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Doctor insights on: Enbrel And Methotrexate

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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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Am taking now enbrel (etanercept) and methotrexate till now no side effects. If I kept taking them will I have bad side effect?

Am taking now enbrel (etanercept) and methotrexate till now no side effects. If I kept taking them will I have bad side effect?

Impossible to answer: The risk of long term therapy is relatively low. Infection is the major risk but studies have suggested that Enbrel (etanercept) has less risk than other meds in its class. The benefits, however, are enormous. These meds prevent joint damage and deformity. ...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.

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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Have a sudden tooth abscess (sat). Dentist won't treat until mon and rheumy won't call back. On enbrel (etanercept) and methotrexate. Should I go to er?

Have a sudden tooth abscess (sat). Dentist won't treat until mon and rheumy won't call back. On enbrel (etanercept) and methotrexate. Should I go to er?

Maybe: If your infection is very large and there is lots of swelling then go to er. If your pain is manageable with over the counter pain medication than wait and see your dentist on monday. If you are not sure go to the er anyways. ...Read more

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Can I take enbrel (etanercept) 50mg and methotrexate 2.5mg x5 same day as sulfamethoxazole and trimethoprim?

Can I take enbrel (etanercept) 50mg and methotrexate 2.5mg x5 same day as sulfamethoxazole and trimethoprim?

No!: Enbrel yes. Mtx oral no! The generic Bactrim (sulfamethoxazole and trimethoprim) will minimize absorption of the Methotrexate oral. This would not be the case if you took subcutaneous mtx. But taken orally, the same transporter protein puts both mtx and your sulfa drug into your blood stream. The dose of Bactrim (sulfamethoxazole and trimethoprim) is so much larger, it interferes appreciably. ...Read more

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When would a doctor use remicade (infliximab) when treating jra? Currently on methotrexate, enbrel, indocin, and now. 3 weeks of steroids

When would a doctor use remicade (infliximab) when treating jra? Currently on methotrexate, enbrel, indocin, and now. 3 weeks of steroids

Any time: It is always an option if your current meds are no longer effective. Sometimes changing from Enbrel to Remicade (infliximab) yields a better response as one can adjust the Remicade (infliximab) dose to a particular situation. ...Read more

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What causes you to have a vitamin d deficiency (aside from lack of sun, correct foods etc usual stuff!) - methotrexate? Enbrel? Prednisone?

What causes you to have a vitamin d deficiency (aside from lack of sun, correct foods etc usual stuff!) - methotrexate? Enbrel? Prednisone?

D: Normal levels of vitamin D vary between ethnicities with lowest in African Americans. Vitamin D in units of 1000 or 2000 per capsule and 100 tablets per bottle, and not expensive. Available over the counter in pharmacies. ...Read more

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Will methotrexate or enbrel (etanercept) affect my ability to have children?

Methotraxate&Enbrel: If you are on these meds you proably have some modserately sever conditiona nd this may cause you to have difficulty to conceive or if you do these meds may affect the fetus. ...Read more

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25mg of methotrexate and 25mg of enbrel (etanercept) is that to much for a 7yr old with jra and enthesisitis?

Probably not: Maximum recommended dose of Methotrexate (according to epocrates dosing guide, which I use a lot) is 30 mg/m2/week. For an "average" 7 year old (and I use that term loosely, because there is a huge range) that is 25 kg and 130 cm (55 lbs and 51 inches) that would be a max dose of 28 mg/week (bsa=0.93 mg/m2.) for enbrel, (etanercept) max dose is 50 mg/ week, with usual dosing 0.8 mg/kg (dose = 20 mg starting). ...Read more

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How long before methotrexate works for jra? How long do u need to be on it before adding another med like enbrel (etanercept)?

See details: If you have a good response to Methotrexate it can remain effective indefinitely. I will add a tnf like Enbrel (etanercept) if Methotrexate is not effective after 3-4 months at a dose of at least 20 mg weekly. ...Read more

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On actemra (tocilizumab) IV (dose increase in dec)and methotrexate for 5 mon now but still having bad flare ups. Tried humira, enbrel, etc. Since diagnosis in Dec 2013?

On actemra (tocilizumab) IV (dose increase in dec)and methotrexate for 5 mon now but still having bad flare ups. Tried humira, enbrel, etc. Since diagnosis in Dec 2013?

Your question is?: Your have not asked a question. This issue needs to be discussed with your rheumatologist. No one can give you specific advice over the internet without a complete history and exam. ...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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What's more effective for pustular psoriasis, methotrexate or enbrel (etanercept)?

Both: Both can be effective, personally I feel Enbrel (etanercept) is safer. There are other options. Talk it over with your dermatologist. ...Read more

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I have MS and can no longer use enbrel (etanercept) which worked great for my psoriasis....I started methotrexate 3 weeks ago and no real change yet, any ideas?

I have MS and can no longer use enbrel (etanercept) which worked great for my psoriasis....I started methotrexate 3 weeks ago and no real change yet, any ideas?

Suggestion: You possess a complex problem which afflicts several patients; i.e., two automimmune disorders. This creates a need to have very coordinated care from both a neurologist and a dermatologist, and you are advised to get a consult or two from a local medical school. The Methotrexate may yet work, as could take a few more weeks, but you may want to modify your ms medicine if needed. ...Read more

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Alt high 60, AST high 45 on methotrexate 25mg, arava (leflunomide) 20mg, enbrel weekly. Should I be concerned? Never had pblm.

Alt high 60, AST high 45 on methotrexate 25mg, arava (leflunomide) 20mg, enbrel weekly. Should I be concerned? Never had pblm.

