All posts filed under: Methotrexate

I thought I was going bald, it was just the MTX

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About six weeks ago, I started noticing my hair thinning. I thought it was odd because my dad had thick hair in his older years. I expected my hair would do the same. My hairdresser also noticed the thinning. It was real. Next, I started noticing bunches of hair on my comb. “My hair is falling out,” I thought. Right again. I quickly realized that it was the methotrexate (MTX). Hair loss only occurs in 1-3% of those on MTX. I have been on it for five years and the last three years I have been giving myself 25mg injections. It works for me. I am also on hydroxychloroquine (Plaquenil). Plaquenil can also cause hair loss. I started taking MTX every eight days instead of every seven. Every nine days starts an RA flare. I stick with the eight days. I also cut the Plaquenil to 200 mg daily from 400 mg daily. My hair is no longer falling out. However, my hair hasn’t grown since my last haircut. Unfortunately, it was the second worst …

Methotrexate NSAID or DMARD ?

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I can now count myself  as one of the few who has read the package insert for methotrexate. I am researching RA drugs for my book.  I give myself injections of 25mg methotrexate weekly. I was opening a new box and preparing to give myself an injection.  Impulsively, I decided to read the insert. Methotrexate has become the gold  standard for RA treatment. It has been one of the few drugs to help relieve my symptoms. Imagine my surprise when I read the following. Medication guide insert with boxed  methotrexate; “Although methotrexate clearly ameliorates symptoms of inflammation (pain, swelling, stiffness), there is no evidence that it induces remission of rheumatoid arthritis nor has a beneficial effect been demonstrated on bone erosions and other radiologic changes which result in impaired joint use, functional disability, and deformity.” So since it doesn’t stop RA progression how can it be classified as a DMARD, Disease Modifying Anti Rheumatic Drug?  Shouldn’t it be a NSAID,  Non-Steroidal Anti-Inflammatory Drug?

Ten things to know about methotrexate and RA

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  Methotrexate has been used for RA since the late 80’s.  It is the cornerstone for RA treatment and considered to have an impressive safety record. Methotrexate is classed as  a DMARD, Disease Modifying Anti-Rheumatic Drug. It decreases pain and swelling. It can lessen joint damage and consequently long-term disability. Methotrexate is taken once a week usually in pill form. The injectable form is reserved for those who don’t tolerate the pill or to extend the effectiveness of the drug. Self injection is not hard to learn for those who need it. It can be easy to do with a prefilled  auto-injector that comes in a variety of doses. The auto-injector is useful for children with JIA, too. Methotrexate is frequently paired with other DMARD’s. Plaquenil, an anti-malarial drug is often used. Sometimes Sulfasolazine is added, too. Drugs used in combination with methotrexate are usually more effective. Methotrexate is also paired with the biologics including Orencia and Rituxan. The biologics become more effective when teamed with methotrexate. RA can continue on its destructive path when there are no obvious symptoms. It’s reassuring …