Medication pros and cons

Posted , 10 users are following.

Need to make a decision between methotrexate and sulfasalazine. Would appreciate any input regarding experience of either drug.

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  • Posted

    Methotrexate much more effective
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    • Posted

      Thanks have u tried both? Just would like more information on individual experiences. It seems sulsfasalazine has less side effects going by information I was given. 
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    • Posted

      I have tried both and as of now taking prednisone and max dose of methotrexate. Unfortunately hasn't slowed progression of disease. Staring entanercept in March and will have to continue methotrexate with it until showing signs of remission. 
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  • Posted

    There's a risk of side effects with all these drugs, but if sulfa has less side effects then give that a try first.  If it don't work or you get a reaction then you can always try methotrexate or something else. Take a tip from me - always take the least amount of medication that you can get away with.
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  • Posted

    Hello there

    Sorry I cannot comment on this at all as I have no knowledge of these drugs. I am

    on a learning curve here as my daughter has just been diagnosed with this illness and is due to see the Rheumatologist tomorrow and I'm asking kind contributors on this site for advice so I may help her.

    Best of luck to you :-)

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  • Posted

    Hi Iain,

    i have been on Methotrexate, Sulfasalazine and Hydroxychloroquine they call this a combination drug, all worked well for a couple of years but have had to come off Sulfasalazine as it gave me a rash, nausea and after a while liver tests were not great.

    everyone is different and you will be monitored by your consultant and start on a low dose.

    hope this helps

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  • Posted

    I have been on both. At moment am on sulfazaline 2000 mg day= 2 am + 2pm teatime.no side effects

    Was good on methotrexate until told to take highest dose n this then effected my liver so had to come off it.also thinned my hair. It is very strong drug

    All these strong drugs can give side effects n cause other bad things.some people get good results and others not.wish just one thing would work well

    Are you on anything else like prednisolone or Pregabalin

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  • Posted

    I m thinking your symptoms can't be too severe if they are giving you a choice? Have you recently been diagnosed?

    I too am on combination therapy of methotrexate, sulphasalazine and hydroxychloroquine ( plus I am on a biologic) the current thinking is to make early diagnosis and use combination therapy to 'knock back' the disease then gradually reduce meds till only using what s necessary to stay well.

    Methotrexate made me lose hair a bit and made me have brain fog on the day I took it- minor side effects so am still on highest dose of 25mg. Maybe no side effects of sulfasalazine BUT I have suspected it may make me feel down- so difficult to know what is caused by disease and what caused by med. I was chatting to someone recently whose mood was badly affected by sulfasalazine . Of course all returned to normal when stopped.

    so I think whichever you choose, keep a diary if how it may affect you.

    If your symptoms are mild, sulphasalazine may work well for you. But if not methotrexate is the basic treatment to which other meds are added if necessary Hope this may be of help.

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    • Posted

      I was first diagnosed over 10 years ago. Despite a high pain threshold recently I have suffered quite a bit. My consultant is amazed that I am able to keep going and have keep as well as I have. I spent quite a bit of time researching lifestyle and dietary changes as I was reluctant to medicate. I have to say that until recently these changes have made a huge impact on the management of my condition.
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    • Posted

      That s really interesting- and can see why you re reluctant to use med when you have managed for 10 years with lifestyle changes.

      so maybe it depends how much it hurts now as to which you end up taking as I would think mxt is generally more effective.

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  • Posted

    Thanks to everyone for their replies. To date I have managed to get by on pain killers and the occasional steroid injection. Part of my reluctance to medicate is due to the side effects of RA medication that my mother experienced which ultimately ended in her death last year at 74 years old. I do appreciate medication has moved forward tremendously since but can't help being cautious. Do the side effects cause more problems than the disease?

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    • Posted

      You are being a brave soldier but you could be doing more damage to your joints.The strong RA drugs will dampen down your symptoms if they find the right one for you and slow down the disease.I didn't realise how bad I was until consultant put me in hospital on steroid drip for 5days.I then started on methotrexate but went downhill as Hosp forgot to send me out with steroids as well.I am still on steroids 4 years later and on high painkillers .I have tried 3 biologics.nothing has helped me enough.am on Sulfasalazine but still racked with pain.I am still convinced thou that last biologic caused me to have Hughes Syndrome. I was jerking after months of taking this drug and couldn't walk properly. memory shot n speech was slurring. Not being offered any other strong drugs now!

      I personally dont recommend the biologics but methotrexate was great for me until it got raised too much n started damaging my liver.

      I also was given choice what drug to choose.sent home with leaflets which is crazy as they are the professionals who know what's best for you aren't they.

      If one drug doesn't help you could always try another

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  • Posted

    Hello, I was feeling so good (other than right knee) I wanted to believe I did not have arthritis so I stopped taking both the Methotrexate and Sulfasalazine.  It has been a bit over a month and I am so sorry I stopped.  The ankles, wrists hurt something awful.  I found a new doctor because we moved out of state and I can't see him until March.  So I am taking Prednisone and it helps.

    Now, regarding the choices.  I would prefer no pain.  I have read pros and cons about a few on the market.  I would take both.  Methotrexate is once per week and the Salfasalazne is taken daily.  Taking all the pills is what really made me want to stop.  But now I know I need to.

    Good luck 😀

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  • Posted

    Sulfasalazine did nothing for me, ESR never dropped, so specialist started me on MTX, a tablet once a week, worked wonders, and my arthritis went away for about 2 years.

    Regular blood tests are a requirement to make sure your liver is coping with the medicine.

    Then arthiritis came back again, flares as they are called, second time around MTX did not work in very low doseage.

    I am now on 35mg by injection once a week after they discovered that I wasn't taking up the medication through my stomach, for someone who is a little needle phobic a very patient GP, and a little gentle shaming about children with diabetic conditions, having to give themselves injections a few times a day, rather than once a week.

    My arthiritis is currently under control, although I do still have flares, and they are not nice.

    Over time I have worked my way through the chemists shop of medications that may be better than MTX, but have come back to MTX as the medicaiton that works best for me.

    Another medication worked wonders, Leflunomide, within days my arthiritis cleared up, but I had a rare reaction of extreme blood pressure, so had to come off that, otherwise the blood pressure would have caused a stroke.

    Cannot take biologicals as I have had cancer and also have a positive TB test, I was given TB injection when I was about 15 as a preventive measure, and now that is a NO NO for biologicals.

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  • Posted

    Iain if you enjoy a beer sulsfasalazine. I was persribed Mez but after discussing my life style with my Rheumatologist decided to use Suls. 4 works on still working and excercising. However Mez is a superior product. suppose it depends on the severity of your condition.
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