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Enbrel and sedimentation rate
HI Rose, I agree with you !! If your sed rate is 75, that definitely suggests that your RA is not responding to the Enbrel....
Blood thinners (coumadin) and treatment of RA
Hi Nancy, Great question !! Definitely nonsteroidal antiinflammatory drugs (NSAIDs) like ibuprofen and naproxen and all in that category are contraindicated because they will thin the blood further in someone on ......
Dental work and remicade
HI Helen, The TNF inhibitor class of drugs which includes Humira has been associated with an increased risk of some infections. They may predispose to infections in bone around the time ......
Edema and arthritis medications
HI Mary, In general, the drugs that you list do not cause edema. The arthritis drugs that can cause edema are the non-steroidal antiinflammatory drugs (NSAIDs) like ibuprofen, naproxen, celecoxib, etc. ......
prednisone use
We generally prefer patients NOT to be on prednisone as it takes it toll long-term on bone quality, risk of diabetes, risk of hypertension, weight gain, etc. The methotrexate dose of ......
TNF inhibitors and lupus
HI Cheryl, Good question. In general, the TNF inhibitors (Enbrel, Remicade and Humira) have indeed been associated with development of lupus like syndromes, mainly manifested by rashes and some other mild ......
RA and surgery
Hi Anna, There is no specific contraindication to having breast implant surgery, or any other surgery, while on treatment for RA. However, some medications should be stopped prior to surgery, and ......
methotrexate and side effects
Dear Becky, Some people think injectable MTX actually causes fewer side effects. It can vary from individual to individual. ...
TNF inhibitors and shingles
Yes, Enbrel and Imuran do increase your chances of infection such as shingles (Herpes zoster) and urinary tract infections. But these infections might also occur without these medications. Other medications to treat RA ......
Switching TNF inhibitors
There is not a lot of good controlled information from studies on the effectiveness of switching from one TNF inhibitor to another versus trying a drug with a different mechanism of action ......
Infusion reactions
Most infusion reactions are allergic type reactions that are specific to the drug. Some patients are allergic to all mouse proteins and thus are allergic all drugs that have mouse proteins ......
Centers for rheumatic disease treatment in Long Island NY
The university medical centers, Long Island Jewish, SUNY Stony Brook as well as others are excellent places to start. The American College of Rheumatology website www.rheumatology.org also lists board certified rheumatologists ......
Rituxan (rituximab) for rheumatoid arthritis
Rituxan is a monoclonal antibody that is directed against CD20, a protein that is specifcially found on B cells ( a type of white blood cell). B cells are important in causing the ......
Prednisone for Rheumatoid Arthritis and Pregnancy
Dear Arturo, Prednisone can suppress the inflammation and the pain very effectively. However it is associated with significant side effects ( high blood sugar, high blood pressure, thinning of the bones ......
Enbrel and positive tuberculin test
HI Janira, With a positive tuberculin ("PPD") test, you must take isoniazid before administration of Enbrel or any other anti-TNF agent (TNF= tumor necrosis factor). The general recommendation is to take isoniazid ......
Folic acid and cancer risk
Hi Lois, Those are good questions. My understanding of the folic acid issue is that an overabundance (taking more than is generally needed by the body) raised the risk of prostate ......
RA and a sore wrist despite MTX and REmicade
HI Carolyn, Sounds like you should get another opinion from a second rheumatologist. An MTX dose of only 10 mg per week is pretty low. And a Remicade dose of 125 ......
Vitamin D and Rheumatoid ARthritis
HI Liz, Vitamin D is becoming the wonder drug of the decade. The more we learn about the functions of vitamin D, the more we want people to have adequate levels ......
Enbrel and potential birth defects ???
HI Shellie, TNF inhibitors (Enbrel, REmicade and Humira) have been on the market now for 7-10 years. Yet, we still don't know for sure whether they cause birth defects or not. ......
Humira and low dose MTX not working for RA
Hi Barbara, You haven't been on MTX long enough nor at high enough dose to determine whether it will work for you or not. We usually want patients to be on ......
Humira and low dose MTX not working for RA
Hi Barbara, You haven't been on MTX long enough nor at high enough dose to determine whether it will work for you or not. We usually want patients to be on ......
