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Thread: Methotrexate VS Cellcept

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    Default Methotrexate VS Cellcept

    I had my 1st flare in Nov 2013 and did 4 treatments of iv Rituxan, and high dose pred. A repeat Ct scan showed lung nodules almost gone and I'm back in remission. yay! Now my Dr (Dr. Langford) wants me to decided which maintenance drug to use. I was on Imuran when I flared. She gave me choice of Methotrexate vs Cellcept. To be honest I'm 32 and not a huge drinker but would like to be able to have a few drinks on the weekends with my husband/friends. I'm also nervous about gradual hair thinning, and all the side effects that people seem to report with MTX. Dr. Langford said both meds are a good choice and in a resend study they were almost comparable, with cellcept having very slightly higher relapse rate. Any advice??? Thanks in advance!

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    I'd take the lower relapse rate. I was never really given a choice as Mayo threw stuff at me telling me it was correct...they were correct! Duh! I'm on mtx for 2 1/2 years now, lost hair at beginning but folic acid took care of that, never have had any bad 'organ numbers' at all...well, OK...lungs sucked...literally! But not a fault of mtx. Best to you!
    Knowing how to think empowers you far beyond those who only know what to think. -NdT


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    I'm with Don. My side effects with mtx have been minimal. I take folic acid and have no hair loss issues. I get a little tired the day after I take mtx, but splitting the dose in half twelve hours apart has reduced that. I can still do normal activities, but I have to push myself a little more.

    As for alcohol, I've found some non-alcoholic beers that are pretty good including Clausthaler, Kaliber, Buckler, Beck's, and St.Pauli Girl. Non-alcoholic wine is just grape juice, so no satisfaction there. I'll have 1-2 glasses of wine per month or six weeks with no resulting problems.
    Pete
    dx 1/11

    "Every day is a good day. Some are better than others." - unknown

    "Take your meds as directed and live your life as fully as you can." - Michael Chacey, MD

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    I'm on MTX and have a little alcohol when I feel like it. The key phrase is "a little". Usually a very small amount, but did have a whole, delicious, Bloody Mary last week with my sister and her husband. Just one! Have not had anything since, but sometimes have a very small amount for a few days in a row and have never had it be a issue with my blood tests or anything. I would say just exercise caution, don't use a lot, and don't do it often. My doc never even told me not to do it, but that doesn't mean anything. It does warn against it on the label. I believe liver problems are the main issue.

    Otherwise, the same as everyone else above with MTX, split the dose for less ill effects, take folic acid. My hair has started thickening up again since I got off CTX and onto MTX. I did have one small flare but the dose was too low, and raising it knocked it out quickly. Dose is still moderate, only 15mg./wk, and no more flares since the small one a year ago. Currently on 7mg./day of pred and Bactrim DS 3x/wk.
    Anne, dx'ed April 2011

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    Quote Originally Posted by Happy Camper View Post
    Dr. Langford said both meds are a good choice and in a resend study they were almost comparable, with cellcept having very slightly higher relapse rate.
    Hi Happy,

    This to me would be a no brainer. This quote straight away tells me what the best option is - I would be choosing the one with the lower relapse rate, every time.
    What is more important to you - having a few drinks with your husband and friends, or not having to feel like crap or worse, with yet another flare.

    Sorry, no contest here for me.......I would go without the drinks everyday.
    Hair thinning is only a cosmetic problem and really, I know many people on methotrexate and they all have their hair.
    Keep Smiling
    Michelle


    Live your life in a way that you wouldn't be ashamed to sell the family parrot to the town gossip - WILL ROGERS

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    Thx everyone for all your input. Having WG can be so overwhelming at times. I'm just glad to be down to 5mg of Pred and am still tapering with a goal to be off it in 1 month. I think I'll start with the MTX and see how it goes. My Dad who has an autoimmune dx could not tolerate MTX and has been on cellcept for 10yrs. We are oddly very similar in medication/blood work/ side effects aspect. I think this was another big concern of mine. But as I know everyone is different. So I will see how it goes. Thx.
    Tracy

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    Hi Tracy,
    I have been on cellcept for over 13 years, probably 8 or more of those years without any prednisone. I may have been "smoldering" off and on over that time period but none of the Drs I was seeing were able to pinpoint my symptoms as a "flare." I really haven't noticed any side effects from the cellcept and I am a person with many drug sensitivities. For me, the Cellcept seems to be working well (I also take it as an antirejection med for my transplanted kidney). I did take 2 doses of Rituximab late Dec/early Jan and now continuing to taper my prednisone dose. Our hope is that once everything quiets down the cellcept will be enough to tide me over again.
    good luck with you choice,
    Jennifer

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    Thx Jennifer for your response.

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