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Benlysta Preauthorization Denied; Pain Meds That Help Lupus?

Posted by sarahintexas @sarahintexas, Mar 29 5:46pm

Hi all! Hope you're doing good. I learned last week that my insurance denied my doctor's preauthorization request for Benlysta, a biologic designed for Lupus. Disappointing to say the least.

Insurance is requiring I first try Plaquenil, which I understand is very common and foundational for many autoimmune conditions, but my doctor originally said it isn't "strong enough" for my numbers and pain symptoms, and so, that's why we started with Methotrexate (but had to stop because my white blood cells dropped too low).

Sigh. It's a process. But my pain while I wait 2-4 months for Plaquenil to kick in isnt adequately resolved by daily Prednisone, and I'm having to temporarily add pain meds.

Questions: Has anyone tried Benlysta for Lupus? Did it resolve joint and/or muscle pain? How long did it take to kick in?

And, has anyone found a prescription pain med that helps with autoimmune joint and muscle pain, as a bridge while finding the right immuno modulator/immuno suppressant? I'm hearing good things about Cymbalta.

Thank you!

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lmpa65 | @lmpa65 | 1 day ago
In reply to @sarahintexas "Hi Judy! Thanks so much for reaching out and sharing. I'm so sorry for what your..." + (show)
Profile picture for sarahintexas @sarahintexas

Hi Judy! Thanks so much for reaching out and sharing. I'm so sorry for what your daughter is enduring. I hope she is able to find relief and care from her doctor(s). I saw my Rheumatologist today, and am 9 days in to my Plaquenil prescription, while still on 20mg daily Prednisone. We will be giving Plaquenil one month to resolve my joint and myofascial pain; if it does not, we will resubmit the request for Benlysta preauthorization to my insurance. (My doctor did appeal/argue my first denial, and provided details for why Plaquenil is not considered the appropriate medicine based on my numbers, but to no avail. Seems to be a trend at the moment). I haven't yet tried my Cymbalta or Gaba prescriptions from my GP, but feel..safer having them available if days get worse while we test Plaquenil. I do understand from my GP that Cymbalta is an SNRI at first, which can also offer musculoskeletal pain relief; my GP has had success with several patients. But will definitely stay on the lookout for worsening mental health if I try Cymbalta - thank you for the warning. Best of luck to your daughter, and you as caregiver!

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@sarahintexas gabapentin and Cymbalta are both medications that should be taken daily as usually prescribed. When taking the it takes at the very least two weeks to see the benefits. Those two drugs do not help acutely for pain.
Laura

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lmpa65 | @lmpa65 | 1 day ago
In reply to @lmpa65 "@sarahintexas gabapentin and Cymbalta are both medications that should be taken daily as usually prescribed. When..." + (show)
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@sarahintexas gabapentin and Cymbalta are both medications that should be taken daily as usually prescribed. When taking the it takes at the very least two weeks to see the benefits. Those two drugs do not help acutely for pain.
Laura

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@mech
I have been on Gabapentin for several years and it has helped with pain.

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mech | @mech | 1 day ago

My rheumy put me on hydroxychloroquin

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