Drinking alcholic drinks while taking methotrexate
Hi Marybeth, Rheumatologists differ on how much alcohol they allow their patients to drink. Our general rule of thumb at the Hopkins Arthritis Center is to allow two drinks per week. ......
Are Enbrel, Humira and Remicade all equally good?
HI Cindy, Remicade, Humira and Enbrel are all fairly equivalent in clinical trials (although they have never been compared head to head in the same trial). However, interestingly, sometimes if a ......
RA treatment and positive TB test
Hi Marybeth, A positive PPD is concerning and should be treated if one is going to receive Enbrel or any of the other biologic drugs for RA. Enbrel is a little less ......
Is methotrexate enough for RA?
Hi Regina, Methotrexate is a great first-line drug and about 50% of folks who are started on it for RA have a perfectly good response, at a dose of about 15-25 ......
Other treatments for RA besides MTX and Remicade
Hi Donna, There are many other treatments for RA, other than just methotrexate and Remicade. If you go to our RA Section and look under treatment, you will see all of ......
Does Orencia cause kidney stones or bladder infections?
HI Susan, Orencia, like most of the biologics, does modestly increase the risk for infections. However, it is not associated with kidney stones. ...
My 14 year old daughter has rheumatoid arthritis
This must be very distressing news for you. One of the reasons we developed our website is to provide lots of in-depth information about the treatments available for patients with rheumatoid ......
severe pain with rheumatoid arthritis
Dear Jean, unfortunately we cannot provide this type of advice over the internet. I would strongly suggest that you explore pain medication options with your rheumatologist. At the young age of ......
Shingles while taking Enbrel
Hi Ken, Yes, I would strongly recommend that patients who develop shingles on Enbrel or Humira or Remicade should stop the medication until the sores and blisters have crusted over. While ......
Not getting better with methotrexate
Hi Catharine, A rheumatologist will usually increase the dose of a medication, or add a second medication, in a patient with rheumatoid arthritis if pain and swelling in the joints have not ......
New RA diagnosis
Hi Nancy, You have asked a lot of questions but my sense is that what you want most is reassurance. Treatment of RA is generally fairly safe. The FDA doesn't usually ......
Pregnancy and rheumatoid arthritis
Dear Jodi, The severity of chronic illnesses like rheumatoid arthritis can change over time. It is not unusual for someone to be on one medication (e.g., Enbrel) and over a few ......
Vaccines and immunosuppression
Hi laura, The general recommendation is that any vaccination with a killed (inactive) virus is safe, but vaccinations with live viruses should be avoided. I recommend that you be seen in a ......
Popliteal Cyst / Baker's Cyst Treatment in Rheumatoid Arthritis Patient
A popliteal cyst or Baker's cyst is caused by chronic fluid accumulation in the knee. If the fluid is caused by inflammation from the RA, then increases in medication are warranted. ......
Should I find a new Rheumatologist?
The need for a second opinion is a very difficult question mainly because the answer is independent of whether your diagnosis and treatment is ultimately correct. You need to feel comfortable ......
Botox injections safe while on Methotrexate and Humira?
I don't think there should be any problem with resuming the injections while on MTX and Humira....
Helping children with Rheumatoid Arthritis
Hi Tammy, what a wonderful question - how can you help children with arthritis? I suggest you contact either the national Arthritis Foundation in Atlanta, Georgia. Or see if there is ......
Efficacy of Enbrel for RA
Do you mean Enbrel? Yes, it is highly effective for RA. Search our website for the term "enbrel" or "etanercept" and you will find lots of information....
Is there a replacement for the Prosorba Column Treatment for RA?
We get a lot of referrals to our Arthritis Center who have "failed to respond to all treatments for RA". Often we find, in taking a careful history, that they just ......
Methotrexate related to an increased risk of breast cancer?
Methotrexate has never been linked to an increased risk of breast cancer. It can cause mild lowering of white blood count. A count of 3000 to 4000 is not dangerous. It ......
Non-Hodgkins Lymphoma patient develops a cough
Would suggest that you discuss this with the oncologist. Pulmonary symptoms can be associated with Rituxan, but infections in the lung should be ruled out first....
