Question
I am a SLE patients with CNS Involvement and severe arthritis pain. I have been on prednisone and Plaquenil for over 8 years. The prednisone is now doing damage to my bones. My Rheumatologist wants me either in Methotrexate or Imuran. I like to know what is the difference (side effects, etc) and know which would be better for me.
Answer
Both medications have been around for a long time and there is good long term information on their use. Methotrexate is most often used for rheumatoid arthritis, while Imuran is used extensively in patients with kidney transplants. Both are well tolerated. Side effects are similar. Both can affect the liver and blood counts and must be monitored with regular bloodwork. Imuran and methotrexate have been used as “steroid sparing” drugs– drugs used in place of prednisone. Without knowing more about your condition, it is hard to say which would be better.
