PLEASE HELP, i have pustular psoriasis on my feet dr wants me to try methotrexat!


Question: Ive tried creams and steriods nothing seems to work. what are the risk of these drugs and side effects thanks for all your help


Answers: Ive tried creams and steriods nothing seems to work. what are the risk of these drugs and side effects thanks for all your help

Alright, Methotrexate is a pretty strong drug. It's used in psoriasis as well as in cancer treatments, arthritis, etc. It's use in psoriasis is warranted only when other treatments havent' worked, so I'm assuming that you've already been on other prescription strength meds. As I mentioned, this is a very strong drug. There is a long list of the possible complications and side effects with this drug. The most common side effects are ulcerative stomatitis (mouth sores), problems with blood cells (white blood cells = used to fight infection), nausea, abdominal distress, fatigue, fever, chills, dizziness, and malaise (which means feeling "sick"). If you're taking this drug for psoriasis, then once the beneficial effects are noted, the doctor should reduce the dose to the lowest possible level with long rest periods between doses (again, b/c it's very damaging). Take this medication at bedtime with an antacid (tums, rolaids, etc.) to minimize stomach discomfort. Do NOT take OTC vitamins! Avoid ASA and alcohol (this medication is hard on the liver and ASA and alcohol can cause damage and bleeding). Also avoid contact sports (increased risk of bleeding and increased risk of infection). If you notice any mouth sores report it immediately, b/c that is one of the first signs of toxicity! Keep in mind that some people experience hair loss, but it should regrow after the medication is discontinued. Also make sure to drink at least 2-3 liters of fluid a day to prevent kidney damage. This drug can cause the acid levels in the body to rise, so your urine should be checked for the pH. Because of the increased acid, you may be at risk for developing "gouty arthritis" so if you notice problems with your joints tell your doctor. And because I mentioned earlier that it decreased the white blood cell count, you should avoid crowds and those with infections, also do NOT get any vaccinations while you're taking this medication.

Etanercept (Enbrel) is commonly used in conjunction with methotrexate. Some of the more common side effects of etanercept are upper respiratory tract infection (URTI), injection site reaction (this is administered as a shot), headache, nausea, dizziness, infection, rash, abdominal pain, cough, swelling in the extremities. If you're going to be self-administering these injections, just remember to rotate your sites (you can use the thigh, stomach, or upper arm).

Your doctor or nurse SHOULD explain all of this and more to you when you receive the medication. Whatever you do, make sure that you don't leave that office without a firm understanding of exactly what you're supposed to do and who to call if you start experiencing adverse effects (especially with methotrexate). These drugs are used to control psoriasis, but just be careful. Methotrexate is a strong drug and can cause serious damage if taken incorrectly. Your doctor should be following you closely while taking these meds. I wish you the best! :)

Before methotrexate, I would try, in this order:

-Acitretin (it's an oral retinoid that works very well with pustular psoriasis).
-If there is no response, then I would try Enbrel (it's etanercept, an antiTNF)
-Methotrexate would be a recommendation if you have psoriasis + psoriatic arthritis or if nothing else works, since it's very toxic and causes liver cirrhosis depending on the total dose received during your whole life (it's accumulative).

Of course, if you are a woman, you can't get pregnant during this therapies or until 2 years of finishing them, because they're seriously theratogenic.

Ashley, hello. Both of these have nasty side-effects and should be avoided. Instead, try a herbal anti-psoriasis cream and spray combo from http://www.champori.com It works better than anything on my plaque psor.: no flare ups in the last 15 months after only 2.5 weeks of treatment.
Best,
Bernadette

Over the last ten years or more I have tried everything for my psoriasis. The best thing I have found thus far is flax seed oil capsules. I take 1200 mg in the morning and 1200 mg at night. Flax seed oil not only heals my skins it helps with the itching and helps my arthritis. I talked to my dad's cancer dr. about the methotrexate and she said people who don't have cancer shoud not take cancer meds. She said there is to much risk of it damaging the immune system more and actually setting the stage for cancer. I am not a Dr. But the flax works great for me.

Ashley, my husband has psoriasis. In fact, we moderate a Yahoo support group on topic. He has tried a number of so- called cures--expensive and inexpensive. He has seen several doctors and tried home remedies. Believe it or not--Vick's Vapor Rub helped some, but he started Enbrel about three weeks ago.

We went to the dermatologist two days ago--we compared the "before" photo shots with the "after" photo shots. It is amazing--in less than a month the difference. Yes, there are side effects to every drug, but you will be under doctor's care. My husband had flu-like symptoms, when he first started the Enbrel, which is common, but now he is doing better. His psoriasis was so bad, that it would crack and bleed all over the bed. It hurt really bad. He was scared about taking Enbrel, but now that he is getting treatment--he feels so much better. The bleeding has stopped, and so has the pain.

The decision is yours. You have to look at the pros and cons. I posted two Web sites. Good luck to you and hope you find something that will help. I agree with the other posters--try natural before taking any heavy duty drugs.





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