Starting MTX

[D Foster]

Well it has been a few weeks now that I have been off MTX and it is starting to show. I think it is about six weeks since my last dose and it has started to return inexorably.

I am having to use Dovobet to keep it at bay on my face and butt and I have some very tiny patches coming on my arms and legs.

I can still go swimming it hasn't come back bad yet but is patchy on my face and I can have a beer now but really I don't want to go back where I was.

I have my NHS consultants appointment on the 12th November and I only hope they don't look at me and decide I do not have it bad enough for them to not prescribe it.

Knowing that it will take about 4 weeks to be effective puts me getting towards Christmas for it to have receded again if it does.

When I went on to Stelara I was off the MTX for 6 weeks and mine came back with a vengeance .

[Fred]

I am having to use Dovobet to keep it at bay on my face

You really shouldn't be using Dovobet on your face.  

Dovobet contains a potent group III-steroid, skin of the face is very sensitive to corticosteroids.

Quote:

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Special precautions
• Avoid use on more than 30 % of your body or using more than 15 grams per day
• Avoid using under bandages or dressings as it increases the absorption of the steroid
• Avoid use on large areas of damaged skin, on mucous membranes or in skin folds (groin, armpits, under breasts) as it increases the absorption of the steroid
• Avoid use on the face or genitals (sex organs) as they are very sensitive to steroids
• Avoid excessive sunbathing, excessive use of solarium and other forms of light treatment.

Source: Dovobet Patient Information Leaflet

[pingu]

Hi Fred and all I hope you are well.

I agree I have been told this before. However lets not get started on the lack of diligent GP monitoring within the NHS who freely prescribed me Dovobet for years, at least a decade, without referral.

So yes I hear you. Unfortunately without access to any other treatment for the last x years my options, and no doubt many other peoples options are extremely limited.

That said this forum provides me some intelligence (only limited by the amount of time I can spend here and my own intelligence) and ammunition to pursue other therapies.

[Fred]

Hi Fred and all I hope you are well.

I'm very well thank you.

Sorry I can sometimes sound like a parent telling off his children,    but I have known people end up with very thin skin on their face due to it's over prescription and lack of knowledge in how it can effect the skin.

I'm pleased to hear you say Psoriasis Club provides you with some intelligence. None of us are professionals, but I sometimes think we know more than the white coats and we do have a good mix of people. You yourself are only 2 posts away from 100 and your input is greatfuly received, so much so that untold surprise may soon be heading your way.

OK Pingu it's Friday so you go on and enjoy your evening. But remember to be back home by 11:30  

[pingu]

Hi I hope everyone is well.

Well I had my NHS appointment today and it was not what I expected.

Firstly they had zero records of my blood tests or xray from my GP, pretty sure joined up thinking failure here from my GP. The NHS consultant implied that the GP was doing me a favour. So I a not straight back on MTX where I left off but need to start the journey again.

They took some bloods and I need to call the secretary on Monday. If all is OK I can pick up a prescription starting on 5mg again. This time however I can only up the dosage 1 tablet every two weeks so it will take nearly 3 months to get back to the 20mg dosage. Obviously not sure how long it will take me to get to the full dosage as I will only get a prescription to take me to 15mg. I calculate about 10 weeks.

Bloods every 2 weeks but what is weird is that I will have to take folic acid every day except the day I take MTX, this makes it a little less attractive. Not sure how I feel about this and I may, possibly not take folic acid every day. I guess it depends on what folic acid dosage I am taking.

Yes I am a little upset as I know my psoriasis is coming back and I did so well on MTX previously.

I only hope I have the same response as I had previously and its just a question of time. I do intend to see if I can just use 15mg as a maintenace dose rather than the 20mg I went to previously.

However it does mean I can have a beer this weekend!

[jiml]

Indeed pingu the only good news there is that you can have a drink this weekend  

It's a shame our health service isn't consistent in my neck of the woods the hospital and GP both have access to my records.
Your experience of lost test results etc is unacceptable, and extremely frustrating for you.
I hope you can get back on a sensible dose fairly quickly and when you do get clear again they don't stop you using it, so it returns again.

Taking folic acid every day apart from the day you take methotrexate is not unusual, I have read several people that use that method,
I hope it works as well for you this time and wait to hear the outcome of the tests and that you are getting back on track

[mataribot]

Sounds like they're being a tight wad to me. At this point there isn't any reason to start you lower than 10 mg. A low dose daily FA isn't going make much of a difference in overal results. To be honest, if you cannot maintain (psoriasis) on 10 mg, it is time to look at another treatment.

[Fred]

Shame on them. No record of your blood test one of the most important things to be done with people on methotrexate, someone should be getting a bollocking.

Enjoy your Beer though.  

[Bill]

No, it's the privacy laws, Fred. It has stuffed up much communication that was hitherto straightforward. Send your thanks to the UN.

Cheers,

Bill

[Fred]

No, it's the privacy laws, Fred. It has stuffed up much communication that was hitherto straightforward. Send your thanks to the UN.

Cheers,

Bill

You're probably right Bill the Brits do follow the rules that the others make.

Here my dermatologist can get hold of blood results from my neurologist as can my GP and vise versa. But as an extra back up I always get a copy through the post too.