Fortunately for patients who need more relief, combining methotrexate with other medications will usually do the job, says Dr. Yazici. Most often, methotrexate is combined with other DMARDs, such as leflunomide (Arava), cyclosporine (Neoral), sulfasalazine (Azulfadine) and hydroxychloroquine (Plaquenil). Methotrexate should not be taken by people who have liver disease, significant kidney disease, alcoholism, blood disorders (e.g., anemia , leukopenia) or a bone marrow disorder. Methotrexate should also not be used by women who are pregnant or who are breastfeeding. It also should be stopped by both women and men who are planning a pregnancy.
About 1 – 3% of patients develop mouth sores (called stomatitis), rash, diarrhea, and abnormalities in blood counts. Some side effects do not cause symptoms, so it is important to have routine blood tests performed every 8 – 12 weeks. Fighting inflammation helps relieve painful, swollen joints. But Dr. Chan notes that adenosine also causes fibrosis, or buildup of scar tissue, in the liver; over time, that could result in liver disease. Your doctor will run routine blood tests to monitor your liver function, but it’s worth noting that only about one in 1,000 patients with RA who are taking methotrexate experience serious liver damage. Yet it’s important to note that alcohol also releases adenosine in the liver, says Dr. Chan.
Well, KNEE PAIN IS THE MOST COMMON MUSCULOSKELETAL COMPLAINT BROUGHT TO DOCTORS, so it does happen to many peopleâ¬ ¦ Injuries in this area are numerous, and many are left confused, and unsure how to deal with their issues. Most people with RA who use methotrexate – and about 90 percent of patients with this form of arthritis do use the drug at some point – take it by mouth. Typically people will start with a weekly dose of 7.5 to 10 mg, equal to three or four pills. If that doesn’t help with symptoms, the doctor may raise your dosage to 20 to 25 mg per week, or as high a dose as you can tolerate.