Thursday, October 09, 2008 Anna, Community Member, asks

Q: What else is available for pain to take with methotrexate? I would like to get off the prendisone.

Is there anything other than prendisone to take with methotrexate? I am tired of the weight gain and without the prendisone if I miss one pill I am in alot of pain. I am on a very low dose but still I cannot do without it. I go to my RA Doc on Monday but was curious what else is out there for the pain. Thanks!


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Answers (5)
Lene Andersen, Health Guide
10/11/08 1:12pm

Prednisone can be a miracle drug, but sometimes, the side effects means that it doesn't work in real life. The fact that if you miss only one pill, you are in significant pain is another indication that this may not be the drug combination for you. And when you have arthritis, weight gain isn't a good idea, as it can become a problem for you joints.


In terms of painkillers, there are many different types out there - anything from Tylenol, NSAIDs (nonsteroidal anti-inflammatory drugs), Cox-2 inhibitors like Celebrex and Mobicox and opiates like Vicodin.


However, I wonder whether your current dose of methotrexate is too low or if it's still the right disease modifying drug for you. If your current dose is not controlling your RA well enough to give you significant pain relief, maybe you need to talk to your doctor about increasing the dosage. Or maybe the methotrexate needs some help, in which case you can potentially add another medication instead of prednisone (Plaquenil, Arava or one of the Biologics). Or maybe you need to switch to a different drug altogether. It's quite common to develop a tolerance to whatever medication you're on or for it to stop working as well as it used to, but the good thing is that in terms of medications that suppress the immune system and therefore your RA, methotrexate is near the bottom of the ladder (so to speak), so there are a number of other options for you.


Don't be shy about telling your doctor exactly how you feel and how much of the pain is interfering with your ability to live your life. Maybe it's time for discussion about what your other options are.


Angie, Community Member
10/ 9/08 4:05pm

Hi Anna,

I would check with your doc before taking any pain pills with Methotrexate.  I now my rheumy tell me to take Tylenol for pain, I take that with Sulfasalazine and Plaquenil.   I know when I took MethylPrednisone dospak in the beginning it was like a miracle drug for me, but you can't stay on it for long, it's really meant for a quick fix and relief!




bon410, Community Member
10/10/08 4:53pm

I am sorry Anna. It is hard to deal with so much  pain. I have been on Prednisone for 22 years and am taking only 5 mg now. That amount shouldn't cause weight gain. When I took 10 mg there was a problem with weight. For pain I used to take Vicodin with Methotrexate but after 15 years it started to make my head feel funny so I asked for another kind of pain pill. The doctor gave me Panlor which helped a lot. Tylenol or any OTC drugs don't touch the pain. I have RA in every  part of my body and sometimes it is just too much to deal with.


Hope you find what you need soon. Bon

kathy, Community Member
4/12/11 5:29pm

Hey Bob,  Did you know that Panlor was used in treatment of opiad dependence? Just wondering     i take vicodin for ra and oa pain   i may ask for it

feeling.great, Community Member
10/14/08 6:33pm

Hi Anna, I have found Vicodin to be an excellent pain blocker and I do take Methotrexate - so, there seems to be no problem with the two drugs.  Fortunately, I don't have to take Vicodin very often these days as I am on Humira also and it is working pretty good. It is not 100 percent but it makes life very liveable. Vicodin will help with your pain but, of course, it won't replace prednisone.  At some point you probably need to get off prednisone as it is meant for only short term usage. You might explore an alternative  partner drug with methotrexate with your rheumatologist.  There are a lot of drugs out there these day, especially the bio drugs; eg, enbrel, humira, remicade, etc.   Hope you get well soon.  Danny

Dave, Community Member
1/30/10 9:19pm

Find a Dr. That will give you, low dose naltrexone it has very low side effects and will heal your Body. Look it uo on 

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By Anna, Community Member— Last Modified: 04/07/14, First Published: 10/09/08