Talk to your doctor: Those are not terribly high lab values for alt and ast. Such modestly elevated labs that measure liver irritation (or damage/disease when > 2-3 times the upper limit of normal) can be temporarily caused by common viral infections, alcohol consumption, or interactions with other meds that affect the liver. Getting labs checked within 48hrs of Methotrexate can also result in higher lab values. ...Read more

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Please help, I have pustular psoriasis on my feet dr wants me to try methotrexate or enbrel (etanercept). What are those meds?

Please help, I have pustular psoriasis on my feet dr wants me to try methotrexate or enbrel (etanercept). What are those meds?

See details: Methotrexate is an anti-inflammatory with some immunosuppressive properties and Enbrel (etanercept) is a tnf agent. Both are very effective for psoriasis, especially the enbrel (etanercept). They both have risks with infection the greatest one for enbrel (etanercept). ...Read more

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My daughter on methotrexate and enbrel (etanercept) is it ok for her to be around my mom who has MRSA on your arm pit? They packed it today how long to wait?

My daughter on methotrexate and enbrel (etanercept) is it ok for her to be around my mom who has MRSA on your arm pit? They packed it today how long to wait?

Only with cautions: Your daughter is on immunosuppression and it is unwise to be near anyone with active contagious infection. MRSA is a hazardous bacteria and she should not be near or touch anything your mother has come in contact with until your mother`s doctor says she is cleared. ...Read more

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Psoriasis+psor. Arthritis. Methotrexate 15mg for 2 mos. Already+humira weekly. Dr say stelera no good for arthr...Says remicade (infliximab) or enbrel maybe. Ok?

Nod to others:: Humira is a tnfa antibody, and is similar to envbrel. Remicade (infliximab) is an antibody to the tnfa receptor, so it works differently. But I would have tried you on leflunomide, and oral drug, before starting biologics. ...Read more

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Saw rheumy. Today. Gave me arava (leflunomide) 20mg+methotrexate 25mg+enbrel for psoriasis/psor. Arthritis. Is it safe, r all 3 used frequently/sometimes, opinion please?

Saw rheumy. Today. Gave me arava (leflunomide) 20mg+methotrexate 25mg+enbrel for psoriasis/psor. Arthritis. Is it safe, r all 3 used frequently/sometimes, opinion please?

Psoriatic Arthritis: Methotrexate (trexall) is the most common dmard used to treat psoriatic arthritis. However, it has potentially serious side effects, including lung, kidney and liver problems. Using Arava and Methotrexate together my increase the risk of hepatotoxicity & leukopenia.I would just use a biologic like Remicade or Humira or Enbrel or stelara (ustekinumab) which should control your disease but this is my opinion. ...Read more

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I'm being treated for RA with plaquenil, methotrexate, and Enbrel. My most recent blood work has low values of MPV 7.3 and MCHC 31.4.

I'm being treated for RA with plaquenil, methotrexate, and Enbrel. My most recent blood work has low values of MPV 7.3 and MCHC 31.4.

Blood and RA meds: It is best to discuss these numbers with your rheumatologist. There are significant side effects of all these medications, although many other issues including diet and exercise may be another cause of the findings here. Serum folate levels may be of some value, and adjustment of the medications you are now on should be considered ...Read more

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Daughter on methotrexate and enbrel and indocin for JRA but hates getting shots every week. Could remicade (infliximab) be a better choice?

An alternative: It is an alternative. However, it still requires being stuck for an IV every 4-8 weeks and sitting in an infusion chair for 2 hours. ...Read more

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I took myself off methotrexate for psoriatic arthritis without my doctor knowing it. I was on arava and enbrel and my enzymes were slightly elevated. I want to see if psoriasis comes back. If it does and my enzymes go down, I will start start the medicine

No, bad idea: You are on the same team as your doctor. Use your doctor as a consultant to help you make the best decisions for your care. If you alter your treatment plan yourself, you are at the very least putting yourself at risk for a flare of disease, and at worst putting yourself into danger if your medicines require a taper to be done safely. Call your doctor now--tell him/her you'd like to stop your meds. ...Read more

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Rheumatoid arthritis for 7 yrs. On methotrexate & prednisone. Tried so many drugs (orencia, enbrel, (etanercept) humira...). Feeling defeated. What else can I try?

Other choices: Some older drugs such as Plaquenil may help, especially with fatigue. There are also newer drugs that act via different mechanisms such as actemra (tocilizumab). I assume the diagnosis of RA is definite. If not, retest other possibilities. An exercise program may be very beneficial, especially if you start slowly and build up with hurting yourself. Don't give up hope. You can get better. ...Read more

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What do you think of the combination of celebrex (celecoxib) and sulfasalazine to treat RA beside taking other medications such as methotrexate and Enbrel? Instead of Norco or motrin or tramadol

What do you think of the combination of celebrex (celecoxib) and sulfasalazine to treat RA beside taking other medications such as methotrexate and Enbrel? Instead of Norco or motrin or tramadol

Depends on severity: It depends on the severity and activity of your RA.
Enbrel and Methotrexate are great drugs if you have active. If it is not active Celebrex (celecoxib) and sulfasalazine are alternatives. We discourage people to use narcotic painkillers for non cancer pain for the long term since it is very addictive and people become tolerant for the doses and expect increasing doses ...Read more

Dr. Robert Lowe
125 Doctors shared insights

Etanercept (Definition)

Etanercept is an immune system suppressor which is a kind of ...Read more


Dr. Robert Lowe
143 Doctors shared insights

Enbrel (Definition)

Enbrel is an immune system suppressor which is a kind of ...Read more