Right combo of meds

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steve eagle
New Member


Date Joined May 2010
Total Posts : 2
   Posted 5/20/2010 9:18 AM (GMT -7)   
Hi all:
I have a general question.  How long, usually, does it take to find a right combo of meds?  I have had RA symptoms for about 12 years.  I was evaluated in 2000, but the Dr only drew an RA foctor, which was negative, and he said, no, I didn't have it.  At that time, I had no family history of RA.  I attributed the pain and swelling to work (PA in a Pathology Lab...lots of dissection, all with hands, tools, and standing up).  I am now 47.  Last year, my Mom (age 65), and my uncle (age 53) were diagnosed in May and June, respectively.  July came around, and guess what...I got the diagnosis too.  There were already significant erosions in hands, feet, and shoulders.  I was put on methotrexate, which we then increased in December.  My liver enzymes spiked, so we went back down onthe MTX.  I started Humira in November.  There has been no improvement (actually, my fingers and toes are now "shifting"/subluxing.  I was switched to Enbrel a month ago, and I still can't tell that I am getting any better.  Is this common?  Or do I just have a stubborn strain of RA?
 
Thanks,
 
Steve

sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 5/20/2010 4:07 PM (GMT -7)   
Well, it isn't uncommon to take some trial and error to get the right combo of meds.
Are you on plaquenel? That helped me feel better-the methotrexate made the swelling go away.
It does sound like you are on pretty aggressive treatment though with a biologic and Methotrexate.

Abol76
Regular Member


Date Joined Mar 2010
Total Posts : 74
   Posted 5/20/2010 7:40 PM (GMT -7)   
I was diagnosed early Aug last year and still not found right combo of meds. Things are pretty bad and CRP and ESR are rising. Just had mtx shots increased for 3rd time and to go up again and due to start Remicade (biologic) soon. Who know's how long it takes to get sorted. How long is a piece of string eh?
Arthritis, GORD, IBS, PCOS, Neurosarcoid, Hypothyroidism, psoriasis, mental health issues, BIH, high blood pressure and high cholesterol. . . Methotrexate injections, folic acid, Prednisolone, Alendronic Acid, Adcal D3, Morphine, Lansoprazole, Domperidone, Norethisterone, Metformin, Levothyroxine, Amitriptyline, Sertraline/lustral/Zoloft, buspirone/buspar, Carbamazapine/Tegratol, Risperidone/Risperdal, Melatonin, Lisinopril, Atorvastatin ". . . but hey, Tomorrow is another day!" :-)


golitho
Veteran Member


Date Joined Sep 2008
Total Posts : 1670
   Posted 5/20/2010 11:22 PM (GMT -7)   
Some times it takes time for the combination to work too. Its all so frustrating. Everytime they find a combination that works for me something happens and it stops working again. Just hang in there, I reacted to mtx at first too then they built up my dose to 20mg slowly over the months now I seem to tolerate it fine, humira stopped working for me so I am on a trial for orencia, so far no joy but I live in hope.

Had a massive flare recently and I'm now filled to the brim with prednisone and thats given me the most relief in ages! Though obviously comes with its own problems... I'm currently trying accupuncture but haven't noticed anything yet.

Keep us posted, its good to get the frustrations out and know you are not alone, golitho

wearyRAsufferer
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Date Joined Mar 2010
Total Posts : 2323
   Posted 5/21/2010 7:22 PM (GMT -7)   
As many times as I have told this story I don't see anyone else as having the same one. Not sure why no one elses doctor has tried this.
During a very severe onset when MTX and 20 mgs of prednisone was not doing anything at all my doctor increased my prednisone to 40 mgs. a day (I am quite small and had lost so much weight from the RA I was like 92 lbs.) It triggered my body back to normal. It was a long taper off but I am doing pretty well to this day on no prednisone at all.

