When to stop DMARds

[Amhoarten]

I know that you should stop taking Mtx when your ill but does that rule apply to the others like sulfazalazine and hydroxychloriquin?

Do they all suppress your immune system?

[medway-lady]

Leflodamide does so yes to that one, but don't know about others. Sorry,

[Hidden in reply to medway-lady]

Interesting about lefluonomide. It has a ridiculously long half life, so I cannot see the advantage of temporarily stopping it e.g. for a week of antibiotics.

I've been on various DMARDs and the only ones I was told I "must stop" are the biologics. I was told "ideally stop" the MTX too but my situation was different in this case because I was on antibiotics for 6 weeks. There's no hard and fast rule. I think you need to check with your rheum nurse or rheum.

[medway-lady in reply to Hidden]

My RA consultant said that LEF is don't take for a week after the antibiotics finished and I had pneumonia, so had three courses in total. It may be that its the half life and then 1/4 life etc that takes time to get out of the system. It's always best, of course, to discuss with the GP or RA consultant.

[Hidden in reply to medway-lady]

Interesting. I wasn't giving medical advice of course , just interested to hear that it was suggested for you to temporarily stop your lef. That said, I suppose it depends on the individual and the type of infection that they have.

[helixhelix]

Sulpha has a very, very small effect but hydroxy doesn't at all. I've never stopped them (mind you I've only once stopped MTX in 6+ years as never really been that ill (fingers crossed)).

[danh1977 in reply to helixhelix]

Hi, Is methotrexate as bad as it reads, my consultant says you cannot drink on it. Now I'm not dependant on Alcohol at all but enjoy a few glasses of wine at the weekends with dinner. I'm reluctant to try the MTX due to this. How do you find it?

[helixhelix in reply to danh1977]

I can only tell you my personal experience, you should always be guided by your own doctors as we each have different medical history.

Anyway, I didn't drink at all for the first 2 months to give the best possible chance of success. After that I introduced one glass a week, and when next blood test was fine went up to 2 glasses a week.

6 years later I now have a drink with my dinner on fri, sat and sun (I take MTX on Tuesday). My blood tests are always fine.

What you absolutely mustn't do is binge drink (or the RA equivalent of binge drinking which is probably only a bottle of wine!) or drink on the day you take MTX.

[danh1977 in reply to helixhelix]

Many thanks for your response..is there an alternative to the mtx that has as good as an effect. Like leflunomide for example. I appreciate everyone's different but not asked anyone with my condition before so the advice is much appreciated. Thanks

[helixhelix in reply to danh1977]

Lef seems to be considered as equivalently effective as MTX, but I think it's no different as regards alcohol. Have a look at the NRAS information on the different DMARDS, here...

nras.org.uk/getting-establi...

And then you can google name of drug + patient information leaflet for each of them to read the contraindications. But bear in mind that reading the same information for e.g. Paracetamol is equally scary! Life is a balance of risks & rewards, so we each have to weigh up our own choices.

[danh1977 in reply to helixhelix]

Thanks again...research time!

[medway-lady in reply to danh1977]

I do have a drink or two on LEF no problem might even have three! but that's not every night. lo

[Fra22-57]

Good gracious no or you will be worse.

[Hidden]

I thought as a general rule we stop the drugs when we're taking other ones with which they're contraindicated or which they interfere with e.g. some antibiotics. And then only if the GP or rheumy feels it is necessary.

The immune system's a complex bit of kit and to say that DMARDs suppress it full stop is probably a kind of shorthand. Obviously the immune system DOES work when we're taking them or we'd be constantly ill. I've had fewer colds etc. than ever since starting meds. If you're unwell, seek your GP or rheumy's advice re. the drugs, I honestly don't think it's a calculation many of us are qualified to make.

[Amhoarten]

Thanks for all your help. I kind of have a better understanding now xx