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Mextrotrexate and Leflunomide

I was in remission for like 6 years on methrotrexate, taking only 5 tabs per week. In late Oct. I got the moderna booster and recently after started getting arthritis pain in foot, horrible, each step painful. I then got covid in late Jan. Since all of this I have been in daily pain somewhere. My Dr. put me on 20mg daily of leflunomide in addition to the methotrexate and I have been on it for 6 weeks. I can not stop the steroid, taking 2.5 mg daily, or I will be in horrible pain. should I switch dr's or my meds? I can't like like this any longer. Today I have pain in left wrist and knuckles and the tendons in arm before elbow hurt so bad can really move arm.
Any advice??

  1. Thanks for sharing and reaching out. I'd encourage you to be persistent in communicating with your doctor about any new, changing or concerning symptoms and pain management needs. In addition to speaking with your doctor, these articles may be helpful:
    Our Communities suggestions on getting through a flare:

    Advice on Steroids and tapering:

    Wishing you some relief very soon! Please keep us posted on how you're doing and any specific questions you think of. Best, Kelly, Team Member

    1. Hi . Steroids should never be a a long-term solution because of the high risk of side effects. So you will eventually have to come off them. We are not medical experts, but my guess is that your doctor is treating this as a flare and hoping you won't need steroids for long. It does sound like the stress of Covid on your system has caused progression of your RA. If you have been on leflunomide for a few months and it isn't helping, it might be time to try something new. What does you doctor have to say about coming off steroids and switching medications? Finding the RA medication that is most effective for you is a game of trial and errors. Doctors never really know which medication will help. They just try one (usually for a trial period of at least four months) and hope for the best. If your doctor is listening to you and willing to try new treatments and you feel comfortable with this doctor, you might want to stick it out a bit longer. If you feel this doctor is not listening, is not well-educated about RA or is not truly a partner in your care, it's probably time to find someone new. Your rheumatologist will always be an important person in your life. You deserve someone who provides the compassion and treatment you deserve. Here is an article about RA treatments that might interest you: I hope this helps and that you get some relief soon. Thinking of you. - Lori (Team Member)

      1. Hi and thanks for the reply
        My Dr. wanted me to stay on the new drug for at least 6 weeks and that is what I am at now. She said if I am not significantly better I have to go in and see her to discuss other options for mediation, she had mentioned Enbrel. I got my blood work done on Monday and my AST was 75 and ALT was 85. Last time I had blood work done in April these values were at 24.

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