Methotrexate vs CellCept?

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Regular Member

Date Joined Sep 2012
Total Posts : 46
   Posted 9/15/2012 12:00 AM (GMT -6)   
Hi All!
I am new to this group, and quite desperate for advice! I thank you in advance for reading my post and for any thoughts you take the time to share with me. I hope to be able to return the favor some time soon, when I am feeling better!  
Here's my situation: A flare came on mid-April and I can't shake it (crazy intense costochondritis and pleuritis, lower rib/adominal pain, and fatigue). My standard meds are 300 mg Plaquinel, with "cycles" of Prednisone as needed. 
My last cycle of Prednisone calmed things down temporarily, but my flare is still raging and my rheumatologist would like me to begin taking Methorexate. (In fact, she thinks I started taking it last week!) I was so freaked out by the side-effects and risks of Methotrexate, that today I sought out a second opinion from a different rheumatologist. I'm doing blood work, X-rays, and a CT scan for her first, but she says that her preliminary thoughts are that CellCept would be a better immunosupressent for me at this time.    
If the second Rheumy had agreed that I should take Methotrexate, I'd make peace with the meds and begin taking them, but now I'm confused and oh-so-worried about making the right choice. Any thoughts/experiences with Methotrexate vs CellCept that you'd be willing to share with me?
Thank you, thank you, thank you!!!
--Nina2 (just plain "Nina" was already taken)

Elite Member

Date Joined Jul 2009
Total Posts : 14475
   Posted 9/15/2012 5:20 PM (GMT -6)   
I haven't started on those yet, but I've heard others discussing them here.

Some people started the MTX and moved on to Cellcept. Others Vis-Versa. I think these two are toss ups on which to move on to after plaquenil. When these don't work then they move on to the big guns-the biologics.
Lupus, Fibromyalgia, Glaucoma, Asthma, Hypothyriodism, and Allergies

When life throws you lemons....
Pick them up and throw them right back at them! :))

Post Edited (couchtater) : 9/15/2012 8:28:09 PM (GMT-6)

Regular Member

Date Joined May 2007
Total Posts : 482
   Posted 9/15/2012 7:50 PM (GMT -6)   
Hello and welcome!  I can totally sympathise with your reservations about starting one of these drugs.  I, too, have been on plaquenil daily and pred as needed since 2002.  about 3 years I started to worsen and my rheumy had me try Imuran.  I had a severe reaction to it.  about a month later I tried Cellcept. Started with a very small dose and worked up to full dosage.  The results have been amazing.  It has given me a quality of life back that I had thought was lost forever.  Not the same as pre-lupus but definitely better than before the CellCept.  It seems like, just as lupus is different for everyone, reactions to these drugs vary.  As far as side effects, yes, the warnings are quite scary.  But you have to weigh the possible side effects against how you are doing without the drugs.  And do remember, not everyone experiences the side effects.
I wish you luck and hope you feel better, soon.

Regular Member

Date Joined Sep 2012
Total Posts : 46
   Posted 9/15/2012 11:33 PM (GMT -6)   
FW: Thank you for a warm welcome to the forum and your compassionate note. I appreciate you taking the time to share your experiences with Imuran and CellCept with me. (I'm sorry your experience with Imuran was so crummy!)
Joy: Thank you, too, for taking the time to let me know that Methotrexate and CellCept seem to both be the "next step" immunosupressents. It helps to know they seem to be on equal footing.
Looks like I have a big decision to make this week! ;-) Thanks again!

Regular Member

Date Joined Jun 2012
Total Posts : 26
   Posted 9/17/2012 5:51 PM (GMT -6)   
Nina, I was dx'd with SLE in March 2010 and was on the same meds you were (400mg plaquenil and prednisone as needed for flares) but I went from one flare to another to another. I also have discoid and subcutaneous lupus and some complications like multiple cranial neuropathies, occipital neuralgia, and peripheral and autonomal neuropathy, pernicious anemia, constant mouth and nose sores, ulceric lesions and discoid rashes, etc. My last rheumie I had for two years did not think my labs (no high sed rate or low comp levels even though my ANA direct panel is highly positive) dictated any stronger meds and I suffered greatly the last two years. I finally got a new rheumie and he put me promptly on CellCept. Thank God. I am finally getting better. I'm glad you are getting a second opinion and respect your choice of being cautious at the stronger meds but I cannot tell you how happy I am that I'm feeling better. Makes a big difference to quality of life. Love Julie
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