View Full Version : prednisolone or methotrexate

03-08-2012, 06:52 AM
Hi guys,

Just wanna know which of the two is more desirable for lupus? Rheumy just advice my sister about methotrexate and she's currently taking prednisolone. I'm scared about the her taking a new drug. Really appreciate some answers over here! thanks!

For my sister.

03-08-2012, 07:15 AM
what my rhuemy told me:

prednisolone is used to get your lupus under control.
it is then used when needed (eg, in a flare)

it is not a good drug to take long term.

when my lupus was stabalised, i was told to start methotrexate, and to taper my pred.

i have needed to use pred again, after my operations, to help me stabalise.

methotrexate weekly and plaquenil daily are my 2 main drugs.
and will be for life.

03-08-2012, 08:16 AM
So you mean that methotrexate do helps more compared to pred? Mtx seems to be good in all aspect but why didnt everybody use it? Is it because it might not work well on everybody? My sister is also taking plaquenil. I always forget about this drug, it seems like it did nth at all. Shes been on it for 1 year. She could feel the difference when her pred got cut down but not for plaq. It seems like everybody is on plaq once they are diagnosed with lupus, is it really that useful?

03-08-2012, 08:27 AM
I am on Plaquenil and have been for just over a year. To be honest, I think it does help. It helps in a different way though. It took months for me to really feel a difference but part of the cloud that was over me in terms of fogginess and fatigue lifted after a few months on it. I also feel like so far I haven't had the same severity of flares while on it though some of that may be due to my learning to recognize some triggers and also to slow down when I need to. I wouldn't want to stop my Plaquenil now, to be honest, as I don't want to go back to how things used to be.

03-08-2012, 09:04 AM
I take all 3. Plaquenil is the baseline drug that most of us will always take (not everyone). It works so slowly that we don't realize how much it is doing unless we stop taking it. I did that and am paying for it 7 + months later.

I take steroids because of all of the inflammation in my body. I was having to take such high doses of steroids that they added the MTX so they could at least lower the steroids. The one thing you have to keep in mind is that there is no "what is best" for all of us. Each person is different and what is best for what is happening in their body is different then it would be for someone else.

03-08-2012, 05:58 PM
this post was really helpful in deciding what I needed to do next since the dr is considering me taking methorexate or doing benlysta. thanks for the information

03-08-2012, 08:23 PM
Thanks tgal and bunny. I also heard about people that did managed their lupus really well ended up only needing to take 2 plaquenil a day and thats it! hopefully my sister will be like that next time just relying on one drug. Also, I think from now I'll just discuss with her rheumy about the increase in pred dosage. My dad just had a discussion with me last night and both of us come to an agreement if pred did manage to relief her chest pain and breathing issues, then we will not encourage the doctor to try metho on her, since plaq and pred is enough to make her feel better.

03-08-2012, 09:14 PM
You should also take into consideration that prednisone (or any steroid) can have bad side effects. One of them is Avascular Necrosis, which makes the bones in major joints, like the knees and hips, die and flake away. I had AVN in my knee without ever taking steroids, but I've been told that I should never take them.
I've taken both MTX and Plaquenil. Now, I'm only taking the Plaq, along with Restasis and pilocarpine for dry eyes and mouth (Sjogren's syndrome).
I'm actually feeling pretty good with the minimum of meds now that I seem to have most things under control.

03-08-2012, 10:04 PM
I answered this question in the other thread. I know it is confusing but please try and have only one thread at a time on the same topic. It just makes it easier to keep up with.

How bad is prednisolone (http://forum.wehavelupus.com/showthread.php?11554-How-bad-is-prednisolone)