What DMARDs are available in injection form? Dr. wants me on inj. Due to elevated liver enzymes. ARAVA was effective until then.

[Ddmc]

Dr. Wants me to move to Enbrel, but I don't want to change to that group yet.

[francherry]

Hello there,

The only one I know about that I know you can take by injection is Methotrexate (as I used to have it injected rather than take the pills). Hopefully other people will know more.

Francherry

[Ddmc in reply to francherry]

Thank you. Methotrexate wasn't super effective for me in pill form, but my liver did seem to be able to handle it. Maybe it would work alongside Daypro? Gotta do something and soon!

[Hidden in reply to Ddmc]

Methotrexate is significantly more effective in injectable form because it bypasses the guts so you don't lose so much in the digestive tract. Gold is administered as an intramuscular injection but I don't think any other DMARDs come in injectable form.

[Ddmc in reply to Hidden]

Thank you! I really am leaning towards trying Methotrxate injections before going to Enbrel. Seems like at 52 years of age, I need to have other options (Enbrel) to go to later.

[Hidden in reply to Ddmc]

Seems like you're up in the early hours still like me?! I'm worrying about a teenage son who hasn't come home yet and won't answer his phone!

But also in similar situation because I've taken myself off injectable MTX despite it working really well for my RA. I was getting really alarmed by peripheral neuropathy - tingling and numbness everywhere which I had last year too while on the tablets. My GPs both think its a rare side effect of the MTX and are pleased I'm off it.

Now its down to my rheumy to decide what next. I've tried Sulpha and Hydroxy so next option is anti-tnfs I think. I'm only 50 and like you I don't feel ready for the next tier of drugs. But also feeling like I'm waiting for the RA to come winging back to wreak pain and havoc on me now as my ammunition has gone?

Oh good son is just home - one less thing to fret about anyway! X

[Ddmc in reply to Hidden]

Glad your son is home and you can relax. Thanks for your answer. I too Mtx orally, but the pain stayed at 2-3. Rheumey didn't think that was good enough. Arava with Daypro made me pain-free. I think I'd rather have a small amount of pain and put off Enbrel......

[rheumatoidymummy]

I've been injecting methotrexate for some time now and can tolerate a higher dose than when I was taking the tablets - I'm on 25 mg now. I was quite squeamish about doing the jabs myself at first but it's easy once you know how. Xx

[Ddmc in reply to rheumatoidymummy]

I certainly don't like the idea of injections, but I also don't want liver damage! Doc said injections would be easier on liver.....

[cathie]

I didnt think about going on anti-TNF as something I should leave til later. I had it about 4 years after first diagnosis and it stopped any joint damage and put me back on my feet so I could take exercise. Some people find that they only need a short course. Its worth looking into that with an open mind. I took anti-tnf for nearly ten years and was so stable that I was taken off them a year ago. But they seem to need a DMARD to work most effectively - I was (still am) on methotrexate. Complicated isnt it!

[Ddmc in reply to cathie]

Hmmmm.....didn't think about being on both, since doc took me off Arava and said Enbrel "instead." Thanks for comment.

[Hidden in reply to Ddmc]

I know someone who manages her RA very well on Enbrel only. And there are several on here who take anti-tnfs without a DMARD so I don't think its a hard and fast rule. If my RA was out of control still I think I would be like Cathie about the biologic drugs and just aim for them but I don't feel ready for them yet. I'm really wanting to get the peripheral neuropathy addressed first as now have a dread of side effects even more than I do of RA! X

[cathie]

My experience was that they wanted me to stay on both. Once I misunderstood instructions and reduced the mtx and found that the anti-tnf (infliximab) was much less effective. I went back on to the two and things returned to normal. I had a period of stability for about 5-6 years and now am just on mtx. So far so reasonably good. I have had one or two short flares but dealt with quickly with ibuprofen (took about 4 200 ml pills).

I suspect that practice varies across the country, from one consultant to another. There dont seem to be any hard or fast rules. At the hospital I went to in England the consultants all had different approaches and I preferred the cautious one!

[cathie]

I think the protocols change between hospitals etc. But I did find a dramatic difference when I reduced the mtxate - but that's just my experience and I wouldnt generalise! Hope you get on ok next week.

[Hidden]

I am on Enbrel and Leflunomide (Arava).