap and effective. But I bet that Remicade or the other TNF inhibitors would work....
Side Effects of Planquil
The main concern, although extremely rare is ocular (eye) problems-- usually loss of visual fields (lack of vision in certain areas of the eye). Thus depending on your age, you may ......
Effect of Humira and Methotrexate on Lungs
It all depends on what this "lesion" is. Humira and the other TNF inhibitors have not been associated with solid tumors like lung cancer. There have been reported cases of lymphoma, ......
Irregular response to Remicade
Treatment response can be tough to assess in part because the the course of the arthritis can vary over time. However, by 1 year, the effect of Remicade should be fairly ......
Neurological Concerns With Humira
To my knowledge, what you describe has not been reported. However, there have been rare reports of demyelinating syndromes (multiple sclerosis like problems) with Humira and the other TNF inhibitors (Remicade, ......
Arava and bleeding
There should be no danger of bleeding with Arava unless it affects the platelet count (rare) or it affects the metabolism of coumadin and raises the protime/INR test. Thus, the protime ......
antibotic therpy for RA
The antibiotics minocycline (minocin) and doxycycline have been well researched and have been shown to be only slightly effective (at most) for RA. Their use has for RA has dropped considerably ......
Whats next, Humira??
I can't make definite recommendations without seeing you, but in general your suggestions sound reasonable. However, you should discuss with your rheumatologist. You are getting a fair amount of Remicade and ......
Enbrel--long term effects on children
I am not aware of any long term side effects in either adults or children, but the long term studies are still in progress....
Enbrel or Humira without methotrexate
Enbrel and Humira can be effective on their own but recent studies suggest that they work better in combination with methotrexate....
Enbrel Vs. Remicade
See our section on TNF inhibitors on this website. Briefly, both Enbrel and Remicade inhibit TNF but by different mechanisms. Enbrel is a chimeric soluble receptor for TNF, meaning that it ......
Humira once per week
There is information to suggest that some patients will do better on weekly Humira. There does not appear to be a signficant increase in side effects when increasing the dose to ......
Rheumatoid Arthritis
See the RA treatment section on this website. Briefly, DMARDs (disease modifying drugs) should be started early in the course of RA to improve symptoms and prevent joint damage....
Is Enbrel an OK Treatment for Scleroderma
I, of course, am in favor of your seeing Dr. Wigley in the Scleroderma Center. There are not a lot of controlled trials of Enbrel or other TNF inhibitors in scleroderma. ......
Can Methotreate cause nerve pain/neuropathy?
I am not aware of methotrexate causing a peripheral neuropathy....
persistant cough
There are many causes of a persistent cough and you need a thorough evaluation. Cough can be commonly the result of a viral or bacterial bronchitis, asthma, acid reflux, post nasal ......
Rheumatoid & Methotrexate
Methotrexate reduces the joint pain and swelling of rheumatoid arthritis as well as prevents joint damage. You sound fortunate in that your RA may have gone into remission....
Methatrexate and Alcohol
If you do not have any history of prior heavy alcohol use or liver problems, then I advise my patients that they may have 1 or 2 alcoholic beverages per week ......
Psoriatic Arthritis long term prognosis w/o Tx
Prognosis is very difficult to predict, largely because the disease will vary widely from patient to patient. To complicate matters, the disease course may also vary in the individual patient with ......
Oral Medications for RA treatment
There is no general answer to your question. Therapy will differ due to your individual presentation. If you are not doing well, meaning that you continue to have swollen and tender ......
Remicade and wound healing
Remicade should not cause problems with wound healing. The concern with Remicade and surgery is the possiblity that Remicade might increase the risk of perioperative infections. Although there are only a ......
Arava Liver Failure, Update Please
Fortunately, liver failure is an extremely rare complication of Arava therapy with only a handful of cases reported. I am not aware of any new studies. The incidence of liver test ......
Increase methrotexate or add a new drug?
Unfortunately, I can't comment on your sister's case as I have not seen her. You need to discuss this with her doctor. There likely is a reason why your sister's new ......
Weekly Humira Injections
Given that you do not have many options left, I would give weekly Humira a 3 month trial before giving up....
Biologics - Injectables or IV - Patient Consensus?
I do not think the convenience factor is a big issue. Most patients receive Remicade very 2 months and thus the 2 hour infusion is not much of a big deal. ......
Drugs,Alcohol, and Arthritis
Lack of proper rheumatologic care, lack of early use of disease modifying agents (methotrexate, anti-TNF agents, etc) and poor overall health, all are major contributors to poor outcomes and increased disability ......
