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Doctor insights on: Effects Methotrexate Ra Nodules

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Methotrexate vs humira (adalimumab), rheumatoid arthritis question?

Methotrexate vs humira (adalimumab), rheumatoid arthritis question?

MTX vs Humira (adalimumab): These drugs fight RA in completely different fashions. Mtx is the consensus first round choice of drugs to treat ra, both by the acr and eular (european version). Most, if not all, insurances require treatment failure with mtx before you start humira, (adalimumab) a much more expensive drug. In most cases, even if Humira (adalimumab) is started, patients will remain on mtx. ...Read more

Methotrexate (Definition)

Methotrexate was originally used in the early 1950's as a treatment for cancer but was also found to be effective in many other diseases including rheumatoid arthritis and psoriasis. It has anti inflammatory and immunosuppressive properties which make it an excellent first line therapy for RA ...Read more


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Methotrexate vs humira (adalimumab), rheumatoid arthritis?

Methotrexate vs humira (adalimumab), rheumatoid arthritis?

Methotrexate: is a first line drug for rheumatoid arthritis, used frequently with hydroxchoroquine and sulfasalazine. Humira is an expensive biologic for those who have failed traditional first line regimens!

Humira works well for RA, but it is second line! ...Read more

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On arava (leflunomide) 20mg, enbrel 50mg weekly, methotrexate 25mg. Any other rheumatologist prescribed this for psoriasis/psor. Arthitis?I'm worried about my liver.

On arava (leflunomide) 20mg, enbrel 50mg weekly, methotrexate 25mg. Any other rheumatologist prescribed this for psoriasis/psor. Arthitis?I'm worried about my liver.

Follow laboratory: You are correct that liver problems are risk with this regimen. Your physician needs to be certain that you are followed closely and correctly. Your own responsibility is to refrain from alcohol, and be certain no additional medicines you take do not worsen this risk. If you are concerned you need to discuss this with your physician. There are other therapy choices available. ...Read more

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Having problems with hydroxychloroquin plaquenil (hydroxychloroquine) side effects?

Having problems with hydroxychloroquin plaquenil (hydroxychloroquine) side effects?

Side effects: Usual side effects are stomach upset and rahshes. Occ headaches. Take the med at lower dose with food and if you can't tolerate tne maximum dose it may still be effective. Vision problems are very rare these s[ecialist and get an opthalmology referral quickly. ...Read more

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What are effects of taking methotrexate for rheumatoid arthritis?

What are effects of taking methotrexate for rheumatoid arthritis?

Works: Methotrexate has become the standard of first choice forra treatment but rarely results in remission, ie no one can tell if you have it including the doctor. The risk is extremely low, although you cannot use alcohol, and is not usually used if ther is preexisting liver disease. Most patients have to add several other disease modifying drugs to get better. ...Read more

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Dangers of plaquenil (hydroxychloroquine)?

Low risk: Potential Plaquenil (hydroxychloroquine) side effects include GI intolerance, itching, rash, muscle weakness and eye inflammation (retinopathy). All of these risks are very low and the benefits of Plaquenil (hydroxychloroquine) will far out weight the risks. ...Read more

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Issues with understanding plaquenil (hydroxychloroquine) side effects?

Issues with understanding plaquenil (hydroxychloroquine) side effects?

Side effects:: Studies at the cleveland clinic and albany medical college clearly demonstrate that ocular toxicity with ho-q is based solely on getting more the recommended 6mg/kg of body weight. I have never seen ocular toxicity in 1000's of patient I have treated. The most common complaint is queasiness of the stomach when starting it. There are other side-effects, but i've never seen them. ...Read more

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38y female seroneg ra. Plaquenil (hydroxychloroquine) not work. Bone scan show si joints & feet. Start 10mg mtx. Doc said may not be RA since si joints?4 relative w/ra. ?

38y female seroneg ra. Plaquenil (hydroxychloroquine) not work. Bone scan show si joints & feet. Start 10mg mtx. Doc said may not be RA since si joints?4 relative w/ra.  ?

Talk to your doctor: There are other forms of inflammatory arthritis, which include the seronegative spondyloarthropathies. It might be something like ankylosing spondylitis. Additional testing might be necessary, and a rheumatology referral may be necessary. Also keep in mind being seronegative does not mean you absolutely don't have rheumatoid arthritis. ...Read more

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Plaquenil (hydroxychloroquine) side effects bad?

