change of meds

[junik53]

Hi I have just changed from MTX to leflunimide do I still need to take folic acid? I was off MTX for about 2 weeks before starting Lef. My psoriasis has become worse, will the 10mg of Lef.make it any better ,or will I have to up the dose , also how long before the Lef. Kicks in. Does anyone have experience of the change in meds and in particular anyone who has PsA. Thanks

[Hidden]

With the caveat that I’m not medically qualified and professional advice should be sought around medication. No, you don’t take folic acid with leflunomide, it’s only needed if someone’s taking mtx. The rest of your questions have no definite answer as they’ll depend entirely on your body’s own, personal response to the leflunomide, but I have PsA and was taking it both alongside mtx and then on its own for a bit, so can give you my own experience. I currently take 10mg a day alongside a biologic.

I had leflunomide added at 10mg a day after about 5 months of being on mtx without any improvement at all. I continued on increasing doses of the two together for about 9 months before binning the mtx as I felt like it had never ever helped me at all. Sure enough, there was no change at all from stopping it, so all the benefit I’d had in that time had come from the leflunomide. When they initially added the lef in, I started to notice an improvement within about a month, although the usual 12 week timeframe applies. Without getting into the ins and outs, I had to come off all treatment for a bit and eventually started back on an anti-tnf (a biologic, specifically adalimumab) last September. They added the lef back in at a lower dose around Christmas and I’ve been on it constantly again since then, although my biologic has changed in that time. I’m not 100% and there’s still room for improvement, but between the lef and the biologic drug I switched to in May, I’m the best I’ve been since diagnosis, and I very quickly noticed more improvement when they put my lef dose up in July.

Anecdotally, leflunomide is considered particularly effective for PsA compared to the other conventional DMARDs, although as with all treatments, it doesn’t necessarily work for everyone, and it may not be enough on its own. I can’t personally comment on its use for psoriasis as I haven’t had active skin involvement in 20 years, but it’s considered an appropriate treatment for plaque psoriasis, so hopefully you’ll see some benefit there as well as with your joints.

[smilelines in reply to Hidden]

interesting that leflunimide is considered the most effective Dmard for PsA.

[vonniesims]

check with your pharmacist.

[smilelines]

I have PSA like inflammatory arthritis. On leflunimide and don’t need folic acid. I think it took about a month to feel better. I found leflunimide didn’t make me feel sick like the methotrexate did.

[junik53]

Thanks for the replies,just a waiting game I guess until Lef. starts to work.

[cathie]

You're best checking with the medics. I'm on leflunomide and dont take folic acid, but I do have regular blood tests to monitor how things are going. But please check doctors.

[LadyJan]

i am on mtx and take folic, but unsure if you do same with Lef.....of which I am allergic to! Could check on Google or your doc.

Ladyjan