Subcutaneous Injection
There is no right answer. It depends on a variety of factors including but not limited to: the volume of the medication, whether the medication (or the material that is used ......
Side effects of the drug, Arava
The cases of liver failure are extremely rare and is not something that is experienced in routine clinical practice. It is difficult to evaluate the case reports of liver failure because ......
When to start DMARDS?
DMARDS should be started once the diagnosis of RA is secure which usually means persistent joint swelling and pain for more than 6 weeks. If you have absolutely no joint swelling, ......
Should I Start Methotrexate?
This is not a straight forward case and I am in no position (literally and figuratively) to second guess your rheumatologist. However, as you have presented things, it seems reasonable to ......
Methotrexate
Folic acid supplementation should not effect MTX. I do not ask patients to stop Folic acid on the days they take MTX, although some rheumatologists do. I frequently increase folic acid ......
Failure of Anti TNF Drugs for RA
Unfortunately, there are patients that fail to respond to anti-TNF agents, and even the combination of anti-TNF drugs and MTX. The clinical trials suggest that about 20-30% of patients may fail ......
RA and Prednisone
The tenderness is likely a milder version of your RA pain that is returning with the taper of prednisone. You may want to be careful not to taper prednisone too rapidly ......
Moving from Enbrel to Humira
While Humira, Enbrel and Remicade all inhibit the inflammatory molecule, tumor necrosis factor (TNF), they are completely different drugs and work differently. The clinical trials show that the safety and effectiveness ......
Pulmonary Fibrosis and Arava
To my knowledge, Arava has not been associated with pulmonary fibrosis and thus it is frequently used instead of methotrexate in patients with RA and lung disease. The main complication of ......
Increasing Methotrexate
You are right. Your hair loss may get worse with the increased dose of MTX and increasing your folic acid to 2 mg or 3 mg daily may help. However, in ......
Enbrel, Preganacy and Adult Onset Still's Disease
There is not enough good data to be definitive in answering your question. There are no tests (and there will never be any tests) of Enbrel during pregnancy. However the small ......
is it possible to gain weight on methotrexate??
I do not think that MTX itself is causing weight gain....
long term prednisone vs methotrexate for GCA
There have been trials with mixed results. If your prednisone can be tapered below 10 mg daily and if you are tolerating it without side effects, then I agree that there ......
Methorexate and side effects
There are a few reported cases of lymphoma cancers that occurred with MTX and resolved when MTX was stopped. These appear to be very rare and isolated occurances. Many studies have ......
Rheumatoid Arthritis
Yes, unless you have had an allergic reaction to the flu shot in the past. You should get the shot and NOT the nasal spray flu vaccine....
recently dxed with RA
The one drug you should definitely NOT take is a TNF inhibitor (Enbrel, Humira, Remicade). You obviously need to consult with your doctors, but I have treated patients with RA and ......
Treatment of RA plus Sjogrens Syndrome
See our section on RA treatment. Methotrexate remains the first choice of DMARDs, initally as a single agent but also in combination with TNF drugs (Enbrel, Humira, Remicade) in patients who ......
Side effects of Methotrexate
A picture is worth a thousand words and unfortunatley, I have no picture of the rash. In general, drug rashes are more widespread and diffuse, rather than local problems....
Remicade Treatment
Look on this website for additional information. Remicade is a monoclonal antibody that specifically binds TNF and neutralizes it. TNF is a protein that is found in high amounts in patients ......
Effectiveness of increased Methotrexate
Your question is difficult to answer because patients respond differently. In general, the higher doses of methotrexate are more effective. However, as you approach 20 mg weekly, the increases do seem ......
Moving from Enbrel to Humira
There is no rationale for using both together, although I have to admit that it has never been tested as far as I know....
NSAID and injecting Methotrexateto control flare
Injecting methotrexate may be slightly more effective due to the fact that blood levels are higher if you inject the same dose that you would take orally. However, in most cases, ......
Can I continue my medication while pregnant?
Enbrel should be stopped when you become pregnant. Although the studies have not shown Enbrel to be associated with birth defects or pregnancy problems, the studies are small and limited thus ......
Radiologist & Rheumatologist disagree
Reading x-rays for erosions is an inexact science at best and there often can be differences in interpretations even among different rheumatologists and radiologists as well as between the two. Although ......
Cough, a side effect?
Patients with methotrexate induced interstitial lung disease often present with a dry cough. Frequently they also have shortness of breath that is progressive and their lung examination (by stethoscope) is abnormal ......
RA and Drugs
So, let's start to tackle these questions. The "best" medicine may vary depending on the patient. However, for most patients, of the disease modifying agents (DMARDS), methotrexate remains the drug that ......
