A little worried about my treatment

[Jeff vinc]

Hi,

I am a little unsure about my treatment.
I started methotrexate 15mg once a week yesterday and they also want me to use septra DS(sulfatrim/trimeth DS) 160mg to take every 2days. After a few research i found that they recommend to avoid to take these 2 medications because Sulfonamides (septra) may decrease the renal clearance of methotrexate. Serum levels of free methotrexate and the risk of bone marrow suppression may be increased. Sulfonamides may also displace methotrexate from plasma protein binding sites, which may further increase serum methotrexate levels and the risk of toxicity. Methotrexate toxicity has also been reported in patients receiving low weekly doses.
I want to wait until monday to talk to my rheuma before i start the septra. I am starting blood works every months to keep tracking my WBC's because of that mix of meds.
I just want to know if anybody used these meds together.

[Jeff vinc]

sorry i added my topic in the wrong section, should use the medication section...

[Palmyra]

OK, so many spanks for using the wrong section! (You will have to wait for your cookies until this is all settled).

Jeff, you may get more answers if you do post on the medication section, but I will offer a brief experience related answer here. I am sure all that you have read regarding methotrex and septra combination is correct, but I would guess many, many Weggies have been on that exact combination of drugs. My daughter has been on septra DS since diagnosis (nearly 5 years,) and has been on methotrexate on more than one occasion (it unfortunately did little to supress her WG activity, but that was her). Her attending physicians were careful to check blood panels on a regular basis. Supression is a titrated challenge. Weggies need some supression, but not to the point of accute or chronic problems with bone marrow production. And everyone behaves differently with medications.

There is a delicate balancing act when trying to control this disease, and monitoring via blood panels is the way to proceed. Have you been on stronger immunosuppressives than methotrexate?

[Jeff vinc]

No I haven't.
I will be on 20mg of mtx in 2 weeks.
I am also on preds 60mg everyday.

[Jeff vinc]

now in the medication section :)

[Jeff vinc]

i want to erase it from general WG chat but i don't know how...lol

[JanW]

Jeff, I replied in the other thread. What's your doc's plan to reduce pred -- that high a dose if you've been doing it any amount of time is quite worrisome, and I'm wondering why that combo with mtx (as opposed to the 'stronger' rtx or ctx). I'm presuming here that the high pred dose is because of the pace/severity of your disease process and damage that is occuring/may occur if inflammation is suppressed very quickly.