Sulfasalazine or methotrexate

[Indersisive71]

I have just received booklets on these medications,

I am undecided which one to take ,I have been on hyroxychloquine

For 11 weeks it didn’t work ,so they have sent me information on these two drugs

Which has the least side effects

[Boxerlady]

It's very difficult to advise a) because we're not medics and b) because all of us are different both in terms of what works and which side effects we experience.

Didn't your rheumy recommend one or the other?

I started on Methotrexate and Hydroxychloroquine and had some improvements quite quickly. When things deteriorated a little, my Methotrexate was gradually titrated up to the maximum dose and then Sulphasalazine was added and this "triple therapy" seems to be the one for me.

I've had some (mostly transitory) mild side effects from both but nothing too problematic. I remember from a past post that you were really struggling with high pain levels so if it is was me, I'd be asking my rheumy what they'd recommend for aiming for a quick result rather than asking them about side effects; I made it clear from the outset that was my priority and tbh, just made up my mind to try anything they suggested and assume that I wouldn't have any problems. I have been accused of being a Pollyanna in the past but find that, for me, a positive attitude gets me a long way 😊

[Indersisive71 in reply to Boxerlady]

Hi thanks for replying , they said to read the leaflets about the two medications, I asked which one would she recommend.you could have one tablet once a week

Or injections . She said the methotrexate, but you have to go for a X-ray and blood test , I like your positively, I am usually a positive person

[AgedCrone]

Speak to your rheumy nurse and ask her advice she will know how you have reacted to drugs in the past and is the best person to know how you might react to SSZ or Hydroxy.

[ketiv74]

I started with Mtx inj 15mg once a week. It worked very well for me last 2 years, we recently added Hydroxy Chloroquine in Feb, I can feel its starting to work, but its still too early to see full effect. I have never taken Sulfa so not sure about that.

I saw in your reply above that your Rheumy is recommending Mtx, I would say try it. I did not have any side effects with Mtx other than some hair loss which was helped with increased Folic Acid & elevated live enzymes a few times but they came down to normal range in next test so that never concerned my Dr.

Hope whatever you end up choosing works well for you. Good luck & Take care!

[Indersisive71 in reply to ketiv74]

Thankyou for replying. I have notice people take the folic acid . Is that why they take it. I have decided I am going to try the mtx

[Boxerlady in reply to Indersisive71]

I think that's a good decision - always worth trying what your rheumy recommends. Folic Acid is to help with side effects; I started on 1 x 5mg Folic Acid a week and it was increased to 6 x 5mg a week (not on Methotrexate day)