Orencia for RA
See our summaries from the research presented at the American College of Rheumatology meetings and Eular meetings over the past 2 years. Although approved, the drug has not yet been "launched". ......
Methotrexate and Heart Disease
I am not aware of any link between chronic methorexate use and heart disease....
How Soon Is It Safe To Get Pregnant After Stopping Enbrel?
The studies with Enbrel and pregnancy have been limited, but reassuring in that therfe has been no link to birth defects. Enbrel has a relatively short half life of 3 to ......
MTX vs Plaquenil
Both drugs are well tolerated and useful in patients with lupus associated arthritis. Its difficult to comment directly on your situation. In general, most rheumatologists (including myself) use Plaquenil before MTX ......
Severe itching on Leflunomide
I agree that leflunomide would appear to be the guilty party. Allergies to prednisone are considered impossible except when patients are allergic to the pill binders. The half life of leflunomide ......
TNF Blockers
The monoclonal antibodies against TNF (Remicade, Humira) appear to work much better for Crohn's disease compared with Enbrel, a soluble receptor that binds TNF. All three drugs clear TNF from the ......
Methotrexate and Memory Loss
This has not been well studied and there is no clear explanation why this might occur. I have certainly heard this complaint from a number of my patients on MTX. It ......
Methotrexate and effect time
The levels of MTX in the body decrease rapidly after the weekly dose, however the immunologic effect persists. Because it works on the immune system, it takes four to 6 weeks ......
Combining biologics to fight flares
Enbrel or the other TNF inhibitors (Humira and Remicade) should NOT be used with Kineret or Orencia because of side effects. The combinations were formally studied in a clinical trials and ......
remicade and rituximab
I have no direct experience with use of both of these drugs together. I would be very concerned about the risk of infection if both were used together. Prior trials of ......
Biologic agent at 77 ?
Unfortunately, I can't comment directly on your case since I have not seen you. To my knowledge there are no studies showing that older patients do worse on a TNF inhibitor. ......
Enbrel and missed period
No. Other causes of missed menstral periods should be investigated....
RA and Enbrel use
Injection site reactions with Enbrel and Humira generally resolve after several days, occur most frequently when starting these drugs and then decrease in frequency over several weeks. Your situation sounds unusual ......
RA Pain Management
I hope your visit with a rheumatologist comes soon. If your pain is due to inflammation from RA, then treatment should be with more or different medication. If your pain is ......
Humira/Methotrexate combination-alternatives
Your situation is way too complicated to be addressed in this forum and requires a thorough face to face consultation. Combinations of agents other than methotrexate with Humira, Enbrel or Remicade ......
Aviva as rheumatoid arthritis medicine
I am guessing that you mean "Arava" or leflunomide. Look on this site for further information. The main side effect of Arava is liver test abnormalities and thus it must be ......
Enbrel & Methotrexate and PPD test
All patients starting Enbrel, Humira, Remicade, Rituxan and Orencia are recommended to have a PPD skin test for tuberculosis. This is to look for latent TB (meaning that you were exposed ......
Pregnancy & Humira
Unfortunately, you are right that there is very little information on Humira or the other TNF inhibitors in pregnancy. To date, the studies with limited numbers of patients (most of whom ......
Risks for heart and lung problems on medications
This is a hard if not impossible question to answer in part because it will depend on your other risk factors for these conditions. In general problems associated with these medications ......
RA Medications
No. The only issue I can think of is that with the medications that require infusion (Remicade, Rituxan, Orencia), the medication is mixed with saline and given by IV infusion. This ......
Possible side effect of Methotrexate
Yes it is still possible even after 8 years on the drug. He needs to be evaluated by his rheumatologist and if necessary by a pulmonologist....
Is TACE a good target for RA ??
Your question is a very good one but beyond the scope of this forum. I think it would be hard to separate isolate the effects of membrane bound TNF from soluble ......
RA Flares
If the flares are so infrequent, then you might talk with your rheumatologist about increasing prednisone for a short time during the flares. If the flares are more frequent, then it ......
Starting Methotrexate
Stomach complaints are infrequent, but when they do happen, they are worse right after the dose and improve with subsequent doses. On occasion, they are severe enough to cause the treatment ......
Methotrexate and strange feeling in head
Likely not methotrexate and frankly, I don't know what you have....
Very Active RA
No. For the treatment of RA, biologic agents are proteins that are either copies of proteins found normally in the body that control inflammation or antibody proteins that specifically bind and ......
Birth Control while on Methotrexate
Yes. Because of the risks of birth defects if you get pregnant while on methotrexate, you need to use effective birth control. Methotrexate should be stopped for 2 ovulatory cycles before ......
