Just prescribed hydroxychloroquine to add to methotrexate - has anyone had success on this combination?

I've just been prescribed hydroxychloroquine by a reluctant rheumatologist and wanted to know how successful a combination people found it to be?

I think my rheumatologist is convinced Im trying to pull a fast one. Why anyone would want more RA meds prescribed is beyond me, but it is such a fight to 'prove' I'm ill enough to warrant treatment. I've been on methotrexate 15mgs for over 6 months with some improvement in that Im not getting any flares and my CRP and ESR are back to normal, but I'm exhausted and take painkillers for pain in my hands and feet. I've been taking 20mgs prednisalone for the last couple of months so that I could get back to work, but despite that my rheumatologist is suggesting my problem is down to OA . I do have a couple of fingers with OA on both hands but the pain is quite different. I feel fobbed off and not believed or listened to.

At my last visit he prescribed hydroxychloroquine, but said I won't qualify for biologics ( I didn't ask for them so a random thing to say?) He also said that the RA meds won't make any difference to my fatigue.

So Im desperate for this combination of meds to work as I don't feel very hopeful I'll get any more help without a fight! My anti CCP is 298 and RF 35 so this really isn't my imagination. I'm feeling very dispirited and hopeless about my treatment and even my friends and family are saying, well maybe it's OA. He's also ordered an ultrasound to see if there's any inflammation present, but selected my left hand and as Im left handed and have more OA, I can only think he's trying to prove the point!

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  • It's quite sad that your rheumatologist isn't working with you. I'm on hydroxychloroquine with Methotrexate and Sulphasalazine and the combination has been good for me, but still get flares and fatigue at times. My rheumatologist always considers what I'm saying and gives his opinion and we usually come to a compromise. I'm usually opposing some increase in medication 🙈😂 I hope it works for you. There are NICE guidelines around treatment of RA and it may be helpful for you to have a look at those if you haven't already. Really hope it works for you. Keep posting and let us know how you get on. Happy Easter too 🐣. Candy

  • What a plonker! It's the absolute standard pathway as recommended by NICE, so not wildly unusual. I started with MTX, which helped, but the same as you after 6 months it wasn't enough so hydroxy was added in which helped more. (4months later still not enough so Sulpha added as well, but that's another story). Rheumy didn't quibble at all. However she was also looking at how my blood tests had changed, and although they had improved I was still just above 'normal' for ESR & CRP.

    Once you're diagnosed your RF and anti-CCP become pretty irrelevant, so it's the regular blood tests results that matter. Are yours still above normal? As if so then I really don't understand why he's being reluctant. Getting you off steroids should be much more important surely?

  • No that's my problem - my ESR and CRP are now at normal levels but I still have pain in my hands and feet and feel very tired. But when I take enough prednisalone these symptoms disappear, so surely that means it's due to inflammation and so will respond to DMARDS?

  • But if you are on prednisalone it will affect blood results, making them drop? When I was during that phase, my markers were normal for 6 weeks or so after each steroid jab. But then they rose (to the heady heights of ESR 21) again. My rheumy expected my results to be lower after the steroid, so a tiny rise was enough for her. These days if I have an ESR over 8 I am flaring, so we each have our own normal ranges.

  • Hi, I have had rheumatoid arthritis for 3 years now and like you I was put on methotrexate and steroids, I took them for two years, which made me feel better, I was then given hydroxy to add, it didn't seem to make any difference, I then got a really bad leg and couldn't walk for a year, which turned out to be cystic artery disease in leg, which I was operated on, and now feel better, I now only take methotrexate needles, 15 mg once a week, I still get pain all over but I manage it and go to work, I think the journey to get yourself ok can sometimes be a mental state of mind and even though you still in pain and feel like crap you have to keep your self going and get mentally strong, I'm not sure if you will ever get pain free, I know I don't, I hope it works out for you xx

  • Hi for some this combination will work didnt wirk for me constantly.making me sick

  • I tried the combination and it didn't work for me. It is hard to describe how difficult to find appropriate meds. I now have Rituximab + methatrexate which works for me

  • Hi there,

    I too have the hydroxychloroquine with 22.5 mg methotrexate and am also on Etanercept injections once a week so it a bit strange of your consultant to say that... No one would ask for more meds to be prescribed would they! I have prednisolone when having a flare up so not too often although I'm never without pain. I am always tired but manage to work 25 hrs a week.

    I hope you are feeling better and the combination is starting to work for you. Its an extra worry for you feeling that you are not listened to properly and disheartening because its a fight to keep on top of this wretched disease without feeling unsupported too.

    Happy Easter

    Delainey x

  • I've been on Methotrexate for almost 3 years and hydroxychloroquine 2years. I haven't found any complaints with them both together. My injection pen is a very small amount. My body can only take 7 5mg it did one time get up too 10mg. But it affected. My kidneys and my liver. I That I am back to. 7.5. The nurse says I may. Have yo stay there. And not Move from there

  • im on that plus Benepali but the mtx will be going i think as its infected my gallbladder

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