GPs and Actemra: Can CGPs prescribe Actemra... - PMRGCAuk

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GPs and Actemra

Mstiles profile image
22 Replies

Can CGPs prescribe Actemra? What are your experiences?

I’m in the US, and have had 3 bad experiences with rheumatologists. One good one who listened, but she left.

My GP has been prescribing my prednisone, but not really managing the dose.

I’ve been stuck at 9 mg for a year due to various problems and would like to get moving again.

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Mstiles profile image
Mstiles
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22 Replies
Koalajane profile image
Koalajane

hi, I don’t know about America but I don’t believe GPS in UK can prescribe it

PMRpro profile image
PMRproAmbassador

GPs in the UK can't prescribe any such medications and it will depend on what the PCP is in the USA but I would doubt a GP would do so. It is a highly specialised drug and as such that is usually the domain of specialists.

Wallysma profile image
Wallysma

Hi. I don't think do. My rheumy did mine but only after confirming my . RA was active. If it wasn't she would not have applied for it. It's a process for them. I have only had one infusion so not sure what it will do....keeping my fingers crossed. I am stuck at 29!!! Good luck with figuring out next steps.

Plains profile image
Plains in reply toWallysma

I hope you will do well on the Actemra. I have been able to reduce my prednisone to 1mg. I could not have done this without it. Remember to decrease prednisone slowly. That is the key to success, I think! Good luck!

Mstiles profile image
Mstiles in reply toPlains

your rheumatologist prescribed it?

I’ve yet to find a good one.

Plains profile image
Plains in reply toMstiles

yes , he did.

Mstiles profile image
Mstiles in reply toPlains

thank you Plains.

I guess you were stable on prednisone before you started Actemra? No aches and pains or other health issues?

Plains profile image
Plains in reply toMstiles

no, I was not. I was on 40, worked down to 20 and then was put on Actemra. I have been on it since October once I got to 10 Mg, I started reducing 1/2 mg every five weeks. I have regular aches in the morning but they seem to go after after I am up walking around. My inflammation levels are fantastic. I will be a little nervous going to zero on the prednisone, we shall see, I know I may have to stay on it .

Mstiles profile image
Mstiles in reply toPlains

that’s great!

What dose are you on now?

Plains profile image
Plains in reply toMstiles

1mg

Mstiles profile image
Mstiles in reply toPlains

wow, that must feel good!

Did you have any issues at the point of adrenal function waking up?, around 6-7 mg I believe.

Plains profile image
Plains in reply toMstiles

no, I had a little tiredness when I got to 5mg, it only lasted a few days and then I was okay. This is why slow reducing is the best. My doctor refused to check my adrenal function saying I would know if there was a problem. Once I am completely off of the I have to wait 6 weeks to be tested. And, yes it does feel good to be off the prednisone.

Mstiles profile image
Mstiles in reply toPlains

you’re inspiring me!

Every one’s experience is so different

Guess I’ve read about so many struggles with getting the adrenals working that I’m glad to hear about your journey going so well.

Plains profile image
Plains in reply toMstiles

keep in touch! All the best!

PMRpro profile image
PMRproAmbassador in reply toPlains

He's wrong I fear - one lady on the forum was down to 2mg and felt great, Her rheumy was one who believed in checking with a synacthen test which found her adrenals weren't working at all! The 2mg pred was enough for her to function day to day but there were no reserves for emergencies. A study by Imperial in London decided that the previously quoted 7mg was high but the effects of poor adrenal function are felt by some at even higher doses.

Plains profile image
Plains in reply toPMRpro

My rheumatologist and endocrinologist both would not do it. I can try my GP. I don’t what else I can do at this point. I have asked each of them twice. I hope nothing happens. Thank you I remember you saying this before and that is why I asked a second time.

PMRpro profile image
PMRproAmbassador in reply toPlains

Your GP might be willing to take a basal cortisol test - blood sample taken between 9am and 1pm. That will show you what sort of area you are in and you can go from there

endocrinepractice.org/artic...

Plains profile image
Plains in reply toPMRpro

Will do! thank you for your support with this!!

Wallysma profile image
Wallysma

Thank you...yes you are right.slow!

PMRpro profile image
PMRproAmbassador in reply toWallysma

And in some, slower than others! Even with Actemra! I have taken a year to get from 19 to 6mg - only just trying 6mg for the second time - last time I just couldn't cope with the stiffness and fatigue.

Wallysma profile image
Wallysma in reply toPMRpro

Good luck with this try....mI am sending positive vibes your way......may it become a reality.

Mstiles profile image
Mstiles in reply toPMRpro

hope it goes well for you this time.

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