I'm currently on 10 mg of prednisone and 200mg of hydroxychloroquine to control my RA. Its been working well to keep the RA in check but I'm beginning to look weird ... Moon face, fat ring around my neck, skin bruises easily or turns purple, n a bunch of other stuff which I still feel is cosmetic. Does that justify switching to methotrexate? Plus I've begun weight training n noticed swelling, joint pain, fatigue etc n I'm thinking that means my dosage would have to increased which would make my side effects worse. So what should I do? Worried about the hair loss from methotrexate as well
Should I switch from prednisone to methotrexate because of the moon face & other cosmetic reasons?
Question posted by Lanaroc on 6 May 2017
Last updated on 23 August 2017
Answers
Do53
22 Aug 2017
Hi Lanaroc. There are many reasons one may choose to switch medications. It sounds like yours are not just cosmetic actually but some pretty specific side effects that are bothering you. I have had a great deal of experience with prednisone. I have a chronic, systemic form of sarcoidosis and this is typically the first line of treatment that doctors try. I have been on prednisone for over eight months this time with my dose as high as 80 mg a day at one point. I have been tapering my dosage down with my doctor's help and I'm now down to five milligrams a day and hopefully this will be my last week of it. (Please remember that you should never just stop taking prednisone when you have been on it for very long! Your doctor can tell you how to taper down and get off of it should y'all decide that's what's best for you.)
I started taking methotrexate about three months ago, at my doctors suggestion, in conjunction with the prednisone to see if it would help, and to try and replace the prednisone eventually as well since it is doing more harm than good for me. I tell you all of this just to let you know I've had quite a bit of experience with Prednisone and with methotrexate to a lesser degree. Personally, I would like to never go on prednisone again because it has caused problems with diabetes that I cannot get under control, and many of the problems that you mentioned with the easy bruising, moon face, etc. So far, I have not noticed any hair loss from methotrexate, but I know there are some very serious side effects with that medication as well. I would talk with your doctor about your concerns with the prednisone and about the possibility of taking methotrexate with prednisone and/or instead of the prednisone. It sounds like you're not getting much relief on your current dosage so the timing would be right to discuss this matter. I really encourage you to talk to your doctor about all of your concerns and work with him/her to come to the best decision for you! I hope this helps in some way. Good luck on getting this matter straightened out! Remember, in this day and age we all need to advocate for our own health care. You know your body better than anyone and you know what you can and cannot tolerate. Just be open and honest with your doctor. Good luck and good health to you!!!
Lanaroc
22 Aug 2017
Thanks for your answer. Its been a whole since I wrote that question and I did get on methotrexate after consultation with my Dr but, the tapering from prednisone has been a problem. My body didn't take it well and I had a flare up ... Presently I'm back on prednisone 10 mg for 2 week (coming from 15 mg for 2weeks which was 5 mg more than what I use to take ) then 2.5 less every 2 weeks till nothing while on methotrexate every week. Sigh.
Do53
22 Aug 2017
I'm so glad you are working with you're doc. I know getting off prednisone is not an easy thing to do for many people… I've had problems with that myself and it can take a while. Especially if you've been on it for any length of time. You have to listen to what your body tells you and take it slow and easy when you taper down. I wish you the best of luck during this process and I hope the methotrexate will work well for you also. If you need any help or just someone to listen I'll be checking in here.
Lanaroc
24 Aug 2017
Thanks a lot, its cool to be able to speak to someone on a similar road. I've been on prednisone for 6 years ... now that you mention it I guess I did forget the longer your on it the more troublesome it is to get off. Its only been a little over two months since we've been trying. There's hope.
Lanaroc
24 Aug 2017
@Do53: I'd like to know your story though? Its the first I ever heard of sarcoidosis, I read a little about it. Is it completely under control for u?
Do53
24 Aug 2017
Hey lanaroc. Thanks for asking about sarcoidosis. Sarcoidosis is I guess kind of an inflammatory disease. It can affect any part of your body but most people have it in their lungs. Unfortunately I have it in multiple places besides my lungs and it has taken my hearing in March of this year. Very difficult getting used to being deaf but I'm managing. It's not well under control and I seem to have flare ups often. Many people find out they have it by accident when they get a chest x-ray and they see a ground glass type of appearance on the lungs. In most people they may not know they have it and likely may not be bothered by it again. Some, like me, have a chronic form which causes flare ups to occur. It's been very tricky to get mine under control. The prednisone worked really well the first time. The second and subsequent times I was put on it it was much less effective. When I started having problems with my hearing the ENT put me on 80 mg a day for several months.
The hope was that it would reduce the inflammation and maybe give me some hearing back but it didn't work that way unfortunately. All that happened was I ended up with out of control blood sugar and a lot of extra health problems resulting from that… That was the reason they put me on methotrexate. The hope is I'll get completely off steroids and the methotrexate might be more effective. I am praying that it works this way. The doctor told me that my particular sarcoidosis is advancing faster than what he's seen but maybe this will slow it down. This is probably been way more than you wanted to know but if I can answer any other questions I will be happy to. I hope things work out for you. Just take it slow getting off the prednisone. Your adrenal gland's will probably need time to start producing the right amount again. I've been through prednisone withdrawal and it's not fun. I'd rather go lower slowly and not feel that way personally! Please let me know how you do! And best of luck to you!!!
Related topics
rheumatoid arthritis, hydroxychloroquine, methotrexate, prednisone, inflammatory conditions, cosmetic
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