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