Plaquenil (hydroxychloroquine) side effects bad?

Not at all: You need eye and other monitoring but it is relatively safe and well tolerated. ...Read more

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Is methotrexate or humira (adalimumab) better for rheumatoid arthritis?

Is methotrexate or  humira (adalimumab) better for rheumatoid arthritis?

It's u as much as Rx: Again, this is a question for the treating specialist, most likely a rheumatologist. When treating a disorder like ra, there are a variety of medications that have been effective; as with everything else in medicine, no one size fits all, and the right drug or combo for each must be assessed over time by a specialist. ...Read more

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Does Simponi (golimumab) Aria for rheumatoid arthritis have any effect when taken without methotrexate?

Simponi (golimumab) and RA: Dear Jennifer, Simponi also known as golimumab, in combination with methotrexate has been shown to improve severe RA; Clinical symptoms of joint pain and swelling as well as less radiographic damage were noted. Therefore the short answer to your question is Yes! Best wishes, Nisha ...Read more

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Methotrexate for rheumatoid arthritis dose it work and anyone had side effects?

Methotrexate for rheumatoid arthritis dose it work and anyone had side effects?

Yes.: My colleagues believe it is the first choice (acr and eular), but while I use it as a second or third drug, the benefit/risk ratio is incredibly good. Methotrexate has little or no justification to be taken orally though. Unpredictable absorption, stomach concenbration build up, and going to the liver on first-pass! the liver sees 600x the ultimate concentration in the blood. ...Read more

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Side effects of plaquenil (hydroxychloroquine) prescription?

Side effects of plaquenil (hydroxychloroquine) prescription?

A few: It can cause eye problems so you need to see an ophthalmologist and peridoic screenings. Other than that we see a few people who have increased skin pigmentation called "plaquenil ochronosis". There are others but these the most prominent. ...Read more

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Anyone taking humira (adalimumab) for rheumatoid arthritis?

Anyone taking humira (adalimumab) for rheumatoid arthritis?

Many patients!: Results are very good, particulary when used alone and better with methotrexate. The dirrence with Remicade (infliximab) is that it binds to tnf-a rendering ineffecftive. It is completely human in origin. A good choice for those who do prefer home sc injection, every two weeks. It is my favorite tnf-a class drug. ...Read more

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Can beetroot reduce methotrexate side effects in a psoriasis and psoriatic arthritis patient?

Can beetroot reduce methotrexate side effects in a psoriasis and psoriatic arthritis patient?

Not really!: Beet root is high in folic acid, but we routinely give Folic Acid to patients on methotrexate, usually 2mg/day. This would be overkill, and add unnecessary expense! ...Read more

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On enbrel 50mg weekly for 3 mos, methotrexate 25mg weekly 3mos, arava (leflunomide) 20mg 1 month, still have psoriasis lesions.Is this possible&willl psor. Ever clear?

On enbrel 50mg weekly for 3 mos, methotrexate 25mg weekly 3mos, arava (leflunomide) 20mg 1 month, still have psoriasis lesions.Is this possible&willl psor. Ever clear?

Still a bit early: So many of these medications requires several weeks or months to start working. Enbrel and Arava usually works around 3 months after starting it, and Methotrexate can take as long as 6 months before working. I would give it another month, then reconsider. There are other good medicines that could work for you including stelara (ustekinumab). ...Read more

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Is arava (leflunomide) effective for rheumatoid arthritis?

Is arava (leflunomide) effective for rheumatoid arthritis?

It may be...: Again, this is a question for the treating specialist, most likely a rheumatologist. When treating a disorder like ra, there are a variety of medications that have been effective; as with everything else in medicine, no one size fits all, and the right drug or combo for each must be assessed over time by a specialist. ...Read more

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Nodule (Definition)

Any growth or deposit in the body or on its surface may be casually termed a nodule until its character is determined by the familiarity of the physician with it or by the results of a biopsy if it is not so obvious. The term is casual ...Read more


Dr. Tracy Lovell
937 doctors shared insights

Rheumatoid Arthritis (Definition)

A chronic inflammatory disorder that affects joints and may also affect ...Read more