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Safe to Take Methotrexate and Cyclosporine at the Same Time?
from Scott

Ed:  I just found FlakeHQ and it's great to find a site with all of this fantastic information. I don't trust doctors too much for obvious reasons, and have been reading the letters which have provided a lot of great info.

One quick question; I was just prescribed a combination of MTX in conjunction with a low dosage of Cyclosporine. I became concerned about this after reading the documentation included with the Cyclosporine which directly states that it should not be used at the same time with MTX  for P.  Much of what I'm reading now on FlakeHQ seems to confirm this, as I can only find people that cycle the two. The documentation seems to infer that it's OK for Rheumatiod Arthritis patients, which makes no sense to me.

Anything you have heard regarding this would be great. Thanks very much.  -Scott


Ed’s Response:  Wow, Scott.  I have NEVER heard of a situation in which it is ok to take MTX and cyclo at the same time.  The effectiveness of either of those immunosuppresants is dose-dependent.  So is the toxicity of the drugs.  MTX is mostly a threat to the liver at higher doses and cyclo is mostly a threat to the kidneys.  Dose is determined for MTX based mostly on what works (although I've rarely heard of any flaker receiving more than 30-35 mgs per week), and cyclo's dose is dependent on the patient's body weight — the more you weigh, the larger the dose. 

Having said all that, I can't imagine anyone being prescribed BOTH AT ONCE at an effectively large-enough dose of either.

But there may be new evidence that indicates doing just that.  After all, lots of us turned to the injectable biologics to get off our circuitous dependency on MTX and/or cyclo.  Recently I've been hearing about a number of folks taking small doses of MTX along with their biologic and getting better results.  Sounds like this is similar to what you've just been prescribed, though in your case the dose of cyclo is small and MTX must be the primary drug. <shrug> 

Please reassure me that your doctor is insisting on monthly lab work.  Also, has your doctor said anything about a prospective duration for this combo drug regimen?  Though lots of folks take MTX indefinitely, lots of others are on limited periods by their doctor (in my case it was always 1 year).  Cyclo, in my case, always wore out its welcome at around 10 months, with symptoms of heightened blood pressure and significant edema in my legs.

And let me know how the therapy goes. -Ed

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