Methotrexate with rituximab

[Keen62]

Is it essential to have to take methotrexate with rituximab infusion.

[Hidden]

I was told yes. They had stopped my 25 mg injections MTX due to my liver function being elevated.. But I now have three 2.5 mg tablets and have my first Rituxmab in two weeks, then a 2nd two weeks after that.

[farm123]

I have had it without as I cannot tolerate MTX and we were trying to find something to work when Enbrel failed and Humira did not do enough and I believe our unit had not got authorisation for Tociluzimab and Abatacept at that point. Unfortunately for me it did nothing. Farm

[AgedCrone]

I'm about to start RTX & really really don't want to touch Mtx again as it had really nasty side effects for me.

I asked the Rheumy nurse & she said RTX is only licensed if given with a small dose of Mtx....so as far as I understand if RTX is going to work for you the Mtx is sort of incidental...so I'm going to take just2.5mg per week

. Haven't discussed whether Folic Acid comes into the equation yet.

[Vickywb in reply to AgedCrone]

Thats a fib i have it without as the side effects of methotrexate were horrendous so insist you do not want it.

[AgedCrone in reply to Vickywb]

Think I might develop pill amnesia!

Thank you everybody for all your replies.

I have been reading that different area have different rules, but moving does seem a bit drastic to try out a new medication!

[jeannette65]

No I had rituximab for 4 years on its own it was brilliant. I had to come off it and am on tocilizumab now for GCA. Keep well x

[Fra22-57]

They tell you loads of rubbish.I had mine whole on sulfasalazine. I had been on methotrexate before but don't think that was connection. Sadly it did not help me anyway

[Silvergilt]

It depends on the NICE guidelines of your particular hospital, I think. I have allergies to MTX but the NICE guidelines in my hospital is rituximab must be prescribed with MTX unless there are strong indications it can't be done - and my rheumy would have to be able to present the case to the NICE board in order to get it cleared. (He had to do this anyway to get me cleared for the biotics). So it all depends on what your rheumy and hospital do. You could certainly suggest you'd like to try it with something else, or on its own, if you have past history showing you didn't tolerate MTX well.

[Neriah]

I am on my second round of Rituximab infusions for lupus and I am finding it quite effective. Methotrexate has never even been mentioned to me.

[AgedCrone]

Yes I have been reading about different hospitals having different guidelines.

If Biologics are so precise you'd think there would be a nationwide regulation.

But I guess agreement would put a lot of these decision makers out of a job?

Hey ho.....I'll try RTX & see how it goes !

[littleR]

I have Rituximab with Sulfasalazine, as I never wanted to go back on methotrexate. This works for me.

[Rosieapple]

I am in Australia. The Rituximab works well for me, so I stopped taking the Methotrexate but last time I saw my Rheumy he said I should take at least 5mg MTX a week because it can help stop me from forming antibodies against the Rituximab.