Alcohol with Methotrexate, Celebrex and Paquenil
In the US, we generally recommend no more than 2 glasses of alcoholic beverages per week. Two is okay as long as the treating rheumatologist or internist is monitoring the liver ......
Weight gain in Rheumatoid Arthritis Patient taking Humira
When RA first starts, a lot of folks lose weight. That's because active untreated RA suppresses the appetite. Once treated, the appetite returns and RA patients can gain the weight back. ......
Methotrexate and Pregnancy
It is safest to wait 3 months. It is true that lower doses of methotrexate may be eliminated from the body sooner but no one would want to take a chance ......
Arava and Celebrex in the treatment of RA and Polychondritis
Arava has been shown in controlled randomized clinical trials to be effective for treatment of RA. Remember, though, that no one medication is effective in everyone. One has to try it ......
Controlling swelling in the knee from Rheumatoid Arthritis
Generally, if there is a lot of swelling in the joints despite treatment, it means one of two things. Either the doses of the drugs are not high enough or the ......
Surgery and Methotrexate dosage.
Methotrexate (MTX) does not have to be stopped prior to surgery. There is very little risk of infection post-surgery with this medication. We rheumatologists use very small doses of MTX to ......
Medication options for Rheumatoid Arthritis in Down Syndrome Children
There are quite a variety of medications available for the treatment of rheumatoid arthritis (RA) at this point. The spectrum of agents (drugs) can be discussed with the treating rheumatologist who ......
How long to be off Celebrex adn Plaquenil for a Surgery?
I currently take Celebrex and Plaquenil for RA and am having surgery soon on my foot. Dr. told me to be off my meds. one week prior to surgery, but ......
Effectiveness of ARAVA in Relapsing Polychondritis
Are there any studies showing effectiveness of ARAVA in Relapsing Polychondritis . What would you recommend for treating it. To my knowledge there are no studies. There may ......
Treating RA with Antibiotics
I've been reading about antibiotics (minocycline, for instance) as treatment for RA. As you probably know, Kathleen Turner is taking antibiotics for her RA, and my wife had diminished symptoms ......
Increasing Methotrexate causing problems?
I have been taking Methotrexate for 6 months. i started with 15 mg, bumped to 20 mg and things seemed to be improving, but still active so I was bumped ......
Effectiveness of treatment and insurance issues?
Kindly answer the following questions1-I have taken 2 in infusions of remicade, third loading dose which was to be a month apart after second dose has been delayed due to ......
Length of time to administer Rituxin
I am considering taking Rituxan for Rheumatoid Arthritis and I was wondering how long the IV takes to administer? Usually about 5-6 hours for the first infusion. The ......
Antibiotic Therapy for RA
<TABLE><TBODY><TR><TD vAlign=top width=60><IMG height=50 alt=Question src="http://65.109.238.243/ask-the-expert/images/q.jpg" width=50> </TD><TD vAlign=top width=520>Do you recommend Antibiotic Therapy for RA? I am currently on Remicade infusions every 6 wks and 15mg of Methotrexate a week, & ......
Methotrexate and Fatigue
I take 20 mg. MTX the next day, I am so tired I can not hardly move, is this normal. Some patients complain of fatigue the day after their ......
RA and Pain
I don't "live" right now, I just "exist" from day to day. My treatment for RA is Rituxan infusions, Prednisone only for extreme flares (I refuse to take it otherwise) ......
How will my rheumatoid arthritis affect my pregnancy?
When me and my husband want to start our family, how will my rheumatoid arthritis affect my pregnancies would you recommend to adopt or would it be ok to try ......
Symptoms vs. joint damage
I am 42 yrs old and I woke up one morning 2 years ago and could not bend my fingers and my ankles, it only lasted a few minutes and ......
RA Flares
My RA is not under control yet. I am taking NSAID, Prednisone, and MTX. I know when I am going to flare. I flare every three months without fail. A ......
Methotrexate and strange feeling in head
Dear Doctor:I have been on methotrexate for 8 years 12.5 mg per week. The last couple of weeks I have had a very strange thing happen. About 5 hours after ......
