Eye surgery And Actemra.

[alvertta]

Question: Monday I had a laser procedure for glaucoma. One little hole in each eye. Pin prick. Opthomologist says ok to do Actemra right away. Neurologist says when eyes are “totally healed” do next actemra. The Opthomologist gave me eye drops for 5 days. Ok. Who to follow? Have waited two days. Would you wait 5. Or just go ahead. Thanks.

[SnazzyD]

Is three more days going to make much difference?

[alvertta in reply to SnazzyD]

I guess not. I should just wait?

[alvertta in reply to SnazzyD]

The eye drops are for pain and inflammation. So I guess he thinks they could be. No pain. Eyesight is ok.

[SnazzyD in reply to alvertta]

You’d think the optho would know but then not all docs understand all drugs’ full effects, the Neuro may be more cautious, perhaps unnecessarily, perhaps not. Perhaps ask your Rheumy how urgent the Actemra is?? Hopefully someone here has been in a similar situation of having eye surgery and Actemra at the same time. What a pickle though.

[alvertta in reply to SnazzyD]

Rheumatologist is ok w me waiting. And she is always super cautious. She would have wrapped me in bubble wrap 2 years ago. Stay home. No travel. Etc etc. So I can wait three more days.

[SnazzyD in reply to alvertta]

I don’t know how quickly the immunosuppression kicks in with Actemra, but if it is rapid, it may mask any infection in the eye. Infections can take a few days post surgery too. So if Rheumy is happy, I’d wait if it were me.

[alvertta in reply to SnazzyD]

Thanks. Three more days is nothing.

[alvertta in reply to SnazzyD]

Yes. A pickle. And I also called my Actemra pharmacist. Lol. No one want to say Yes or No.

[SheffieldJane]

I would wait alvertta . I have missed two weekly doses of Ro-Actemra for an eye infection, with swelling and an ulcer in the corner of one eye with peeling. This had no effect on how I felt with regards to my GCA. I had 7 days of a Penicillin based antibiotic. The infection cleared up. Unfortunately one dose of Actemra and my eyes are prickling again. This makes me think that eyes are particularly vulnerable to the immune suppression of Actemra. I simply wouldn’t take any risk, however slight with my eyes.

I would wait the full 5 days, you have nothing to lose.

This decision was left to me by my Rheumatologist. I wish you a completely trouble- free recovery.

[alvertta in reply to SheffieldJane]

Thank you. Waiting!!

[LemonZest11 in reply to alvertta]

I had very low white cell count and Rheumy put me on fortnightly injections. My inflammatory markers have remained stable. I would wait, it's not that long.

[alvertta in reply to LemonZest11]

Yes. Waiting. Thanks.

[jinasc]

The very best people to ask about drugs and contradictions are Pharmacists, they know more about drugs than any other medical professional, they actually take 7 years to train and the last year has to be spent in a working environment under a Pharmacist before they are let loose on the public.

Lara the pharmacist whom got my first prescription for Pred, asked what I had, I told her it was duly noted and she became a friend. Every time a new drug was added, for whatever was going on at that time, she checked and twice the drug prescribed was changed.

The best thing to do is when you are in for the long haul, use the same Pharmacy.

[alvertta in reply to jinasc]

Thank you.

[scottygirl73]

I would wait, just treat it like you would if you had infection,a few day's won't make any difference i take Actemra to and wait to take it if any issues.Take care.xx

[PMRpro Ambassador]

I'd wait - tcz is also used 2 weekly almost as effectively as weekly so waiting a bit isn't a problem really. I imagine it is to allow time for healing and reduce the infection risk.

[GratefulBailey]

I was off Actemra for a month in the summer because of an infection - didn’t notice anything nasty when I stopped nor when starting up again. I know you are not supposed to have the injections if you have any illness/infections... I would go with the neurologist and wait. Be sure no infections are lurking. Good luck!

[alvertta in reply to GratefulBailey]

Thanks. Waiting 5 days.

[lcove]

I'd wait the full week. I was on Actemra for over a year and would purposely skip a week when I was ill or had a medical issue.

[alvertta in reply to lcove]

Thanks.

[Luciejc in reply to alvertta]

I agree. I'm on Actemra and I would wait a week.