Joni James
New Member


Date Joined May 2010
Total Posts : 9
   Posted 5/22/2010 5:20 AM (GMT -7)   
I am having a very long journey to finding the right combo of meds too. I also had a long path to diagnosis. My internist told me she thought I had RA a few years ago and sent me to a rheumatologist. He did the RA factor test and I was negative but my internist told me that a third of people who have RA don't test positive for the RA factor in the blood. Recently I tested positive on the CCP test which is a more specific test for RA. If you have a positive CCP test, you pretty much definitely have RA. Interestingly I didn't test positive on my CCP test last year but I do now. I have been on many different drugs and so far, not much is helping (I have Fibromyalgia too). I am on Plaquinyl for slowing the progression (have been on it for about 10 years since my first flare up) and I use various pain killers and sometimes, Cymbalta which helped with my mood but not the pain. I recently learned of something new which my doc agreed to work with me on to try out. You can read about it at www.lowdosenaltrexone.org. I have to get some of my pain meds out of my system for 2 weeks and then I am going to try this. You have to find a compounding pharmacy that will custom make the dose. I will report back if it works!

elcamino
Veteran Member


Date Joined Sep 2005
Total Posts : 1744
   Posted 5/27/2010 10:28 AM (GMT -7)   
Hi Steve,
 
For me, personally, it took about 4-5 months for any of the drugs to actually work.  So whenever I was switched in the early years, the longer the wait was for something to start working.  For me, and I gather from my research most other people, the combination of methotrexate and one of the biologics appears to work the best.  But it did take some time.  I suppose if your pain gets bad enough you could request prednisone as a bridging drug (just until the the DMARDs started working).  Be patient, though, as it does take some time for these drugs to do their thing.  It will be worth it in the long run!
 
Best Wishes,
 
El
Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Lupus
Current Meds: Enbrel, Methotrexate, nexium, tramadol, nasonex, Nifedipine, Folic Acid, Tylenol PM


sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 5/30/2010 7:57 PM (GMT -7)   
Oh, by the way, one of my doctors did do the higher pred dose 30 mgs for 30 days, then tapered. It helped a lot while I got the other drugs on board and gave them time to start working. My rhuemy let me decide the speed of the taper based on how well I was feeling.

harrington49
Regular Member


Date Joined May 2010
Total Posts : 355
   Posted 5/31/2010 11:35 PM (GMT -7)   
Hi all, I am new to the site and only found it by chance. I have had RA for 4 years now and have been on methetrextate and prednisone and painkillers and anti-inflammatory tablets for that period. The pain is bearable but I hate being on the mxt and the prednisone as I have put on so much weight although I am only on a low dose of prednisone. I can't afford to put on weight but I can surely afford to lose plenty LOL. Has anyone else had this side effect? My pain is mostly in the shoulders, arms, wrists and hands and I have noticed in the 4 years a decrease in my ability to lift, hold or carry anything that has a small amount of weight to it, e.g. shopping bags. I am the only one in my family that has had this, but I guess it has to start somewhere, right? It is nice to see that I have someone to speak to about this beside my doctor and I look forward to hearing from anyone.
Harrington49


wearyRAsufferer
Veteran Member


Date Joined Mar 2010
Total Posts : 2323
   Posted 6/2/2010 1:36 PM (GMT -7)   
Hey Harrington- I hear ya! It took me forever to taper off 40 mgs of prednisone a day. I put on a bunch of weight but luckily I had been so sick with my RA I had lost 23 lbs. right before I went on. I was stuck at 10 mgs for a long time and between 10 and 1 mg. of prednisone I could not lose weight to save my life. I also decided I was just going to get off the stuff and found that it really wasn't keeping me anymore comfortable. At lower than 12.5- no difference once you got over the hump of the side effects of the drop.3 months after I got off of it the stubborn weight finally dropped off. I hope I never have to go back on.
I wish you all the best.

golitho
Veteran Member


Date Joined Sep 2008
Total Posts : 1670
   Posted 6/2/2010 6:12 PM (GMT -7)   
Yup been there too, prednisone seems to make you hungry and hold water weight so you pile on the pounds but it does go when you finally come off it, it slowly but surely gets out of your system and you return to normal range again. You hate it and love it, seems to really help the pain component but the side effects are awful. Goodluck with it all, golitho

sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 6/2/2010 7:38 PM (GMT -7)   
Plaquenil helped me lose 80 pounds. It made me feel so much better I would not let my rhuemy take me off of it even though for the whole first year I was on it I could not force myself to eat.
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