Very Active RA
My rheumatologist told me that my RA is still very active and he was concerned about my hands and feet due to the swelling. My next appointment is in August ......
methotrexate
can i take birth control pills as a form of contraceptive if i am on methotrexate Yes. Because of the risks of birth defects if you get pregnant ......
Plaquenil
I have been taking Prednisone, Methotrexate and NSAID for my RA. Last week my doctor added Plaquenil. I know that it could take up to months to work. But I ......
Prednisone, how much is too much
Currently I am on 20mg of Methotrexate a week, 2 pills a day of 200mg celebrex and 7.5mg prednisone a day plus 2ultram twice a day for pain. I was ......
Enbrel
I am taking Plaquenil,Methotrexate, Prednisone, and NSIAD for my RA and My doctor wants to add Enbrel. The meds that I am on now are not help very much. My ......
Plaquenil Side Effects
I have RA and Plaquenil just got added to NSAID, MTX, and Prednisone. I am taking 400mg of Plaquenil, 20mg MTX, and 10mg Prednisone. I have only taken the Plaquenil ......
edema of hands legs feet with methotrexate in RA
Diagnosed with acute inflammatory Ra 2/06 - Being treated with methotrexate weekly and nsaids - pain and flare ups improved 60% - now have edema of hands legs and feet. ......
methotrexate and celebrex
My mother is currently on methotrexate (injections)and prednisone for a combination of RA and OA. Her doctor is trying to get her off prednisone and has put her on Celebrex ......
methotrexate and celebrex
My mother is currently on methotrexate (injections)and prednisone for a combination of RA and OA. Her doctor is trying to get her off prednisone and has put her on Celebrex ......
humira
My borther has severe rheumatoid arthitis.Some days he can not get out of bed or feed his self he is only 47 years old he was always a very health ......
leukocytoclastic vasculitis and etanercept
Dear Dr. Matsumoto,Is there an increased incidence, or severity, of leukocytoclastic (allergic) vasculitis with etanercept use? It looks like mine reappeared(confirmed by biopsy)and significantly increased in severity after having to ......
Methotrexate and Enbrel
Right now I take 8 pills of MTX Friday night. I am about to start Enbrel. I am worried about any side effects. If I take them Friday then I ......
Enbrel
I have rheumatoid arthritis and taking Arthrotec, MTX, Plaquenil, and Prednisone. My doctor wants to start me on Enbrel. Can and is it normal to just add Enbrel to the ......
rituxan and arava
I am considering Rituxan to treating RA. I do not take Methotrexate but instead take Arava. Do you know of adverse effects of Rituxan in combination with Arava or the ......
Rituxan and Prednisone
I have RA/Lupus/Sjogren's. A year ago I received Rituxan with good results. My symptoms are beginning to return. Recently, my husband died and I am more emotional than normal. I ......
Enbrel Injections Education
I am going to start Enbrel in August. I was wondering who usualy shows me how to do the injection? A nurse, family doctor, my rheumatologist, or some type of ......
enbrel and uveitis
My 8 year old son has polyarticular ANA negative arthritis and started on Enbrel one year ago, in addition to methotrexate. He has recently developed uveitis that is proving difficult ......
Orencia or Rituxan
I'm a 44 year old woman with a 20 year history of severe non-responsive RA. Having been through all of the other biologics my rheumatologist feels it is time to ......
Dr. Richard D. Adamo and rheumatoid arthritis
My husband has recently been diagnosed with rheumatoid arthritis. He was given the advice by laymen to read the popular book by Dr.Richard J.D'Adamo "Eat Right For Your 4 Type".What ......
Rheumatoid arthritis and infections
I am on NSAID, Methotrexate, Prednisone and Plaquenil for my RA. But lately I have been getting alot of small infections. My big toe, a hangnail on my thumb and ......
Enbrel
I just had my first injection of Enbrel last night. So far there has not been any reactions from the drug. But about two hours after I got itchy in ......
Remicade
If my husband has been on remicade (injections every two months over the past three years) are there risks for birth defects, and if so what typs of birth defects ......
enbrel stopped working
My husband has been taking Enbrel for 9 months. In the beginning it worked great and all the swelling and pain was gone. Now it has started to come back. ......
