Is combination of Methotrexate (10mg weekly) and Methylprednisolone (4mg) common/safe for RA treatment?

[mangoSsh]

Hi everyone,

My mother was recently prescribed the following medication combination for her RA:

Methotrexate 10mg (weekly)

Methylprednisolone 4mg

Depoday 20mg (twice weekly, depending on joint inflammation)

Vitamin D3 (1000mg/880 IU daily)

Folic acid (3 times per week)

Lansoprazole (every morning after breakfast)

Ibuprofen (as needed for pain)

I'm particularly interested in learning about the combination of Methotrexate and Methylprednisolone - is this a common combination for RA treatment? Is it safe to use them together?

Also, if anyone has experience with a similar combination, I'd love to hear about your experience. Any insights or advice would be greatly appreciated.

Thank you in advance for your help!

[Runrig01]

Yws they are perfectly safe to take together. I’ve been on 25mg methotrexate and 4-5mg prednisolone for years. They both work in different ways to reduce inflammation. Brufen though I’ve been told to use sparingly, due to already being on methotrexate. Brufen can increase the risk of toxicity of methotrexate. Although I suspect that’s more of an issue with higher doses. Also the risk of GI bleeds from combination of steroids and nsaids like brufen

[Amnesiac3637]

Yes common, yes safe and if your mother’s doctor, who presumably is a rheumatologist, has prescribed MTX and Methylprednisolone then be assured, it’s fine for her to take them.

[AgedCrone]

Everything that has been prescribed for your mother is a completely normal..in fact a quite a moderate prescription . Her rheumatologist will have examined her, looked at her blood test results and chosen from her/his vast experience which drugs are most suited to her needs.

One thing you should understand however is that every one of us here with RA is different, so anything reported here is the personal experience of that person. If you have any doubts in the future about your mother’s drugs the only person you should ask for an explanation is her doctor.

I hope she is doing well.

[welsh12]

Agree with others as said iprofen not normally recommended regularly with methotrexate have been advised can use it localised on joints lansoprazole normally before food but dr may have some reason she needs to check with them or pharmacy. Presume she will have regular bloods tests and reviews 10mg methotrexate is low. Not heard of depotday. Folic acid normally added but not on methotrexate day. Should be on prescription

[Justanothermama]

not abnormal, but I would like to note the half life of methylprednisolone is much longer than that of prednisone so it does depress the adrenal gland function. I took it for about 5 years and it led to secondary adrenal insufficiency. It took about half that long to taper and though I don’t clinically need steroids now, my adrenals do underperform and my endocrine system has suffered. Prednisone is shorter acting so the adrenals aren’t kept in a suppressed state on it—my endocrinologist preferred that steroid for that reason, if necessary. Thankfully we found a biologic that works so steroids are rarely necessary now. good luck to your mom

[bpeal1]

I’m not going to repeat the good advice from others. However, I thought you may find this booklet from NRAS useful. nras.org.uk/product/medicin...

[mangoSsh]

Thank you all for your valuable advice and for sharing your experiences. Your responses have helped alleviate both my and my mother's concerns

I do have one additional question that wasn't covered in our discussion: my mother's prescription includes two different vitamin D supplements:

Osteofull (Vitamin D3) 1000mg/880 IU daily

DepoDay (Vitamin D3) 20,000 IU oral solution (twice weekly, depending on joint inflammation)

Her recent lab results show vitamin D levels at 22.65 ng/mL (in the 'insufficient' range). Would anyone have experience with taking both daily and weekly vitamin D supplements as part of their RA treatment? Is this a common approach to quickly normalize vitamin D levels?

My mother has started the treatment and is taking all medications as prescribed. I hope that in the future, I'll be able to share our own experience here as well.

Thank you all once again for your thoughtful responses ❤️

[CallMeSunny]

I don’t think any of us can (nor should) offer better advice than AgedCrone has given you. Your mother is very fortunate in having such a caring son. I’m sure we all wish her well on her RA journey.

[Maggsie]

My only comment would be regarding Lansaprasole which I have been prescribed but to take 30 mins BEFORE breakfast