In treating lupus, prednisone and the anti-malarial drugs (such as Plaquenil) remain the cornerstone of treatment because of their effectiveness and safety. Because of some of the side effects, some people do not respond well to prednisone and Plaquenil. After being treated with these drugs for 6 months to a year, and when the patient shows no sign or is slow to respond to these drugs, then alternative treatment is sought.
The immunosuppressive drugs, Methotrexate (Rheumatrex) or azathioprine (Imuran) are used as steroid-sparing drugs. If someone is using prednisone, Medrol, or solu-medrol to help control their lupus, and begin to have complications, their doctor may start them on Methotrexate.
Low dosages of Methotrexate (Rheumatrex), such as 7.5 mg given orally once per week, are extremely effective in the treatment of lupus. Methotrexate can be given orally (drops mixed with water) or by subcutaneous injection once a week. It is now standard practice to use folic acid to counter some of the minor side effects of Methotrexate.
Patients taking Methotrexate should abstain from alcohol, because combined use increases the risk of irreversible damage to the liver leading to cirrhosis.
Are there interactions with other drugs while taking methotrexate?
An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction.
Interactions with this drug may occur with the following:
- alcohol (leads to liver toxicity)
- digoxin (Lanoxin)
- phenytoin (Dilantin)
- aspirin or other salicylates
- arthritis drugs (ibuprofen, Advil, Motrin, Naprosyn, Voltaren, Lodine)
- bismuth subsalicylate (Pepto Bismol)
- carbenicillin (Geocillin)
- cholestyramine (Questran)
- sulfa drugs (Bactrim)
- cyclosporine (Sandimmune, Neoral)
- etretinate (Tegison)
- thiazide diuretics (Dyazide, hydrochlorothiazide)
- blood thinners (Coumadin)
- azathioprine (Imuran)
For more information on lupus medications:
Please visit the site concerning Lupus related medications
The main site page is http://www.itzarion.com/lupusgroup.html
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