For Rheumatoid Arthritis Sufferers…Some Info About Methotrexate
Rheumatoid arthritis is the most common inflammatory form of arthritis. It affects more than 2 million Americans. Because it is a systemic disease capable of damaging internal organs,it must be and usually is treated very aggressively.
The most widely prescribed disease-modifying anti-rheumatic drug (DMARD) for rheumatoid arthritis is methotrexate.
It has been in use since the early 1980′s and is the “gold standard”by which rheumatologists judge all other DMARDS. It is also the drug upon which other medicines such as biologic response modifiers (BRMS) are added.
Methotrexate interferes with folic acid metabolism by blocking a specific enzyme called dihydrofolate reductase. Dihydrofolate reductase is required for the growth of actively dividing cells. Since inflammation is perpetuated by rapidly growing cells,methotrexate is felt to exert its effects by blocking the multiplication or proliferation of these cells.
As a result of its actions,methotrexate reduces the swelling and pain associated with rheumatoid arthritis and also decreases the risk of long term disability. It takes roughly 4-12 weeks to see the maximum effects of methotrexate. During this short period of time,the dose of methotrexate is started at a low dose and gradually increased.
The drug can be administered in several ways. Patients who have extremely active disease can be treated intravenously to help with induction of remission. Patients can then be treated with oral tablets. The tablets come in a dose of 2.5 mgs per tablet. Methotrexate is taken as a single dose of medicine once a week. That means that if a patient is taking the drug either intravenously or in tablet form,they take all their medicine at one time once a week. Some patients who have difficulty taking oral tablets because of nausea may be able to take their methotrexate as a subcutaneous injection.
The dose of methotrexate varies from a low of 5 mgs per week to as high as 25 mgs per week. Higher doses tend to be poorly tolerated.
Potential side effects include mouth sores,gastrointestinal problems such as nausea,vomiting,and diarrhea,shortness of breath,cough,liver function abnormalities,hair loss,sun sensitivity,and drops in white blood cell count or platelet count. Rarely,cirrhosis of the liver can occur. Older people who have dietary deficiencies are at particular risk for methotrexate side effects.
Patients should have laboratory testing of blood counts and liver function tests once a month.
Patients are usually given supplemental folic acid in a dose of 1-2 mgs per day to counteract some of the side effects of methotrexate.
Methotrexate is terribly teratogenic (capable of causing birth defects). Therefore,in women,as well as men,who are contemplating having children,patients need to hold their methotrexate for at least 3 months prior to attempting conception.
Since methotrexate is capable of damaging the liver,patients should be counseled about limiting or eliminating alcohol ingestion.
Furthermore,methotrexate can interact with a number of other medicines including antibiotics such as sulfa drugs as well as non-steroidal anti-inflammatory drugs.
Methotrexate is often used in combination with biologic drugs such as Enbrel,Humira,and Remicade.
About the Author
Nathan Wei,MD FACP FACR is a rheumatologist. For more info:
Arthritis Treatment
or
Arthritis and Osteoporosis Center of Maryland
or
Tendonitis Expert Advice
body hair problem?:/?
uhh,hi. i’m 16,my birthday was in july. most guys in my grade can already grow beards,and i can’t. like,the most i can grow is a thin mustache and little chin hairs. i barely have any armpit hair either. my pubes grow in fine,and there’s no problem with that. i have leg hair too,a normal amount. i’m also on humira and adderal. now i know one of the side effects of humira is hair loss,but the hair on my face/armpits barely grow,and isn’t thick at all. My cawk is 6.5 inches,but it’s not thick. And when i jack off i don’t cumm a lot,sometimes not at all. To tell you the truth,i would even consider testosterone shots. So could someone give me their opinion on this? Am i a late bloomer or are the medicines i’m on affecting my growth. help me please,ha.
Sounds like you are a late bloomer.
Effective Home Remedies for Colitis
Ulcerative colitis is a disease that affects the bowels. The cause is not known,though it is presumed to be a type of allergic reaction. Some theories state that it is hereditary or that when the immune system of the bowels is weakened,it causes irritation of the bowels. Let us examine the symptoms before we proceed further.
The most visible symptoms of Ulcerative colitis are pain and cramps in the abdomen. Other symptoms include blood in your stool,diarrhea,loss of appetite but these symptoms are common to other diseases of the bowel region as well. They are inconclusive unless further tests are done to lead towards a proper confirmation. Some other symptoms are fever,mucus in the stool,and ulcers in the large intestine. Nevertheless,a good physician will diagnose by examining a biopsy of tissue swab from the colon during colonoscopy.
The system of treating Ulcerative Colitis is in using two types of drugs. One type is prescribed to stop an occasional spurt of the disease. The other type is to be taken regularly to prevent such spurts in advance. Some of drugs that are usually prescribed are Azulfadine (sulfasalazine),Asacol (mesalamine),Immuno suppressants (Imuran,6-MP,cyclosporine),Methotrexate,TNF-alpha inhibitors (Remicade and Humira) and Corticosteroids (Entocort and prednisone)
Of all these,the Corticosteroids are taken for a short term and the doses are tapered off and stopped for a while,since Corticosteroids are known to weaken the bones if taken in the long run. Some people resort to surgery,if the affected portion is small and is detected very early. But,this is inconclusive,since irritable bowel syndrome can still prop up in other healthy areas.
Back in January of 2009 I was started on Remicade. This is a drug which you take via an infusion,and it is approved by the FDA for Ulcerative Colitis. For me,I travelled down to the PAMF Infusion center which is actually in Mountain View,California where Google is headquartered. I am guessing you have probably heard of Google. I will go into details on a later post about the Remicade and the infusion process. The long story short is the Remicade was not working as planned,and I was then started on Humira for my ulcerative colitis.
I can remember the first day I started Humira clearly. I made my way up to my GI doctor’s office to meet with his nurse,a woman who at this point was one of my closest friends. (for those of us who have had been given the present of severe Ulcerative Colitis,it is truly amazing how close you can become with your nurses/doctors/even receptionists since they are the first person you see when you arrive at the doctors.
How many people on this planet really don’t mind having shots? I feel like I am a macho person sometimes. Fell down playing ice hockey when I was 12 or thirteen and slammed my face against the ice,blood was flying out of my mouth since my teeth cut some things up along with the impact blowing a hole in my lower lip. But needles…for some reason never got used to them. All along,my doctor was telling me how it was no big deal.
About the Author
Read about colitis treatment.Also Read Article on treatments for colitis. Read more about home remedy
