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Community > Expert Q & A > Medications > Combining Medications
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Combining Medications

Q: I have rheumatoid arthritis (RA), for which I take a prednisone-methotrexate combination. Now my doctor wants to prescribe hydroxychloroquine (Plaquenil) for me. Have you ever heard of someone taking Plaquenil, prednisone and methotrexate at once? Is this safe?

A: It is common for physicians to prescribe a combination of low doses of prednisone and drugs like methotrexate for patients with rheumatoid arthritis. In selected cases, as in your case, physicians are adding on additional drugs. These combinations of drugs are used for patients with RA whose disease has not responded well to a single drug or to two drugs. 

A number of clinical studies have shown that patients treated with certain drug combinations do better with no greater incidence of side effects than those taking individual drugs. In these situations, it's important to have your disease managed by a physician experienced in the arthritic diseases.

Doyt Conn, MD, Rheumatologist

Bernadette
02 Nov 2009, 07:23
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I have recently be diagnosed with RA. I am taking one 200 mg Celebrex twice a day. It is active in almost every joint. I want to stay away from taking DMAD's (Embril, Remicade etc), prednisone, methotrexate. My doctor has said for me to start taking Plaquenil. I am worried about taking plaquenil as there may be eye issue that occur. Does anyone know the percentage of this happening? I am aware that there is (was) a drug free option out there called Prosorba Column. It may have been stopped due to cost of treatment. Does anyone know about the Prosorba Column? Is it better for the patient to be managed by medications or does this better benefit the drug companies?
Kathy Geiger
24 Sep 2009, 13:52
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I suffer from RA. Am currently on arava, plaquenil, sulfasalazine, and prednisone,5 mg. My only side effect is occasional diarrhea and heartburn. My main worry is my blood sugar; I hear pred and plaq combined will raise the blood suger.
mom of 3
05 Aug 2009, 07:44
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I have currently been taking the 3 drugs you mentioned plus several others. I find these more cost effective & less long term side effects when I compared them to biologic drugs. The purpose was to get the RA under control & to gradually whean down off medications. The major side effect for me with plaquenil is diahrea, but I have found that if I eat an hour before taking plaquenil this side effect does not occur.I also get heart burn from some meds, so after taking them I do not lay down for at least 20 minutes. There are all kinds of little tricks of the trade to help with side effects it's all a learning process.Don't fear multiple drug therepy there are alot of us out here on them & are fairing very well.
Brenda
24 Jul 2009, 00:40
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Sue' I just read your comment, I too am on all of the same drugs, but I went off fosamax. I worried about the side affects. I guess you have to weigh the good against the bad .I also started to have pain in my jaw , my dentist gave me a night guard but also sid it could be from the fosamax. Good luck. Brenda
Sue
23 Jul 2009, 10:49
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I had similiar concerns about adding yet another med, I also have RA, but have been able to eliminate, for the most part, the prednisone, which was the Dr's goal in adding Plaquenil. Have had no negative effects, be sure to have enough food in your belly, I stagger my doses around meals, I also take multi vitiamns, Folic acid, 81mg asprin, calcium and Fosamx. Good luck!
Ramona
20 May 2009, 23:05
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I was recently taken of my medications due pausytopenia .My counts have gone up to border line norma.I have ankolosis spondonitis and resently dx with bachets how safe is Imuran,colchacine and methrotrexate?
janice weiner
07 Apr 2009, 13:46
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i am taking alprazolam propranolol 20 mg cymbalta 60 mg clonidine 0.1mg levothyroxine 0.05mg prevacid 30mg in the morning in an half hour i am shacking. and i have to take a alprazolam to get me over it.
jargon08
01 Apr 2009, 18:37
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I am on all 3 of those meds, plus I just started on Arava/Leflunomide too. I haven't seen any negative side effects so far. I also take a Multivitamin, Calcium pill and Folic Acid ... and of course, a birth control pill too. It's A LOT of pills to stomach but if it helps ... !

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