July 17, 2010


Methotrexate is a "Disease-Modifying Anti-Rheumatic Drug" that was prescribed to me by my rheumatologist immediately after I was diagnosed. It is the top-of-the-line medical course of action for people like me. My doctor said that it can prevent further damage. It will not reverse any of the existing damage, and as I research it more I find that it will at best DELAY further damage. There are people who go into a drug-induced remission and/or who can get to extremely low doses of the drug. Doctors are prescribing these much earlier than in the past because the reversible side-effects are deemed more manageable than the irreversible damage caused by the disease. It takes up to six weeks to start feeling the benefits.

Methotrexate is normally used to treat cancer, but it is also used for the treatment of autoimmune diseases like inflammatory arthritis. [Autoimmune diseases involve conditions where the immune system attacks its own body]. As I understand it, it works by inhibiting the natural process of cell replication. As such, it will cause hair loss and mouth/nose sores. You need to take large doses of folic acid to counteract this side effect.

Speaking of side effects - one of the most common effects is feeling 'unwell' (flu-like symptoms, nausea & diarrhea) for 24-48 hours after taking it. The tablets are taken once per week. You also need monthly blood tests, because the drug can mess with your liver and white blood cell counts. You cannot drink any alcohol because of the way it affects the liver. Oh and did I mention it causes birth defects? You must be off the drug for at least three months before trying to get pregnant. The good news is that many people go on to have children after being on the drug. You cannot take antibiotics while on the drug because it lowers the effectiveness of the birth control pill. Interestingly enough, I learned that arthritis tends to go into remission during pregnancy.

There are additional health complaints made by people on this medication, including fatigue, flu-like symptoms, weight loss, hair loss, dry eyes, mouth or vagina, chest pain, jaw pain, or numbness or tingling in the hands and feet. The Arthritis Society of Canada website claims that these are, and I quote, "related to the underlying disease, and not the medication." Personally I don't buy that for a minute.

(Another interesting side note - arthritis.ca is funded by Pfizer Canada Inc., a Canadian branch of an American pharmaceutical developer and producer. How much do you want to bet that they recommend their own pharmaceuticals?)

What I want to be clear about is that I am not choosing to do nothing. It is true that taking this drug would be preferable to doing nothing, because the side effects are much preferable to becoming crippled. I have the same goal in mind: to improve my quality of life. I am just choosing the drugs as a last resort instead of the first.

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