Plaquenil or Methotrexate…I need advice!

[jlynne]

I have a rheumatologist appointment soon and I’m sure my dr will want to put me on one of these drugs. I’ve been having a hard time with all of this. I don’t want to be on anything but I know I have to. The thing I am struggling with the most is suppressing my immune system. I have a strong immune system and I work at a school where illnesses are common. I know my immune system is strong because I never get colds, never get the flu (even swine) and have never gotten a flu shot. I’m really heathy except for RAD. I am exposed to illness daily and the thought of compromising my immune system to help with the RAD doesn’t appeal to me. Because of this, I talked my dr into giving me Minocycline as it is an approved DMARD also. I’ve been on it now for almost two months. The neck pain I have been experiencing is letting up but now I am starting to flare in my right foot, right knee, and right hand. Amazingly, the left side of my body feels great!

I guess I am needing reassurance, honest advice, and support because this is really getting to me.

Gosh, I really don’t want to take anything at all!!! I’m so opposed to it. I do know that I will not take pred.

This disease sucks…totally sucks!

[PhilC]

Hi,

Consider taking both, though not necessarily at the start. Why do I say that? Because, based on my own experience, taking a lower dose of two different medications that serve the same purpose, but work differently, often produces better results with fewer side effects. So perhaps you could start on the lowest dose of Plaquenil and see how that works for you. If it doesn’t seem like it’s enough, you could ask your doctor about adding the lowest dose of methotrexate.

There is another option to consider. You could tell your doctor that you would first like to try Relafen. It is a non-acidic NSAID, and is one of the safest NSAIDs (maybe even the safest). A typical dose is 500 mg or 750 mg twice a day. Your doctor may try talking you into trying a different NSAID. If that happens, I would say something like, “First I would like to try Relafen. If it doesn’t work for me, then I will consider trying your recommendation.” Be firm about it. Later, if you find that the Relafen is not enough, then you could talk to your doctor about adding the lowest dose of Plaquenil.

By the way, methotrexate is an immunosuppressant. Plaquenil and Relafen are not, so my idea of trying the Relafen first may help you to avoid taking methotrexate. Also, if you start taking Relafen, you would need to stop taking Aleve (if you are still taking it).

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[Dawn]

jlynne,

I will just add my short comment in agreement with PhilC to you.

Your DX appears to have been about the same time as mine, however, I started on Mobic NSAID, then added low-dose Prednisone at 10 mg. dropping to 5 mg. (for the flaring), and started the Plaquenil at 1/day, now at 2/day since I dropped the Prednisone. All that within just a month’s time and the flaring has greatly moderated. I will be adding the Minocycline in the next few weeks and hope to drop the Plaquenil as soon as possible. Sounds like you are responding well already and I certainly hope the best for you!

Best Regards,
Dawn

DawnF

[bonnielou]

Hi Jlynne. I am sorry you are flaring on your right side, but your doctor is right, you do want to get that under control. You don’t need to fear the plaquenil. It is not an immune suppressing drug, as Phil said. I have been on plaquenil the entire time I have been on minocycline — about 4 1/2 years now. My rheumatologist started me on a high dose (400 mg/day) — as it takes a while for the plaquenil to build up in your bloodstream and work — and then over time she continued to cut the dosage back — about every 6 months. Now I only take 200 mg once or twice a week — a very low maintenance dose, and I have no side effects. Maz has also taken plaquenil.

It can be a good combo with the minocycline or other drugs. I also never get colds or flu — but I do get viral flareups from herpes virus, that manifests as cold sores. I do use an anti-viral now and then to combat those — while continuing to work to strengthen my immune system and eliminate toxins. You can find a lot of threads on here from folks who take (or have taken) plaquenil. And it came in very handy the last couple of years when I traveled to both Vietnam and Honduras — and didn’t need malaria medication for either trip!

Send a message if you would like to talk more. Enjoy.

Bonnie

Bonnie Lou
RA 02/07,AP 10/07
Minocycline 200mg MWF; Plaquenil 100mg 3 days/week
Fish Oil, Ubiquinol, Turmeric, Vit C (2 grams) , MultiVit, Magnesium, Astaxanthin, D3 (5000), probiotics and a daily dose of yoga!

[Author]

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