methotrexate

[kaysixteen]

The new dermatologist I was able to see today suggests I use methotrexate, at a lower, once-weekly dosage, to treat the psoriasis and assorted lymphedema-exaggerated skin conditions from which I suffer, but he emphatically told me not to start doing so (he wrote a script) until and unless I clear this action with my PCP (who also happens to be a cardiologist), since said PCP knows my overall history, including any heart concerns, and will know whether this be safe.  Anyone have any experience with this drug, esp with using it *not for cancer*, which the dermatologist emphatically notes that I do not have?

[Antiphon1]

Kay, methotrexate has been used off label for rheumatoid arthritis and other immune reactive diseases for at least 35 years.  It depresses immune responses thus lowering the body's ability to attack itself.  My MIL used it for 30 years or so for the treatment of arthritis.  She experienced a somewhat higher susceptibility to infection and a very severe case of osteoporosis.  It's effective, but it's really hard on your body.  I think you have to have bloodwork done every 3 to 6 months to monitor for organ damage and nutrient absorptions.  So, yes, you definitely should see your PCP before deciding on this course of therapy.

[Wahoo Redux]

Hope it works, buddy.  Prayers.

[kaysixteen]

well, I will in any case also have to consult with the hematologist, as the Wikipedia article on the drug suggests it can exacerbate anemia.  I am leaning towards taking a pass, but will consult the docs.   

[fleabite]

I took a low dose of methotrexate briefly many years ago for an autoimmune disease. I was unable to use it for long because I developed paresthesias (which disappeared after stopping treatment). I had no other side effects. Like any drug, it can have side effects, but I wouldn't rule it out automatically. There are very few perfect treatments in the world.

[wellfleet]

My mom took methotrexate for about 20 years for rheumatoid arthritis and for most of that time, she tolerated it pretty well. Then she didn't. I'll just echo the earlier comments that ongoing monitoring is very important and you definitely want your whole health team to be in on the decision/follow-up, especially around any changes in dosage. Depressing immune response is a big deal.

[kaysixteen]

I would obviously like this skin condition to be significantly ameliorated, but I ain't gonna go for such bettering at the cost of heart damage or exacerbated anemia.   We will indeed have to see what the docs do say.

[apl68]

I would obviously like this skin condition to be significantly ameliorated, but I ain't gonna go for such bettering at the cost of heart damage or exacerbated anemia.   We will indeed have to see what the docs do say.

If risks are low at low doses, and the medicine would make a significant improvement in your quality of life, you may find it worthwhile.  Prayers for you as you make your decision regarding the treatment.