6 doctors weighed in:

Dx:ra. Enbrel (etanercept) not effective after 6 mo. Humira 2x mo prescribed. Liver can not tolerate mtx. What medication can replace mtx to make humira work best?

6 doctors weighed in
Dr. Ronald Krauser
Internal Medicine - Rheumatology
3 doctors agree

In brief: Arava (leflunomide)

Arava (leflunomide) can be substituted for Methotrexate but they both have similar risks.

In brief: Arava (leflunomide)

Arava (leflunomide) can be substituted for Methotrexate but they both have similar risks.
Dr. Ronald Krauser
Dr. Ronald Krauser
Thank
Dr. Martin Raff
Internal Medicine - Infectious Disease
2 doctors agree

In brief: See a rheumatologist

The only person who should be advising you on this is a doctor who is seeing you and examining you and has your entire medical history available.
There are several ways to approach this and decisions must be made only after a face to face encounter. Hope you get this worked out soon. Best.

In brief: See a rheumatologist

The only person who should be advising you on this is a doctor who is seeing you and examining you and has your entire medical history available.
There are several ways to approach this and decisions must be made only after a face to face encounter. Hope you get this worked out soon. Best.
Dr. Martin Raff
Dr. Martin Raff
Thank
Dr. Robert Lowe
Pediatric Rheumatology

In brief: Ask re: wkly Humira (adalimumab)

Leflunomide is another drug that is sometimes used instead of Methotrexate if Methotrexate is not tolerated.
However, i rarely use it for patients who do not tolerate Methotrexate because it doesn't seem to work nearly as well (but other docs think it works fine). Instead, i would try increasing Humira (adalimumab) to weekly dosing of 40mg. This works for half of my patients who don't get relief from 2x/month.

In brief: Ask re: wkly Humira (adalimumab)

Leflunomide is another drug that is sometimes used instead of Methotrexate if Methotrexate is not tolerated.
However, i rarely use it for patients who do not tolerate Methotrexate because it doesn't seem to work nearly as well (but other docs think it works fine). Instead, i would try increasing Humira (adalimumab) to weekly dosing of 40mg. This works for half of my patients who don't get relief from 2x/month.
Dr. Robert Lowe
Dr. Robert Lowe
Thank
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