Change in medication advice

[poppykhanom]

Hi everyone just wanted some advice on drug change. I'm currently taking deflazacort daily with Metoject injection once a week and Folic acid 1 a week.I'm currently living in Valencia Spain so working with the Spanish health system is quite tricky.

Anyway I have been on this combination for a year. I got in touch with a friend in the UK who is a doctor and said I should stop taking the deflazacort steroid and think about a combination drug such as the metoject with either sulfasalazine or hydroxychloroquine.

I've never heard of them has anyone has problems with these.

I read that hydroxychloroquine can effect your eyesight (mine is very bad as it is).

I.m trying not to over think it but i'm also concerned about the long term effect I'm going to be 35 and want to think about having children in the future so its all concerning me. Any advice is appreciated.

The Spanish sun has been really good for me and generally i feel good but i know i cant stay on the steroids long term.

thanks for listening

[helixhelix]

I think you do need to try to have proper discussion with a GP at least, if not a rheumatologist. But whatever you do, don't just stop taking the steroids as you have to taper down carefully. Certainly my rheumy got me off steroids as quickly as possible, and is v anti their long term use unless absolutely necessary. I'm on triple therapy of MTX, Sulphasalazine and Hydroxychloroquine which works well for me. I recently went to see a French rheumy who called this mix "the Anglo-Saxon cocktail" as apparently it's much more common in UK and US and not used that much in other European countries. Hydroxy can affect eyesight at high doses for long time, but I get my eyes checked regularly and all seems fine. Hope this helps. Polly

[allanah]

Yes its amazing the differences in Europe. NRAS have a blog out, I think Andrew put it up a couple of days ago about EULAR having a campaoign we can join in to make british treatment up to the standard of european treatments. Maybe have a look and joimn in the campaign? Xxx

[Hidden]

I think you should definitely consider getting onto triple therapies - especially the Hydroxichloraquine - if you are thinking about starting a family. You certainly don't want to be on the Metoject and I think it takes 6 months after stopping it before you can safely conceive. Do you have a consultant back in England or one in Spain? Who is prescribing and monitoring the MTX for you? I would ask them about coming off steroids slowly and introducing one or both of these DMARDs. Tildax

[poppykhanom]

I have a rhumey in Spain shes always very responsive and helpful and i have to say that everything seems to work a lot faster here so im happy with this.

Im back in july for a consult so I will talk to her about this.

Luckily my friend is a GP in the UK who also Works for Arthritis Research UK so i get advice from him. I wanted to speak to people who have experienced the medicine as the doctors cant give me that information so I thought best to talk to you all.

Thanks so much for your advice its nice to be able to talk to someone. It can be a Little bit difficult out here especially with the language. OK im going to go and enjoy the spanish sun i have 3 hours of rehersals with the children for sumer festivals (the joys of being a Primary Teacher)

thanks Poppy

[Hidden]

If your rheumy is as good as you describe then I would stick with her and follow her advice closely. Its great seeking views on drugs from those who actually take them but important to remember that each of us responds to medicines differently so for some Metoject is fine where others, such as myself, are struggling with it a lot, despite sticking it out for 19 months now. I also struggle with steroids and had a serious reaction to Sulphasalazine but Hydroxy was fine although it did didn't do much for my RA.

The EU sounds generally better in its approach to rheumatology than the UK - a lot of this is to do with very overstretched and under resourced services rather than the quality of rheumatology overall I feel. But its really good that you have better access to your consultant in Valencia and great to have a doctor friend who knows his stuff too. Tilda x