RA in fingers
You didn't mention the medications you are on. Look through this website. You will see that there are many options for the treatment for RA, including two recently approved drugs-- Orencia ......
Remicaid therapy
Look throught he information on this website about Remicade and the other TNF inhibitors. You may be on Remicade for a long time, as long as your arthritis remains active. The ......
Psoriatic arthritis and Remicade
Obviously, options need to be discussed with his doctors. The other 2 TNF inhibitors, Enbrel and Humira are also approved for psoriatic arthritis....
Adding Enbrel
Look on this website. If Enbrel doesn't work, then options would include the other anti-TNF drugs (Humira and Remicade) or the new biologics (Orencia and Rituxan)....
Plaquenil Side Effects
That is an unusual side effect for Plaquenil. I would try stopping and restarting it to make sure Plaquenil is at fault....
Can cyclophosphamide cause pain in joints?
I am not familiar with cyclophosphamide causing joint pain and cannot come up with a reason why it might occur....
Remicade and Pregnancy...is it safe?
Unfortunately, there is not a lot of information. The largest case series is with patients taking Remicade for Crohn's Disease. The records of approximately 90 patients who recieved Remicade during pregnancy ......
Can cyclophosphamide cause pain in joints?
I am not familiar with cyclophosphamide causing joint pain and cannot come up with a reason why it might occur....
Edema of hands, legs, and feet while taking Methotrexate for RA
Methotrexate does not cause kidney problems and does not cause leg swelling. RA also does not cause kidney problems. However, NSAIDs can cause kidney problems and/or leg swelling....
Should I start the Disease Modifying Agents?
The critical question is whether you have rheumatoid arthritis. Your description raises some doubts. An MRI scan of the knees might be useful to see if there is evidence of bone ......
Methotrexate and Celebrex
Your question involves a complex treatment decision and should be discussed with her rheumatologist. In general, I agree with attempts to limit prednisone use by substituting Celebrex, to avoid prednisone side ......
Humira for Severe RA
I don't know your brother's clinical situation but in general the TNF inhibitor drugs including Humira, Enbrel and Remicade are very effective in severe rheumatoid arthritis....
Leukocytoclastic Vasculitis and Etanercept
I know that leukocytoclastic vasculitis has been reported but I do not know the frequency or relation to methotrexate use....
Taking Methotrexate and Enbrel together
The combination of MTX and Enbrel is well tolerated and in clinical studies, the combination is no worse than either drug alone. They may be taken on the same day....
Adding Enbrel
Most rhuematologists including myself add Enbrel (or other anti-TNF agent) and then try to taper the other medications if possible depending on the response to Enbrel....
Rtuxan and Aava
One of the early studies published showed that Rituxan was much better in combination with methotrexate. There has not been any information on Arava/Rituxan combination to my knowledge....
Rituxan and Prednisone
IV solumedrol (a steroid preparation similar to prednisone) should be given at the time of infusion to prevent infusion reactions. Oral prednisone (given in the earlier studies) does not need to ......
Enbrel Injections
Usually the rheumatology nurse does the instruction, but it will vary from office to office. It is not complicated. You might prepare by viewing our presentation on this site on how ......
SureClick Enbrel
The Sure click Pens will likely be the same price and are no better than the syringes. They use the same needle and the drug is exactly the same. It is ......
Enbrel and Uveitis
I am not aware of any reports of Enbrel causing uveitis. In fact Enbrel and the other TNF inhibitors are being looked at for the treatment of uveitis, and there are ......
Orencia or Rituxan
The decision about which drug to use is a difficult one. The short answer is that it appears from the clinical trials that Orencia takes longer to work (achieve maximum effectiveness), ......
Rheumatoid arthritis and infections
Hygiene helps prevent many different infections-- hospital control officers always lecture about simple hand washing. But I agree that in your case, I'm not sure how much improvement you are going ......
Remicade cross placental barrier during pregnancy?
There has been no studies to date that show an increase in birth defects with the TNF agents, but the studies are small. Thus we continue to stop the TNF agents ......
Side effects of Methotrexate
Your complaints are unusual for possible side effects of methotrexate. But if they continue, you need to convince your doctors that they are real and they need to consider other medications. ......
Enbrel
Certainly its possible that you might be experiencing a mild allergic reaction. Keep on the look out for reactions with future doses. You might want to keep some Benadryl around the ......
Remicade
The studies are still in progress, but to date there has not been any increased birth defects, miscarriages or pregnancy complications in men or women taking TNF inhibitors at the time ......
Enbrel stopped working
All medications have the possibility of losing effectiveness over time. Of the anti-TNF agents, one is not better than the other in this regard. Talk to your doctor. Most rheumatologists would ......
