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Doctor insights on: Zosters And Methotrexate

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Can the shingles vaccine be taken with humira (adalimumab)?

Can the shingles vaccine be taken with  humira (adalimumab)?

Not a good idea: The shingles vaccincation (known as zostervax) is a live virus, therefore you would run the risk of infection from the vaccination itself. Any medication in the class of drugs like Humira (adalimumab) would be a no-no to receiving the shingles vaccine. This is the official published guidelines from rheumatologists that just came out in early 2012. ...Read more

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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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Since starting Accutane i've experienced more frequent herpesvirus outbreaks consisting of more lesions. Why? Valtrex (valacyclovir) and Accutane together?

Since starting Accutane i've experienced more frequent herpesvirus outbreaks consisting of more lesions. Why? Valtrex (valacyclovir) and Accutane together?

Possibly related: There are some reports in the literature of increased h. Simplex perioral outbreaks with Isotretinoin use. Some dermatologists recommend pre-treatment with herpecidal medication (such as valtrex) for one week prior to starting Isotretinoin in those with a history of outbreaks. ...Read more

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Can we give steroid with acyclovir in chicken pox or herpes zoster patient?

Can we give steroid with acyclovir  in chicken pox or herpes zoster patient?

I wouldn't: Any steroid taken during these outbreaks can suppress the body's immune response and increase the intensity of the outbreak.The worst case of chickenpox I ever saw involved a kid given steroids for a skin condition while he was incubating (10-21 days) the chickenpox. ...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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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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What drugs block the immune response and are used for rheumatoid arthritis and psoriasis?

What drugs block the immune response and are used for rheumatoid arthritis and psoriasis?

Immunosuppresants --: are the class of drugs. A rheumatologist would probably provide you specifics if you need that Info.. ...Read more

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Can topical steroid treatment be given in viral diseases like varicella, herpes, chicken pox infections?

Can topical steroid treatment be given in viral diseases like varicella, herpes, chicken pox infections?

Topical Steroids : Topical steroids used on viral infection can affect the healing process. In fact the lesions may heal a lot slower. If you want to use topical steroids to decrease inflammation make sure you also take oral antiviral medications at the same time. ...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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Will taking cytoxan (cyclophosphamide) and prednisone decrease my fertility?

Will taking cytoxan (cyclophosphamide) and prednisone decrease my fertility?

Yes: Cytoxan (cyclophosphamide) can be damaging both to eggs and sperm and therefore needs to be monitored closely by your rheumatologist and fertility doctor. Cytoxan (cyclophosphamide) is also considered class d in pregnancy suggesting risk of fetal harm. Long term Prednisone therapy has little effect on sperm production or ovulation. ...Read more

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Should methotrexate patients get shingles vaccine?

Should methotrexate patients get shingles vaccine?

Dose dependent: This judgement has to be made by the provider. Technically low dose Methotrexate is not considered a contraindication to receiving the shingles vaccine. But only your provider will have a full picture of your immune status. Shingles vaccine is a live vaccine and not given to those with significant immunosuppression. ...Read more

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What are the side effects of tnf inhibitors such as humira and enbrel (etanercept)?

See below: The important side effects that have been most extensively related to tnf blockers include: lymphoma, infections including tuberculosis, congestive heart failure, demyelinating disease, a lupus-like syndrome, induction of auto-antibodies, injection site reactions, and systemic side effects. ...Read more

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Is eczema an auto immune response? If so can drugs such as methotrexate and tnf blockers aid in the treatment of extreem cases?

Is eczema an auto immune response? If so can drugs such as methotrexate and tnf blockers  aid in the treatment of extreem cases?

Allergy Respons: Eczema is an allergy to something, often foods. Using immune suppressant drugs will clear the problem but it is better to find the cause and remove it or treat it than to suppress the immune system. Suppressing the immune system can be very dangerous. ...Read more

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Dr. Robert Lowe
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Rheumatrex (Definition)

Rheumatrex ...Read more