Question
Thank you for your response to my earlier question, “Effectiveness of increased Methotrexate “.This is a follow up question . The flare ups that I experience are not very severe, in that there is not much redness or much swelling (as experienced when I was first diognosed with the disease).Usually the maximum recommended dose of NSAID for 3 or 4 days and with restricting the movement of the affected joint, either with a brace (as in my wrist)or resting a painful hip, I am able to get back the functioning of the joint.However movement of any joint beyond a certain limit causes it to flare . My question is, if Methotrexate does not work as effectively as before and I am wary of the TNF blockers as well as the phenomenal cost of the treatment , is it safe to continue with using NSAIDs. Also will injecting Methotraxate be more effective than pills?
Answer
Injecting methotrexate may be slightly more effective due to the fact that blood levels are higher if you inject the same dose that you would take orally. However, in most cases, I do not think it is worth the hassle. Very rarely, patients experience some GI upset on methotrexate and thus do better with injections.