What's the next step drug wise after pain killers... - LUPUS UK
What's the next step drug wise after pain killers, hydroxychloroquine? Should I ask for Methotrixate? what are you views please, thank you x
I'm not quite sure what you mean. Hydroxychloroquine is quite good at managing mild to moderate arthritis and skin manifestations of lupus so it is usually the first drug to be prescribed. The second line would be prednisolone but it cannot be used long term so if it doesn't work after a while then you are usually given an option of taking disease modifying drugs such as methotrexate, azathioprine, mycophenolate etc. I have been fight for a long while against taking disease modifying drugs as they can have pretty serious and nasty side effects. Only after being diagnosed with osteoporosis and increased eye pressure I decided that it was time to start getting off the steroids. I first tried azathioprine but I got severe gastrointestinal toxicity and had to stop. NOw I'm starting mycophenolate and will see how it goes.
Have been taking hydroxychloroquine for 6 months now but am quite sure that there not doing much, had prednisolone for a month but rheumy wouldn't prescribe for longer as my blood pressure is usually high. So not sure what he will suggest when I return next week, thank you for replying.
I've battled lupus pretty damn well for nigh-on 30 years Becky. In the first instance, I'd concentrate on finding a NSAId that works well pain-wise, even though it may mean you sampling many drugs over some months before you find the right one. That's the next step up from anti-malarials. If NSAIDs fail to keep you comfortable then you should try steroids - either in tab form or long-lasting injections. I don't believe it's wise to accept chemotherapy of any flavour unless and until your SLE proves life-threatening and there's no option other than to take it! Whatever you diecide, best of luck! x
Hi Becky, it's definitely a decision to take in a planned way with your rheumatologist. I tried the NSAID's, hydroxy and now on the methotrexate which has I have been on for 6 weeks. For me so far the methotrexate has minimised the flare ups and I still take the placquenil too. I was on just the placquenil for 18 months but then It got to the point where I was always at the GP with either infection/inflammation in body and torso/stomach in pain. After a discussion with the rheumy she suggested methotrexate. I have overlap of lupus and polymyositis. I guess it's what works for you and your body/symptoms/blood results etc. I have no doubt that my meds will change in time as symptoms change either lessen or worsen. But for now it works and what happens tomorrow is a brand new day. Although I have had steroid injections I am reluctant to go down the steroid route, even though others do very successfully. Again, I may have to my mind on this in the future. I hope you are able to make a choice that is right for you. Good luck with itx
Hi Becky I was on plaquenil for 9mths before I felt the benifits next to added was nsaid's then steroids and finally now Imuran was added as a steroid spearing drug. So I take 400mg plaquenil, 100mg Imuran I have tolerated them well and have had less flair ups when I do flair it's usually shorted in duration. Have a good chat with your rheumy.
Hi i have been on plaquenil since Nov, can only take before bed as makes me very drowsy...not sure if its doing any good. I seem to be feeling worse, will see the doc in April.... Good luck to you.. Uzi..xxx
Hi beckybooboo I am the same as you and are due to see rheumy in 3 weeks time, the pills are not doing me much good yet.I started them in October and feel no better.The pain all over is bad, teeth ,mouth ulcers,itchy legs where does it end.i worry about all these drugs including B/P as well.Keep smiling and hope you get some help on your next visit.
Hello Shanti, This is all such a pain?! It's good to know your not alone, Im so very fed up with it all myself, I just hope that on Tuesday I get some result or direction, will post how I get on, you keep smiling too and thank you.
Hi beckybooboo, not trying to alarm you but I was on methotrexate. Took a few months to cope with nausea but after was fine. I developed a cough after 6 months which nobody seemed interested about.wasnt till my phlebotomist said that I should be given lung function test as standard practice, that it was too late and my lungs are now scarred. My liver didn't like it either. Shame as it did help.
