new medications

[katsgirl]

:wave: Hello All;

I was finally seen by a rheumy doc at the school of medicine. He discontinued the MTX and the prednisone that I was on, then started me on plaqunil and diclofenac.

I am now stressing because its going to take another 6-8 weeks for the new meds to kick in. Im starting to have repeat symptoms. My knees are burning again, my feet and toes are even hurting. :angry:

The new doc also ordered a whole series of blood work(lupus panel). He told me that I had been on MTX for 6 months already. If the MTX was going to work, I would not be having the same problems.

I am able to walk with a cane, but I still take pain meds daily due to joint and muscle pain. I think he came to the conclusion that I wasnt better when I almost fell in his office. My knee just refuse to work or something, my leg locked and I was almost on the ground. :hehe:

Now Im waiting for the results of my lab work, and for the new meds to kick in. Does anyone have any advice or information on the new pills that Im on? I know that I could read about it, but I need real expertise :)

Thanks Kat

[meg4340]

Hey there :)

Sorry you're not feeling well. :( I can add my on personal "notes"...Plaquenil was orginally developed as an anti-malarial drug. It works to help suppress the immune system...which we need because in lupus patients the immune system is haywire and over-reactive. Sometimes, docs will ADD plaquenil to methotrexate or methotrexate to plaquenil, because for many it takes a combination of the two. Quinacrine is another good drug used for lupus control (Clare T knows more about that). Diclofenac is a non-steroidal anti-inflammatory drug (NSAID), used to treat pain and inflammation. It has been around a long time and is not a narcotic. The biggest thing to watch for is an upset tummy (overuse of NSAIDS can lead to stomach ulcers). The diclofenac should work fairly quickly for pain if it is going to help you. The plaquenil needs time to "do its thing"....sometimes up to six months. Hope this info is helpful! Take care! :cloud9: :flowers:

[raggedyann1]

Kat,

Imuran is an immune suppressant similar to methorexate. It can start working in as few as 4 weeks, depending how fast your doctor has you jumping up from dose to dose. The normal therapuetic dose is 150mg unless you are "large" then it sometimes is taken up to 200mg. There is a formula based on weight that some doctors use to determine dose but mostly I have seen start at 50mg then to 100mg to 150mg. My rheumy tried me on imuran but I had horrendous nausea that never went away. Most of the time the nausea goes away after a few weeks.
I am surprised that he took you off the prednisone before the imuran has had a chance to start working.

Imuran is not thought to be as effective as methotrexate when dealing with joint pain in lupus. I would ask him about adding plaquenil as well. Plaquenil is the one med that deals with the disease process and is very helpful for most patients who have joint pain and skin symptoms.

Let us know how things go,

Karen

[bananawear]

Hi Kat- the plaquenil is pretty much the standard for us lupies and is one of the drugs used to actually modify our disease activity. The plaquenil goes in and modifies the lupus at the cellular level by changing the acid base of the the cells.

For most people it does take about 4-6 months to get the full benefit from the plaquenil so you probably will notice some benefits from the anti inflamatory drug first because it will most likely provide you with some pain relief at first.

I was one of the people who also could not take methotrexate - so everyone is different and its good that your dr. is trying some different things for you. One of the things that some people need to look out for with the plaquenil is tummy upset at first but it usually goes away within a couple of weeks. If you do have some upset you may want to talk to your dr. about starting with a lower dose and then taper up slowly. The standard dose is to start with 200mg a day and then take 400mg a day - some docs will start you on the 400mg a day right off.

Hope you are feeling better very soon and let your dr. know if you have any new side effects from your new meds!

Take good care- Chris

[katsgirl]

I really want to thank all of you guys for the information. Im starting out on 400mg of panquenil each night at bedtime. My doctor said that by taking it at bedtime will lessen the nausea.

When I was taking methotrexate, I also took folic acid daily. Is it still ok to take folic acid? Im sorry for so many questions. I can probally reach my doctor tomorrow for answers, but its so much easier and quicker to get information from people on this site that knows.

thanks again kat

[raggedyann1]

Kat,

If you are of child bearing age and hope to get pregnant the folic acid is not a bad idea. Otherwise I don't know of it being used with any other meds we take for lupus.

Karen

[katsgirl]

Thanks Karen.

Kat.