MTX and Leflunomide

[joo10]

Does anybody take Leflumonide (arava) and MTX together? Im on 10 MTX and 20 arava. Not sure about the combination...........?

[helixhelix]

If you do a search for "MTX and Arava?" you should get an old post all about it....in fact if you look on the right hand side of your screen under related posts you might see it!

[allanah]

Yes me! And Rituximab infusions . No probs X

[cathie in reply to allanah]

Allanah, do you find that the leflunomide helps the rituximab to last a bit longer? I'm not great after about 4 months

[allanah in reply to cathie]

Not really Cathie. I'm not great after 4 month too but I think it really helps with the swelling. My consultant says that the methotrexate is what makes it work better and I know u r not good on that, I'm not either lol , but he wants me to try a snail injectable dose. Haven't be able to start it yet due to chest infections!

[Ellioteva in reply to allanah]

What is a snail injection Allanah

I've never heard of that xx

[nomoreheels in reply to Ellioteva]

I think she means small, a small injectable dose of MTX. Haha snail dose would be very slimy, yuk!

[allanah in reply to nomoreheels]

Need to put my specs on!!!! Lol 😂

[allanah in reply to Ellioteva]

I do great typos !!! A small dose injection lol x

[allanah in reply to Ellioteva]

Or it's when you give an injection slowly ...... Joking xx

[nomoreheels in reply to allanah]

Ha! See what you did there!!

[alicn]

Me too! Have done 3 months on 10mg Lef and 22.5mg methotrexate with no probs, now Rheumy has upped Lef to 20mg all okay but still early days yet. Not sure it's helping joints as I'm actually in more pain but heyho am trying to keep optimistic for now anyway! As long as your bloods are regularly monitored (and your stomach/bowel is coping-as Lef can cause probs here) any issues will be highlighted early. The only problems I have are some indigestion which omeprazole sorts out and strangely I seem to need to wee more often and with more urgency. It's def not an infection and only started with the Lef..what an odd one!

Good luck with the combo!

[Monkeydog1965 in reply to alicn]

Hi,

Check the interaction between omeprazole and methotrexate. My doctor took me off pantoprazole because it can cause more toxicity with the methotrexate.

[nomoreheels in reply to Monkeydog1965]

The interaction relates to high dose MTX where temporary withdrawal of all ppi's is recommended during high dose use in treatment for cancer. I refer to the European regulations which state that ppi's possibly reduce excretion at high doses MTX but not at low doses (what we're prescribed for RD & associated conditions). Any individual adverse effects would feature in drug monitoring blood tests.

[Monkeydog1965 in reply to nomoreheels]

Okay, just trying to be helpful.

[nomoreheels in reply to Monkeydog1965]

Maybe it's different guidelines in different countries or you were on high dose MTX?

[Monkeydog1965 in reply to nomoreheels]

Only 25 mg weekly, which is not a high dose. I think he did it as a precaution. In my reading, it did indicate higher doses.

[nomoreheels in reply to Monkeydog1965]

For use as a DMARD 25mg is the high end. But of course your Rheumy is the one who controls your scripts so I'm sure he's doing what's best for you.

[Monkeydog1965 in reply to nomoreheels]

Yes, thank you. I have Polymyositis along with th RA.

[nomoreheels in reply to Monkeydog1965]

I hope you're doing well.

[Monkeydog1965 in reply to nomoreheels]

I am doing better. I hope the same for you!!

[allanah in reply to Monkeydog1965]

Great name monkey dog ! Love it !

[Monkeydog1965 in reply to allanah]

Thank you! My brother gave me the name!!

[allanah in reply to Monkeydog1965]

Sounds like a great brother!

[Monkeydog1965 in reply to allanah]

Yes, he is!!!

[Monkeydog1965 in reply to allanah]

You are from Scotland?! How cool!!

[allanah in reply to Monkeydog1965]

Originally! Married an Englishman so came to England 1980

[ords]

I take them at same time and all night i have been having pains in my head really heavy and painful

[SilverWolf]

Yes me. I am on exactly the same meds. I've had a few side affects.headaches.sickness. no appetite to name a few. But I am newly diagnosed. Six months ago so maybe I'm just getting used to it x

[alicn]

Thanks Monkeydog1965 for raising the question and to nomoreheels for the evidence based reassurance! X

[MajaJantje]

Yes, me too, on 15 MTX and 10mg Arava sinc october 2015. First, I was on 20 MTX which wasn't sufficiënt enough, so MTX went to 15 injection/weekly and 10 mg Arava daily.

Rheumy wants to take it to 20 mg. But I have a sensitive stomach and bowel, asked to keep a at 10mg till March. It helped on the infections, first 2 months, but now I they are slightly back, not too much pain however.

My bloodpressure is too high, perhaps due to the Arava, since bloodpressure went up when starting to take Arava. But it could be stress at work too (started at the same time).

And a lot more weeing, happy to read further on that more people have this, so that will definitely be the Arava.

And so tired, so tired...perhaps when Rheumy says higher Arava in March, a few weeks on sick leave, and try to look for another job ;).

[Beaches2]

Hi

Yes me too on this combination plus abatacept. 25 mg mtx and 20 leflunomide, so a hefty dose of both. I do worry about the amount I take and hope I can soon reduce something! Fortunately I seem to be coping ok with regards to side effects so far.