Methotrexate drug combinations - advice please

Methotrexate drug combinations - advice please

I'm on mtx 15mgs weekly but haven't had any improvement in the last 4 weeks (18weeks in total). I've been prescribed prednisalone 10mgs and after only 3 days my pain is greatly reduced to a level where I'm only taking cocodamol at night.

I have an appointment with the rheumatologist and would really appreciate peoples advice on what drug. combinations are working for them?

Also I was late taking my mtx this week and took it on Sunday night rather than Saturday night as usual- can I take it on Saturday this week as usual? 😊

9 Replies

  • The theory is that there should never be less than 7 day gap. So if your normal day is Sat, and you skip to the Sunday then next week is Monday, the next Tuesday, then Wednesday and so on until you get back to your preferred day. Having said that I have been known not to follow that advice...

    I'm on triple therapy and it works great for me. There was a period when it was totally out of fashion, and biologics were seen to be 'the answer'. However research has shown that you can have as good outcomes with the old fashioned triple therapy as you can with the posh drugs.

  • Actually I might try different days and see which feels the best day. Can I ask what meds you are you on and what doses?

  • MTX, mainly 17.5mg injections but sometimes 20mg due to supply problems. That was first drug. Then Hydroxychloroquine added and now on 400mg/day. Then Sulphasalazine added, had to go up to 3g or 6 tablets a day to start with, but over last few years I have managed to drop down to 1.5mg/day. Plus all the other add-ons. It's a lot, but it works so I've got over worrying about the amount.

    Was that your anniversary drink? Looks like something that would have me on the floor in seconds....

  • Ha ha ha no it's mermaid hot chocolate! My granddaughter loved it, but honestly it was disgusting!

    That's really helpful my dad's a pharmacist so we've been looking at combinations and he's quite keen on using the older DMARDs

    I've been so disheartened by the medical ?advice/information I've been given , which has been vague, patronising and at times wrong!

    This site has been so informative and reassuring. I've found it invaluable.

    Thank you xx

  • Haha...."posh" drugs?! That amused

  • Everyone will say here she goes again when I caution about staying on Prednisolone for too long calms things down, & takes away the pain but it is no protection for your joints

    That nasty RA could still be gnawing away!

    If,you feel Mtx is not helping you - ask your Rheumy to have another think..maybe add something....or change to another Dmard. He is the best one to decide which route to take. A lot of people here take a few different pill....I have only ever been prescribed one drug at a time. Each Rheumy has his own preferences.

    But you have to stand up to the Rheumy.....I have been told something is working when it wasn't...& I just had to stand my ground. Make sure to be fair, but firm

    I Hope next time you post it's good news!


  • I agree AG I didn't want to go back on prednisalone. I called the RA nurse to say I think it's time for another DMARD and she said she'd discussed this with the rheumy Dr and he wanted to see If the pain was my RA as my CRP and ESR were now down!! What can I say - I feel like I have to prove my illness everytime, it's very wearying! X

  • I know what you mean.......when I was first diagnosed & knew nothing much about RA, I often felt like saying I didn't care what my blood tests said I was in pain & could I please have something to help me!

    I do hope your Rheumy gets you settled on the right meds for you very soon.


  • MTX has worked for me for over 35 years (46 years since dx), best drug ever for me. I inject 25mg. It does take a while to get in the system, maybe its a case of needing a higher dose? I tried Humira & Rituximab but neither worked and Humira caused infections. Also taken steroids on and off for 46 years, despite the risks. I used to be injected with A.C.T.H. three times a week as a child and now take oral Prednisolone. Also take HCQ, 400mg daily plus Etoricoxib 90mg and codeine for pain. Good luck!

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