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Just diagnosed

Hello,

I was just diagnosed with beginning stage of seronegative rhumetoid Artheritis.

I have been given the choice of two medications and both I have read up on and don't like either. Need your feedback on what you think.

1. Methotrexate 15mg
2. Hydrocloroquin 200mg.

They are both low does but worried about side effects.

Would like some advise on what others have done with the same condition I have. Thank you!!

  1. Hi . The concerns about treatment side effects are certainly understandable. I can tell you that methotrexate and hydroxychloroquine (Plaquenil) are two drugs that have been around for a long time and have a long track record. Many in the community have used them. This article gives an overview of methotrexate: https://rheumatoidarthritis.net/treatment/methotrexate and in this one our contributor Tamara discusses her experience: https://rheumatoidarthritis.net/living/whats-worth-pros-cons-methotrexate. Here is an overview of hydroxychloroquine: https://rheumatoidarthritis.net/treatment/hydroxychloroquine and here is a Forum discussion on its use: https://rheumatoidarthritis.net/forums/hydroxychloroquine. I can also tell you that my wife, Kelly Mack (a contributor here), was diagnosed at two, over 40 years ago and used both drugs individually and, for a time together. She used methotrexate for years to decent effect, with side effects like brain fog, but none too serious. Plaquenil was not as effective for her, but that is just her individual experience. When she was put on both her liver function tests spiked, so she was taken off the Plaquenil. She has since moved on to biologic medications to greater effect. It is important to note that each case is different and how a person will respond to a treatment is also. Close monitoring of any treatment regimen with you doctor is key. Wishing you the best and please know that this community is here for you. Richard (RheumatoidArthritis.net Team)


    1. Hello, I have used Methotrexate (MTX) for about 15 years. I have not used hydrocloroquin so I cannot comment on that. As Richard said MTX has been around a long time it is generally thought of as safe when used safely. One exception is use during pregnancy. I believe most doctors advise that both males and females should not use MTX when contemplating pregnancy. Of course your docotr can advise you better about pregnancy and MTX than I.


      As for me I have had issues with mouth sores while using MTX. The best way to counteract that is to use folic acid. Your doctor will also tell you how much and which to take.


      As for danger, I think Richard has given wonderful references and I suggest you read them over. One thing many people get upset with is the thought that MTX was originally a cancer oriented medication. That is true, however in RA treatment the amount of MTX used is very small in comparison to what it was used for in cancer treatments. While the medication is the same the dose is so different it is as if these are two different medications.

      1. I think it’s incredibly important to also be aware of the effects of not treating RD with appropriate medications. The effects of RD go far beyond pain in our joints. Cardio-vascular, lung and mobility problems are the top of my list of worries and part of why I fairly aggressively pursue RD treatment. That said, I believe it is my responsibility to take on the additional non-pharmaceutical steps to help myself. For me that means exercising in the pool, doing yoga, eating a healthy diet and trying to get better at handling emotional and physical stress. I’ve taken MTX (plus Folic Acid) in the past and I preferred the injectable over oral. I may be adding Hydrocloroquin to my current biologic in the future. Both drugs have years of use and a pretty good safety record. With Hope and Best Wishes, Jo

        1. Hi . Thank you for raising these important points. , every person has to make their own treatment decisions, but it is important to weigh not only the risks of specific treatments, but also the risks of choosing not to use them. One of our contributors referred to it as the risk to risk ratio. I have to admit, I'm a fan of aggressive treatment and this comes from my wife, Kelly, being diagnosed before modern treatments and having the damage to show for it. Kelly has used a wheelchair since her late teens. On more than one occasion we have discussed with her doctor the hope that children diagnosed today will not have the same level of damage. That said, every situation is different. Kelly had a very aggressive case. Others may have a milder form, which will change the decision dynamic and raise different options. Wishing you the best and please know that this community is here for you. Richard (RheumatoidArthritis.net Team)

      2. Thank you Richard! It is alot to take in. I recently battled stage 3 neuroendocrine small cell carcinoma. A rare aggressive Cancer. I just passed my 2 year remission anniversary and so happy to be feeling great until my RA diagnoses. The thought of taking all these meds again scare me but I know it is necessary. I am jist the beginning of the disease and agree I need to treat this aggressively. I did start the Hydroquinone last week and so far no side effects. I am a flight attendant so I have decided to go part time as the work is so hard on the body. I am a swimmer also so that is a plus as I can keep my body moving.


        I also have a prescription for the Methotrexate and will keep on hand if the Hydroquinone does not work. I saw a Naturalpath yesterday and going to increase my corcumin whixh helps with inflammation and get rid of sugar and alcohol in my diet.


        One day at a time. I really appreciate everyone's feedback. I don't feel alone in this!!


        Sincerely,


        Shari

        1. Hi . I hope Hydroquinone is effective for you. That was a smart decision to cut back on work right now. In time, you might be able to return full-time if you choose. Many people do well with a combination of dietary changes and medications. Hopefully, you will be one of those people. You are never alone with a community like this to support you. Wishing you the best. - Lori (team Member)

        2. Hi Shari (). It certainly understandable to be reluctant to go back on meds following cancer treatment. I want to share with you this paper written for medical personnel on the use of biologic medications for RA: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370108/. It notes that "Current available data, however, suggest there is no increased risk of cancer recurrence upon initiation of bDMARDs for the treatment of RA." Of course, every case is different and your doctor may be able to provide additional information, but hopefully the research can put you a little more at ease. Best, Richard (RheumatoidArthritis.net Team)

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