Methotrexate and Mycophenolate together?

[ShannonB]

I’ve been on Mycophenolate for over a decade but in recent years it’s less effective and I am trying to find a way to better manage my lupus. One of my rheumatologists is recommending ADDING methotrexate, and the other one (don’t even ask why I ended up with two, it’s a nightmare) says to taper MMF down and then start methotrexate.

I am nervous to taper down as worried everything will flare up even more during that two month process.

Does any one take them both?

Thank you!

[Sara_A]

I dont take them both but I am on methotrexate and have been on the others in the past inc mycophenolate. My rheumatologist has suggested adding another onto my treatment and I'm fine with that. Lots of people have to take 2 so it's not uncommon.As for tapering ur mycophenolate down that seems a bit ridiculous if u are not managing ur symptoms and looking to need increased treatment!?? They would start u on a lower dose of methotrexate to start with and see how u go. I don't really see the point in taking u off a drug that works (as a lot of us have problems with some of them and find it hard to find one that suits).

I'd personally go with the consultant that wants to add on the methotrexate and stay on the MMF too. I'm not sure off top of my head if it's a common combination but they would know that

Good luck and remember, you have a choice too so dont feel pushed into something you aren't happy with!

[ShannonB in reply to Sara_A]

Thx for this input— very helpful

[ShannonB in reply to ShannonB]

Just an update to everyone to say I had another rheumatologist appt and this time my main rheumatologist agreed with the other one and suggested I try low dose methotrexate on top of mmf and see if I can tolerate it and it helps, then taper back mmf if I see benefit. This is what I’m going to try. Fingers crossed.

[KayHimm in reply to ShannonB]

Good for you for getting the communication going. Sounds like you feel comfortable about the plan. Maybe the one rheumatologist just needed clarification that you would be tapering the MMF. I think they don’t usually like to have patients on two immunosuppressants.

Crossing my fingers for you too! Please check in to let us know how you are doing.

xx k