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PMR and Methotrexate
I have been on prednisone for about a year and am finally down to a daily 7 mg dose. However, still feeling some stiffness and my rheumatologist has suggested a couple of times that I could could also go on Methotrexate. I'm reluctant to take yet another medication though so am wondering if anyone else has tried Methotrexate and if it helped lessen the PMR symptoms.
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I thought of one more thing - search around this site for 'split dose". -- that was the major improvement for me -- maybe try splitting your dose and tapering again .
"My flare-up is really affecting my shoulders and starting into my hips. " - I assume this is how you feel in the morning ? and then you take your 5mg and feel ....any better ? many people keep a spreadsheet or journal of the Prednisone dose and and pain levels throughout the day .
also see this thread that is currently ongoing : https://connect.mayoclinic.org/discussion/anyone-tapered-down-as-directed-but-increased-back-up-on-their-own/
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1 ReactionThank you for replying My dr told me not to split the dose. I can't remember the reason as she was throwing so much at me at my first appt. My stiffness seems to last all day. My shoulder is hurting pretty badly right now, I'm hoping she gets back to me soon. Of course, the weekend is coming so maybe by Monday hopefully. Thanks, again!
I have just been diagnosed with PMR and as a diabetic that I'm controlling with diet and not so much exercise right now I've opted to go with methotrexate rather than prednizone to minimize glucose spike and have to look to insulin. Starting first dose tomorrow. Any insights? Biggest downside for me is not being able to be in the sun without precautions. What can I expect with side effects and do they diminish as the doses continue? What are you doing for pain management until inflammation starts to get under control? Any response is greatly appreciated. This is one crazy roller coaster ride!
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1 ReactionYes. Its going to be a wild ride. If you can bear the pain then try to stay off steroids. They can create or enhance so many other things. But the largest percentage started using them for PMR pain and inflammation because its about the only thing that works. So you say do I want a life or not. Diet helps many. But sounds like you work on that. Methotrexate is an immune blocker. works on RA and can reduce cancer cells. Many try it as a means to taper off steroids. But it doesnt help with PMR. Newer biologics like Kevzara and Actemra reduce inflammation by blocking the IL-6. IL-6 has been shown to be active in PMR. If you can stand the pain maybe add one of those to the mix. I am sure someone has better information. good luck.
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5 ReactionsI took methotrexate to try to reduce my prednisone dose. It worked for that as I was able to reduce from 8 to 5mg after being stuck at 8 or higher for 2 years. The side effects were bad for about a month: nausea, headaches and just not feeling well. The methotrexate worked for 5 months, then I got a disease flare-up. The methotrexate also caused my liver enzymes to be high, which means damage to the liver is happening. I'm now taking Kevzara and prednisone. From my experience and everything I have read methotrexate does not work as a sole treatment for PMR. The pain and symptoms of PMR I had could not be endured without treatment. I could barely function, was spiking a fever on an almost daily basis and developed the temporal headaches that can be a symptom of giant cell arteritis, a more serious disease. My impression is that some people have a less severe case of PMR and other approaches may work.
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1 ReactionHello, I have been a diabetic for about 12 years, it is genetic in my family. However, I also have a long intermittent history of prednisone use of over 50 years! My history includes Asthma, Reactive Arthritis and now PMR.
I have taken methotrexate and Arava in the past with prednisone. I take 2000 mg of metformin a day for my diabetes and I’m currently on 7.5 mg prednisone and getting ready to start Actemra. So far I have had no need for insulin. Prednisone is unfortunately the drug that really gives almost instant pain relief for arthritis and PMR. I would discuss this with your PCP and Rheumatologist and they can address your concerns. Really I believe you should do well since you said your sugar is under control with diet.
Good luck!
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1 ReactionAs an add on to my previous comment, you might try using the topical pain crème, Aspercreme. The original formula, 10% Trolamine Salicylate, NOT the lidocaine formula, works for my shoulder and upper arm pain.
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1 ReactionThere is a brand new YouTube video that discusses this in depth. At 32 minutes.
https://www.youtube.com/watch?v=mWBPr-zZI44&t=106s
The doctor stated that it takes 6 months for methotrexate to work. I take Plaquenil instead. I do drink some alcohol so I avoid things that damage the liver, like Tylenol
I fell off a cliff with PR as he describes, one day playing pickleball, the next day can't walk or get out of bed.
Has anyone heard of Symboni taken with methotrexate? Rheumatologist wants me to start it. Not sure. An infusion. I guess. Afraid of any new medicine that brings on its own side effects.
@tuckerp Have you heard of Simponi a medicine my rhumey wants me to take with methotrexate which I am not on at present time. An infusion I guess with its own side effects.