Mtx and Leflunomide

[Elmo333]

Hi guys. Can you take mtx and leflunomide together? I’ve been having a terrible flare for 6 weeks and had a telephone chat with rheumatologist today. He wants to increase the mtx injection but I’ve tried it before and any dose over 15mg makes me sick. He said if that didn’t work, he would try leflunomide. How are the side effects/tolerance of lef? I also take hydroxychloroquine. Thank you

[bubblyalex]

I’m sorry I don’t know but I hope that you get respite ASAP

[Hidden]

This is my current combo for PsA - diagnosed after a good 10 years of active disease in Jan. I was initially put on 15mg mtx, then 20mg, but still couldn’t get off steroids for the ongoing flare. Had 10mg lef added in, and was able to get completely off the roids within a month or so. For me, it’s definitely helping, but I do have some side effects where the mtx alone was alright., although it seems to only be exacerbating pre-existing, non arthritis issues that are listed as possible side effects, nothing entirely ‘new’. I have acne (started in my late 20s🤦‍♂️🙄), as well as being very prone to cysts and abscesses since my early teens, and have had a vast swathe of nasty lumps and bumps since the lef kicked in, including 6 new cysts. Ultimately needed some antibiotics to calm some of them down. The other thing is that it seems to have made my long-standing stuffy nose/post nasal drip worse. I spoke to my rheum yesterday, and were it not for the skin side effects, I would quite happily put the lef up to try and get things more under control, but we both agree that’s not an option.

[Elmo333 in reply to Hidden]

Thank you. Sounds like you’re having the age-old side effects/benefits dilemma! Good luck with your next step

[rounder]

Hi there, sorry I don't know if they can be taken together, but when I decided I couldn't tolerate the methotrexate side effects any more (after10 years of nausea and being completely wiped out for 2 days every week, not to mention horrendous mouth ulcers), I was switched to leflunomide with sulphasalazine and hydroxychloroquine,. I very quickly felt much better in terms of side effects but unfortunately in order to get a high enough dose to control frequent flares it pushed my neutrophils count too low. This was a problem for me because I have lung damage and asthma.

[Cal48]

This is what I’m on. Side effects not much but I my mood is much better than when on methotrexate alone.good luck.

[Suzy-P]

I take 15mgs of Metho a week and 10mgs of Leflumonide a day and have done for a couple of years. Not had a problem thus far - have to have blood tests every two months (more frequently initially) and the combination has allowed me to live a normal life. If you read all the possible side effects of Leflumonide it’s very scary but I have been ok - but we are all different.

[Canadiangeese]

Yes, I was on 25 mgs of MTX and 10 mgs of leflunomide , plus hydraxychloroquine . this is called triple therapy. The only side effects were elevated liver functions, which the Doctor monitors via monthly blood tests. These allowed me to control my symptoms and live normal life including doing kick boxing which I love. After a year and a half, I have been weaned off leflunomide and my MTX has been reduced to 7.5 mgs. My liver functions are back to normal now. Yes, more medications sounds scary, but it’s more important to prevent further joint damages as this cannot be repaired.