Enbrel, Metho, Humira
Irregular menses is not a common side effect of the drugs but can occur when the body is under stress, such a very active rheumatoid arthritis. If you do not have ......
Methotrexate and getting pregnant
Methotrexate should not affect his fertility. In men, methotrexate needs to be stopped 90 days prior to attempting pregnancy. Women need to be off 2 ovulatory cycles (2 menstral periods). Thus ......
Humira and breast implants
Humira likely increases the risk of post-op infections, although the exact level of risk has been hard to pinpoint. The risk will vary with the type of surgical procedures. I am ......
Enbrel eye problems
I hope you are being seen by an eye doctor. I am not aware of any problems with the eye with Enbrel or the other TNF drugs, Remicade and Humira with ......
How safe is the flu shot while on Remicade?
A flu shot is recommended for all patients on Remicade and the other TNF inhibitors, Enbrel and Humira. The shot does not contain any live flu virus. You should NOT use ......
Side Effects of Long Term Methrotrazate
A very small number of patients can develop inflamamtion in the lung related to methotrexate. It can happen any time during methotrexate and is not related to length of therapy. Methotrexate ......
Re: Methotrexate
This is not a common complaint with methotrexate therapy. You should discuss with your doctor....
Enbrel before colonoscopy
Enbrel does not need to be held. However, I suppose in those who want to be super cautious based on theory, you could consider skipping the dose immediately prior to the ......
Humira and Skin Cancer risk
Your question is somewhat difficult to answer as many published studies do not report the incidence of skin cancers other than malignant melanomas. Since skin cancers are frequent and usually taken ......
Live vaccinations in RA patients
Your question is a good one. I am not aware of any published guidelines for RA patients specifically, but live vaccinations are contraindicated in patients on immunosuppressive therapy which would include ......
Pregnancy and Enbrel
When going off Enbrel, her RA will likely flare. Approximately 50-80% of RA patients will improve or some will go into remission at the end of the second trimester until delivery. ......
safely transporting biologic drugs
I have not heard of this problem except in a few rare instances. If you notice shipments arriving warm without sufficient ice packs, I would complain loudly to your insurance company ......
Can Methorexate cause gastritis or aggravate it?
Although methotrexate can cause stomach upset both with the oral tablets and injections, it does not specifically cause gastritis. In my experience, the stomach problems with methotrexate tend to occur when ......
New medication
Arava or leflunomide is not new. It has been approved for RA since 1998 and was used for organ transplant rejection before then. It has similarities to methotrexate including the side ......
RA and MS
Some treatments for RA and MS can be given together. Your rheumatologist and neurologist need to discuss. Unfortunately the anti-TNF drugs (Enbrel, Remicade and Humira) cannot be used in MS patients. ......
Enbrel and susceptability to flat warts.
I have not found this to be an issue with my patients. This is also not been reported in clinical studies as well. However, many patients don't mention this during visits ......
Any alternatives for Prednisone
The less prednisone the better. There is likely no totally safe dose. There has been increased recognition on the long term side effects of prednisone based on clinical studies. Osteoporosis, increased ......
Rash from Enbrel
There have been a variety of skin conditions associated with the TNF inhibitors (Remicade, Humira, Enbrel). They have included eczema, worsening skin psoriasis, pustular psoriasis and allergic reaction. I am not ......
Pregnant and was on Methotrexate
It is difficult to give you exact numbers but the risk would be considered small. You should see a maternal fetal specialist to undergo further testing....
Enbrel and strange pain
It's difficult to tell without seeing exactly where you are having the pain. In general, if you hit a nerve, I would have expected pain going down the arm into the ......
Exposure to Vaccinations
There should be no problem. Most vaccines including hepatitis B do not contain any live viruses. The only exception I can think of is the oral polio vaccine does contain a ......
Help for RA patients with no money
Make sure that you explore all the patient assistance programs for all the drugs similar to Enbrel. Enbrel (Amgen), Humira (Abbott) and Remicade (Centecor) all have programs, many of which are ......
Use of TNF's with CellCept
There are no studies that have directly addressed this question, and the combination of a TNF inhibitor and CellCept is not used frequently. I am not aware of any negative reports ......
Can MTX be causing my dry cough?
A dry persistent cough can be a symptom of inflammation in the lung. Methotrexate can cause this, but generally it doesn't get better unless the drug is stopped. Inflammation in the ......
Concerns about Arava
Diarrhea is a particularly common side effect of Arava. Usually stopping the Arava is enough to get rid of the side effects. Arava does stay in the body a long time ......
