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.
My wife is on 10 pills of methotrexate a week all at once for Rheumatoid Arthritis. Is there an even higher doses for uncontrolled flare ups?
No. 25 mg is considered the highest weekly dose of methotrexate. A biologic should be added if that dose of Methotrexate is not sufficient.
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.
Patient taken methotrexate for rheumatoid arthritis but now patient plan for pregnancy so how many days will stopped befor pregnant?
Need to have plan. There should be no attempt at getting pregnant until off Methotrexate completely but should not move forward until a plan in place that involves your obstetrician and rheumatologist. There are certain vitamin levels that need to be in appropriate range and will need to be supplemented before conception and during the pregnancy. There should be a protocol in place in case the rheumatoid flares.
What is an analgesic drug other than nsaids (because of interaction with methotrexate) for rheumatoid arthritis and stronger than paracetamol?
SSNRIs, opioids. There are several options. Selective serotonin and norepinephrine rein take inhibitors, anti depressants and opioids.
See below. He/she may experience a flare in his/her symptoms. Let the doctor know what's going on.
I have rheumatoid arthritis and I'm on methotrexate, is it ok to still have breakthrough pain flare ups?
Not really. In the early stages of treatment flares can occur. If they do persist you should speak with your rheumatologist about increasing the Methotrexate dose or add a second medication, possibly a tnf agent.
No. That is a sign that your rheumatoid is still active. See your rheumatologist to see what other medications you are a candidate for.
Good. Usually helps within 2-4 months but rarely produces 100 % remission. Quite low risk.