Rheumatoid Lung - Starting meds

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Hi, 

Hubby diagonosed sero positive 3 months ago.  But also early Interstitial Lung Disease.  RA Dr said yesterday they want to hit him hard as the lung disease can be reversed.   We now have a script to start on 10mg Methotrexate and 50mg Prednisone! Far out!!! 50MG of Prednisone.  That's huge!!!!  I'm guessing they will taper that off over time, but wow! My thinking is "it's your lungs" stop messing around and start popping those pills.   Anyone have any input into the dosage?  Anyone else started off so high???    Thanks for any help!  Cheers Del

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  • Posted

    Yes I used a lot of Z packs and felt great on 60mg. That only lasted until I was fully diagosed and all the other drugs were intoduced to get me under control. That was seven years ago and Im doing pretty good. Best of luck
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  • Posted

    Hi Del, I was suspected of having Temporal Artritis whilst waiting for results of tests and I was put on 60mg Predisnolone for a while, be aware your Hubby will eat you out of house and home haha I could get through two breakfasts without blinking, I got the hard moon face and extra padding on my shoulders and very bad tempered. Luckily I was only on it for a while until the biopsy proved it wasn't TA. It was easy to reduce them and no ill effects. I still have some very low dose ones if I get an RA flare but try not to take them. Methotrexate can cause liver damage which is why they will have put your Hubby on a small dose and a high dose of Predislonone. The liver recovers fairly well luckily. I am on 20mg Methotrexate and have had to reduce it when my liver showed signs of stress, it recovered in weeks. They will monitor his liver regularly whilst on Methotrexate anyway and will pick up on any changes.

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  • Posted

    Can only advise on MTX, I am on 35mg, and coping very well, liver tests come back OK, so it is possible to be on a very high dose and cope, monthly blood tests which both speciailist and GP monitor.

    Have been experiementing as been having really bad night sweats, taken off MTX for 3 months, no change, so back on MTX, and now taken off Leflunomide, and night sweats have vanished, so we have tracked down what is causing the problem, now to figure out what other medication I can try, seems to be an ongoing exercise with me, have already worked my way through most of the drugs available.

    Predizone, disaster area for me, gave me mental health problem became very sick, so taken off it pretty quickly.

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  • Posted

    50mg is a common dose for severe inflammation where it is important to reduce the inflammation quickly. On my "home forum" for giant cell arteritis they may even go above that, to 80 or even 100mg if a patient has visual symptoms but that is usually only for a few days. But 50-60mg is a common starting dose for as much as a month. and then reducing 10mg at a time. However there the inflammation is being "topped up" every day so when high dose pred is used for existing inflammation such as from an infection or in asthma they usually reduce far sooner. My daughter and granddaughter are often on 40mg for asthma.

    At the high doses he may well be like the Duracell Bunny and find it difficult to sleep - and he will also probably be hungry all the time. But if he wants to avoid the weight gain, cutting carbs drastically not only reduces the food cravings but also helps avoid weight gain and fat being deposited in the usual places (hamster cheeks, around the midriff and on the back of the neck). Pred can cause wild swings in blood sugar - and that triggers the production of insulin, the BS falls too far and that makes you desperate for food again. On the other hand - both I and my other daughter go off food when on pred - everyone is different.

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  • Posted

    Wow! Dont blame you for being alarmed, I have never heard of such a high dose of steroid, just check and recheck! As for mtx, I wasnt known to have any lung disease but developed pneumonia whilst on mtx, the consultant respiratory physician said he thought it was mtx induced! I still have mild bronchiectasis but dont take mtx anymore!
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    • Posted

      As I said above - it is actually used a lot, sometimes even higher, for severe inflammation where it is important to sort it out quickly, like in lungs where you need to be able to breath!
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  • Posted

    Hi

    i was diagnosed yesterday with RA of the lungs. I've had 2 CT scan 6months apart the 1st showing nodules on a lung I was taken off Mxt  straightaway.

    yesterday I was shown the scan it showed about a quarter of my left lung is damaged and the right one a little. The doctor is sending me for PHYSIO. ????? And said he may send me to a Chest clinic at another hospital. He was runner 1 hour 35 minutes behind so he didn't seem to have the me to explain what would happen next . 

    I don't know what to expect ?

    i have RA for 28 years which has attacked all over my body including my eyes which is Sorjgen syndrome  . 

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