Humira and Methotrexate
I had a checkup with my rheumatologist this morning and she recommended I add methotrexate to my humira. I am nervous about this addition. Is anyone taking a similar regimen? Does it help? Is it worth it?
I've not done the methotrexate in combo with a biologic due to past adverse reactions to methotrexate alone, but don't be dissuaded by the experience of others, as we all react differently to different medications. Methotrexate is often prescribed as an add on treatment, but in lower dosage than when it's a stand alone, because it is thought that doing so can hold off the body's development of anti drug antibodies (immunogenicity)for a far greater time. But honestly, if the drug isn't working all that well any more, then you may have already begun developing immunogenicity, and changing to a different drug might be more helpful.
I've been on Humira for a little over 6 months and it has helped some. The swelling in my fingers is so much better. The constant tightness in my lower back is gone. The random swelling of some joints is also improved. But I still have a good amount of pain where I need to take a strong nsaid most days. And I still wake up pretty stiff or have extreme fatigue on random days so I think she wants to try the combo before completely changing up the medicine. Really it's the nature of the drug that scares me. Don't worry. You'll be subjected to regular labs to check your liver enzymes. The nausea can be pretty bad when you first start on MTX, but it subsides over time.
I also started on Humira
and later added methotrexate (it is supposed to
increase/complement Humira's effects). I did get prescribed folic
acid which helps
curtail side effects from methotrexate. I've seen previous posts from others who did not take folic acid and seemed they had a harder time. Like eric said above, everyone reacts differently, but the rheum should also be able to start you off a relatively low dose to see what is appropriate, and adjust it based on your symptoms/tolerance. They'd also be regularly monitoring your bloodwork so you should be able to stop right away if there are any issues for things like liver function. I would say if you take it, do allow for some adjustment time and anticipate the commonly reported side effects - like nausea.. (for me that got better with time). And take with food in the evening/weekend when you can rest the next day if you need to. I was also concerned at first adding more meds, but
