NRAS
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Methotrexate & Sulfasalazine

Hi All - I was on 15mg of Methotrexate since Nov 2017 in the first week of January it was put up to 20mg and the next week Hydroxychloroquine was added - I felt sick all the time had an ongoing dull headache, no appetite and in general just felt awful. I spoke with my Rheumy Nurse who told me to stop the Methotrexate and later stop the Hydroxychloroquine. I have missed two weeks of Methotrexate and I have now been advised to go back to the 15mg and Sulfasalazine will be added. I have been having fluish symptoms for the past 6 days and am a bit worried about started on Methotrexate again with Sulfasalazine added is anyone else on these meds and how to do they affect you - side effects etc. thanks

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No, but interested as suggested sulfasalazine or leflunomide as add ins on next appointment: stopped Hydroxychloroquine as week long nausea and unable to sleep. Just on Mtx at mo' which causes I day fatigue and 2 slightly nauseous now: can cope with that, just not all week.. However joints starting up again, know I'm not on enough and don't expect any of these drugs not to have some side effects by now, it's all a balancing act between symptom relief and what you can put up with. I'd be really interested to know how you get on, especially with sulfasalazine, bit wary of Leflunomide as I know it stays in system for ages. Cheers.

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Hi - thanks for your reply, I am a bit wary of all of them but what option do we have? I am going back on 15mg injection methotrexate for now then they are introducing the sulfasalazine slowly, I will let you know how I get on with that. We are all different and it is finding what is right for us.

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Thanks, know were different but nice have feedback especially if it's good for a change, two down, how many more to go? I guess thats why they don't tell you at start 😄

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I did say when I was diagnosed - you are not going to torture me are you? The reply was "not intentionally"

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I started out on Hydroxychloroquine way back in 2013 but then had 20mg Methotrexate added as the HDX wasn't doing the job. Later had the Methotrexate increased to 25mg and stopped Hydroxychloroquine as it was playing havoc with my stomach. I have been fortunate that apart from mild nausea on the day after I take MTX I have had no side effects.

MTX doesn't completely control the RA and I am being assessed for Etanercept soon.

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The flu'ish symptoms could be the RA getting active again...?

I take 20mg MTX, 3g Sulpha and 400mg hydroxy and I'm fine. Took a while to adapt to them. Thing is everyone's different so you just have to try. But take it very slowly in increasing doses. And drink lots of water.

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Hi - They up my methotrexate dose from 15mg to 20mg one week then added the Hydroxy the next week, I think it was too much too quick for me. I am going back on my 15mg injections of Methotrexate and they will be adding sulpha slowly. I just hope it works. thanks for your reply.

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you dont say if the methotrexate is tablets or injection once I got to 15mg I swapped to injections and that helped with the nausea a lot. Sorry no experience with hydroxy.

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Hi - it is the injections I have been on - I was ok on 15mg but when they put it up to 20mg and added in Hydroxychloroquine it made me very nauseated. I spoke with my nurse today and they are dropping it back down to 15mg and going to introduce sulfasalazine slowly. fingers crossed. thanks for the reply

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