Question
For the past 8 years I have been on a weekly dose of 17.5mg of oral Methotrexate and 500mg of Plaquenil( the dose of plaquenil was reduced after 2 years of taking it, when it stopped being effective.) I have had several minor flares all along and taken NSAID .However since the last 6 months my joint flares are frequent and I am on constant anti-inflamatory’s . Please could you tell me if the dose of Methotrexate is increased , will I experience less number of flares? Or has Methotrexate stopped being effective ?I am waiting to get an appointment to see my rhuematologist. I am 52 years old and was diognosed with ‘Poly-arthritis”
Answer
Your question is difficult to answer because patients respond differently. In general, the higher doses of methotrexate are more effective. However, as you approach 20 mg weekly, the increases do seem to have less effect and if your flares are severe, your rheumatologist may want to consider adding other agents such as a TNF inhibitor.
