How to take methotrexate in the treatment of rheumatoid arthritis?
Methotrexate in rheumatoid arthritis is used by doctors more often than other medicines. This medication is effective in the early development of the disease, and the need for a comprehensive therapy with long-term course of the disease. Methotrexate in rheumatoid arthritis is often prescribed to the patient before the definitive diagnosis, if the patient manifests symptoms of the disease.
Form of release of the drug
The drug exerts a powerful cytostatic effect, which slows down the development of rheumatoid arthritis. Himself to drug belongs to the group of antimetabolite, an analogue of which is folic acid. Is a crystalline powder-like substance yellow or yellow-orange color. It is practically insoluble in water or alcohol, it is sensitive to light radiation, hygroscopic. Under the action of the drug supplies of folic acid the DNA of cells of the patient, which helps combat the symptoms of arthritis. Most pharmaceutical companies and manufacturers produce this drug in two forms:
- Tablets for oral administration.
If you want to implement an intravenous or subcutaneous injection, doctors use the extract or the concentrate of methotrexate. From it is prepared a solution for injections. Some manufacturers produce already cooked the mixture for injection.
If the patient supports doctors recommended mode, he will prescribe pills. If the patient does not or when taking the pill form of methotrexate there are certain problems in the gastro-intestinal tract, the doctors transferred him to a subcutaneous or intravenous injections.
How to use this medicine
Instructions for use of this medicine States that when determining starting doses for the patient physicians should consider the General condition of his health, the activity occurring in the body inflammatory processes, individual characteristics of a person. To determine the dosage of drug the patient will not be able. This should be done by specialist as it is necessary to consider many different factors specific to the patient, which can be detected only by thorough examination of the patient.
The usage instructions says that the first positive signs in a sick person appear 14-16 days after the start of use of methotrexate. If the disease runs hard, the deadlines are shifted, improving the health of the patient will not begin until 40-50 days. But it happens when mild disease. In more complex cases, the first positive results will appear not earlier than 6 months or a year.
Side effects and contraindications for use
Use of this medication may cause such unwanted effects as:
- the Development of encephalopathy.
- Headaches and dizziness.
- Violation of visual images.
- a wasting or aphasia.
- Pain in the back.
- muscle Tension of the neck.
- Convulsions and the development of paralysis.
- Occasionally you may experience General weakness, ataxia, tremor, fatigue, causeless irritability. The person confused consciousness, appear conjunctivitis, cataract, increased secretion of tears.
- coma May occur.
But this is not all the side effects that may develop when using medicines. Prolonged exposure to methotrexate may receive the following losses:
- Thrombosis, etc.
respiratory system medicine may be affected adversely and cause fibrosis of the respiratory system or aggravate the infection in the lungs.
Lesions of the gastrointestinal tract – nausea, ulcerative stomatitis, diarrhoea, bleeding from the stomach. There is vomiting, cirrhosis and liver fibrosis, enteritis, difficult swallowing, etc.
The skin may appear rash, acne, eczema, itching, erythema of the skin, blisters etc. Of the Genitourinary system may respond to medication in the following disorders: hematuria, nephropathy, fetal defects. Perhaps the generation of sperm. May show signs of allergies: skin rash, chills, urticaria, anaphylaxis, etc. When all the above symptoms the patient stopped issuing medication. Contraindications to the use of methotrexate are:
- Liver and kidney failure.
- human Hypersensitivity to some constituent of the drug.
- the Presence of infections such as tuberculosis, AIDS, hepatitis.
- Ulcersgastrointestinal tract.
- Pregnancy or period of breast-feeding.
- alcohol Abuse.
- - blood dyscrasia.
examination of the patient before prescribing the medication
Initially, doctors prescribe common blood test. When you do this, be sure to be counting the number of thrombocytes, leukocytes. The necessary determination of bilirubin and carrying out various liver function tests.
required passage of x-rays. Carried out a full examination of the work of the renal unit. Over the patients require continuous monitoring, which is carried out during the entire course of therapy.
The patient's Blood is examined for the so-called rheumatoid factor. The most accurate is the analysis of blood plasma on antibody citrullinemia. A positive result of this analysis shows the development in the body of a patient of rheumatoid arthritis. Usually in this case, the form of the disease is very heavy. Has affected dramatically increases the sedimentation of erythrocytes.
Effectiveness of treatment
Fully this disease cure is not yet possible. The task of doctors is to stop the progression of arthritis and to achieve partial remission. Therefore, all their efforts are focused on significant improvement of joint function, eliminate inflammation, prevent the development of such events, after which a person may remain disabled for life. with the sooner treatment begins, the better it is for the patient.
To relieve symptoms of rheumatoid arthritis, doctors use medical therapy, which is based on the use of drugs of two types:
- Fast action.
- Modifying medication to slow (base) effect.
Methotrexate belongs to the second group. It is well suppresses symptoms of rheumatoid arthritis, greatly facilitates the patient's condition. But in the treatment using this medications need constant monitoring of the patient's health. To do this, constantly conduct laboratory tests of blood of the patient that he has not yet developed the inhibition of the protective functions of the body. At first, the medicine in minimum dose, and then, after further diagnosis, it increased in accordance with the individual peculiarities of the organism of the sick person.
For relief of pain syndrome doctors may prescribe pain medication that a person needs to take along with essential drugs. In very severe form of arthritis can be recommended narcotic analgesics.
because of this drug many side effects, at the first symptoms doctors stop giving this medicine to the patient, so as not to cause complications.
since a positive clinical effect occurs gradually, is usually a course of therapy with this drug lasts for at least six months. To enhance the impact of methotrexate and elimination of some side effects occurring when using it, the medicine can be used together with such substances as:
This gives the opportunity to ease rheumatoid arthritis in most patients. The number of cured patients by using only methotrexate reaches 80%. But the rest of the patients cannot be cured only by this drug. So the right combination with other medicines. The healing process lasts comparatively long. If the patient is resistant to methotrexate form of arthritis, doctors suppress it with anti-inflammatory drugs from the group of glucocorticoids. Can be assigned to biological drugs such as infliximab or rituximab.
suppression of the immune system during recovery from rheumatoid arthritis is irrational from the point of view of the patient's health. This leads to infection of various body infections.
Therefore, doctors are forced to use methotrexate because it helps to eliminate inflammation of the joints in rheumatoid arthritis and, thus partly suppressing the immune system, to prevent complications.