Sulphasalazine stopped

Hi I am a newly diagnosed seronegative RA but had to stop sulphasazine after 4 weeks as my liver was not coping and neutrophils were extremely low. Feeling absolutely exhausted! Going to try me on Methotrexate in 2 weeks but will this not have the same effect? Want to get my life back as have 2 young children. Feeling so desperate!

[nomoreheels]

Ordinarily I would have thought yes it would but your Rheumy knows he needs to slow the progression & has to consider which med is better to get you under control to keep damage to a minimum so I guess he thinks in order to do that MTX is the best next step for you. It's possible given the reasons you've needed to stop SSZ may also occur with MTX that he'll introduce it at a low dose, possibly suggest fortnightly bloods for a couple of months to keep an eye on both your LFT's & neutrophils & titre up according to your reactions as shown in both your bloods & physically. But he should discuss all this with you.

If he doesn't tell you why I'd ask the question of him so that you have the opportunity to understand his reasons. If it helps, I've had cause for my MTX to be increased recently but I have a history of going from 15mg to 20mg & it affecting my liver. Because of this my Rheumy's intention is for me to go to 20mg but to increase it in 2.5mg increments with bloods as mentioned above & reviewing in April whether the extra 2.5mg to take it to 20mg is necessary or feasible. So for now I'm on 17.5mg.

Hope this helps?

[helixhelix]

MTX and Sulpha are very different drugs that work in different ways to try to control your RA. So although both can affect the liver they do so by different routes so I don't think that just because one has given you a bad reaction it's automatic that the other one will as well.

Presumably you'll have to wait a bit till your levels get back to normal before starting a new drug, so I hope you can get a bit of extra support to help you through. I can well imagine you're shattered with low neutrophils and 2 kids.

But whatever you do, do try not to drink alcohol and do drink lots of water to give your liver as much help as you can to get back in shape.

[Hidden]

Thank you so much for your comments. It really helps to try and stay optimistic

[Hidden]

Hi mummystiff,

sorry you are feeling so rough at the moment. If you need to have a chat about things then do please call the helpline on:

0800 298 7650 Monday - Friday 9.30am - 4.30pm

One of the previous threads discussed fatigue. I don't know if you read it, but it may be helpful to you:

healthunlocked.com/nras/pos...

And I have put the link to our information on fatigue below for you (also mentioned in the thread):

nras.org.uk/publications/fa...

Hope you feel better soon

Regards

Beverley (NRAS Helpline)