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Tapering Pains Body Response or PMR?

Polymyalgia Rheumatica (PMR) | Last Active: Jun 25 8:36pm | Replies (13)

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@juneannetteayres

A
Has anyone been prescribed Methotrexate at all my consultant wants me to start this by injection but I have heard that the side effects can be severe

Thank you

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Replies to "A Has anyone been prescribed Methotrexate at all my consultant wants me to start this by..."

You might want to give methotrexate a try. It is standard practice to try methotrexate when someone has difficulty tapering off Prednisone.

I tried methotrexate and had mixed results. One of the reasons methotrexate was tried was because the adverse effects are probably less than Prednisone. It is called a "steroid sparer" for this reason. Most rheumatologists would prefer that you be on methotrexate and less Prednisone. Some people get off Prednisone altogether when methotrexate is tried.

The nice thing about methotrexate which isn't true about Prednisone is the following:

If methotrexate doesn't work or you can't tolerate the side effects it is easy to stop taking methotrexate. You can just stop methotrexate whenever you want -- no taper is needed. This is a big plus when you consider how difficult it is to discontinue Prednisone.

Have you ever done a side-by-side comparison of Prednisone side effects compared to Methotrexate? Methotrexate seems to have fewer and less bothersome side-effects than prednisone in the studies I have read. Methotrexate might not relieve your symptoms as well as Prednisone so there are some trade-offs.
https://www.drugs.com/compare/methotrexate-vs-prednisone

Methotrexate is used to help prevent inflammation while trying to taper off prednisone. The idea if it works is that you can reduce your prednisone dependency. Those side effects are particularly more troublesome. But I see many of these sites that say it doesnt work or their liver function tests were high. There are several choices for RA type inflammation. Humira is one. LDN is another. Then newer biologics like Kevzara and Actemra. They may all have side effects. All these are designed to help with inflammation but you still need to taper your prednisone. Nothing really helps to restart your cortisol. If they work it might make it a little less painful. I dont like drugs either but prednisone is not your friend.