Doctor insights on:
Leflunomide Vs Methotrexate
Methotrexate cheaper: Generic Methotrexate is very inexpensive. If you get name brand pills its more, but generic version of Arava (leflunomide) is more expensive than Methotrexate and Arava is the most expensive. In my experience, Methotrexate works better and has less frequent dosing (weekly instead of daily). I only use Leflunomide (arava) if Methotrexate can't be used for some reason. Side effects are similar. ...Read more
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
Why do I need to stop methotrexate & arava (leflunomide) before alif surgery? I can't take it for 2 months after, why?
What are my chances of getting liver disease while taking arava (leflunomide) and methotrexate together?
See details: Studies of this combination have shown increased risk of liver disease over taking just one of these meds alone. The exact risk is open to debate. I personally never prescribe this combination of meds although other rheumatologists do. ...Read more
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
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
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
Psa have tried mtx w /remicade& w/ humara no help methotrexate caused blood issues but worked better. Now embrel/leflunomide. No relief frustrated help?
MTX sc ?: Mtx causes less live issues given sc versus oral. Also, mtx has more potent metabolites that take 10 weeks to develop. You did not specify what tests where abnormal. But you suggest that mtx was given alone. Was it? Mtx and Humira (adalimumab) are a good combo for psoriatic arthritis. ...Read more
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
Take propecia 1mg, methotrexate 25mg, arava (leflunomide) 20mg, enbrel weekly, B12 & folic acid. Which ones are most likely to cause high liver enzymes(ast&alt)?
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 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
Standard therapy: Methotrexate was originally used in the early 1950s 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 and other rheumatologist diseases. ...Read more
Yes: NSIDs can be taken with Methotrexate. With or without Methotrexate, NSAIDs have many possible side effects and need to be used carefully. Gastrointestinal issues such as ulcers/gastritis can occur. Studies continue to show NSAIDs are associated with increased risks of cardiovascular side effects such as heart attacks and strokes. Routine labs are needed to watch for other side effects of both meds ...Read more
Methotrexate is a medicine that treats several kinds of cancer, including cancer of the blood, bone, lung, breast, head, or neck. Also, treats rheumatoid arthritis and psoriasis (a skin disease).
Fluconazole prevents and treats certain fungus infections. Belongs to a class of drugs called antifungals. ...Read more
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