Enbrel, Metho, Humira
I am 26 yrs old. I began taking 6 tablets of Metho and 50mg of Enbrel per wk since Jan. But around June to Aug I was getting my period ......
Best M.D. for Rheumatoid Arthritis Consultation
Who is the best M.D. in the USA to see for a consultation on what to do about advancing Rheumatoid Arthritis? While there are many expert researchers and ......
Methotrexate and getting pregnant
My husband takes methotrexate for dermatomyositis. We have 1 child we conceived befoer he got sick. He has been on methotrexate for 2 years. How long does he have to ......
enbrel eye problems
i am 23 and have had ra for 20 years i have the condition called stilis this year i got myo carditos very badly and nearly died i have been ......
side affects of long term methrotrazate
I have heard there can be some kind of lung side affect of long term methrotraze. Can you tell me anything about this. I have had a long term cough ......
When should a patient seek a clinic like JH?
My wife has been in treatment for supposed Rheumatoid and Osteo Arthritis for 10 years. It has affected her back, shoulders, neck, and spine. Though she has joint pain in ......
Humira and Skin Cancer risk
Dr., do you think there is a greater risk of getting skin cancer if on the drug Humira? I have been on Enbrel, Remicade and now Humira for the last ......
pregnancy and enbrel
My daughter is thirty years old and is taking Enbrel. When she goes off of it to try and get pregnant. When she goes off of the medicine and hopefully ......
Rheumatoid Arthritis
I have Rheumatoid Arthritis and was told that my lungs are effected. I was told that my lungs had a lot of scar tissue in them. I forgot what medical ......
RA and MS
I have RA and MS my question is do I have to decide between which disease to let be in control? If one is being treated , I have to ......
Enbrel and susceptability to flat warts.
I have been using Enbrel for five years and have been bothered by flat warts the last six months or longer. My skin doctor has tried two methods of getting ......
Pregnant and was on methotrexate
Hi, I'm 6 wks pregnant and was taking mtx I'm pretty bad at taking my medication yet I know I did take it about 1 week before my last menstrual ......
Enbrel and strange pain
Me and my mom has training in the injection of Enbrel so she can injected in the my arms when the time comes. Tonight she injected into my right arm ......
Exposure to Vaccinations
I have RA/OA and have been on MTX and Enbrel for two + years. My white blood count tends to run low. Is there a problem with being around babie ......
depression in immunocompromised patient with RA
A 45 year old lady has RA on methotrexate and cyclophosphamide for 2 years. She had developed bilateral papilledema as a drug side effect which was managed with Acetazolamide 2 ......
Help for RA patients with no money
I have a friend that is in very bad shape because his insurance co. refuses to pay for his medication of Enbrel. He does not make enough money to pay ......
Use of TNF's with CellCept
I was recently diagnosed with spondyloarthritis and I also have myasthenia gravis which has been stable with CellCept and prednisone. The arthritis is not responding despite the doses of prednisone, ......
CAN MTX BE CAUSING MY DRY COUGH
back in dec.2006 i was diagnOsed with an upper respitory infection,sinusitis .i was tReated with antibiotics ,mucinex dm and hycotuss W/CODIENE clear cough syrup i got rid of most of ......
Please help Arava
I have been taking this drug for about 4 months now. I am having side effects that i didn't have before. My other meds (celebrex, prednisone) i have been on ......
Rituximab
I see no mention of use of IV infusion of Rituximab for treatment of acutely active RA. Do you have any information on the use of this treatment? ......
Methotrexate and abnormal liver profile
I was on Methotrexate w/Plaquenil for about 4 months and was feeling great on it however my ALT, AST, and ALP started to elevate. I was taken off the Plaquenil ......
Alcohol
Can you drink beer while taking meds for RA? Beer increases the risk of stomach upset, ulcers, liver test abnormality. The key concept is moderation....
Humira and surgery
How long do you have your pt's with RA stay off of Humira and MTX after Athroscopic surgery of the shoulder, such as; a rotator cuff repair along with subacromial ......
Chemo for Treatment of Rheumatoid Arthritis
My mother is in a wheelchair and has seen a new doctor for RA and has been told that chemo is a good option to take 3 pills each Friday ......
