Question
I was diagnosed with RA in July and I have been on naproxen (500 mg twice daily)and methotrexate (now taking 17.5 mg weekly). I have gone from bad to worse and yet my doctor does not want to add any other medications because of “insurance issues”. I have excellent insurance and am increasingly in pain, greater inflammation and much mmore limited in movement than I was at the onset of the condition. I am not inclined to take medication I don’t need but from what I can read, a combination of medications may be useful in treating RA. Do I need a new doctor?
Answer
Hi Catharine,
A rheumatologist will usually increase the dose of a medication, or add a second medication, in a patient with rheumatoid arthritis if pain and swelling in the joints have not improved, and if the inflammatory markers in the blood have not improved. Usually, the methotrexate will be pushed to the maximal dose first (25 mg per week) before a second drug is added. However, in the case where everything has improved on methotrexate except the pain, there may be some reluctance to make a change, other than using medications like ibuprofen and naproxen (Alleve) for pain management.
