plaquenil and sulfasalazine

[anniebarry]

For the past 3 years I haven't been well.  In '05 was diagnosed with Hashimoto's and was put on Synthroid and Cytomel.  Tried Armour thryroid but didn't work for me.  I've pretty much had my thyroid controlled but always had persistent body pain and fatigue along with GI problems.  Most docs chocked it up to Fibro  Some days better than others but it always seemed to come back.  A couple months ago, I got progressively worse. Symptoms worsened into flu-like symptoms. In addition, I had a nodule on my index finger knuckle.  Long story short, Sed rate and RA factor were elevated. Because I was feeling sooo sick, my GP put me on prednisone and referred me to a Rheumatologist.  After 5 to 6 days I felt 100% better.  In fact, I hadn't felt that good in years.  My Rheumy, however, prescribed Plaquenil and Sulfasalazine and told me decrease the prednisone.  After a week on those meds I felt worse than I've ever felt! Doc said to discontinue the Plaquenil because he thinks that that is the one that has the most side effects.  It's been 3 days and I still feel awful!  Please, If there is anybody out there that has experience with these drugs, let me know.  His justification for prescribing these meds is that he believes that I have the beginning of Rhematoid.  I'm concerned that I won't be able to tolerate these meds and will eventually have to take others that are more toxic. Any input that anyone has is greatly appreciated.  

[kim481962]

I was on methotrexate for one year felt very good ,best in years except my liver enzmes kept creeping up until they had no choice but to take me off of them.now i am on plaquenil and sulfasalazine,worried about this as its not as strong and I do not want a flare up with rhuemtoid.

[anniebarry]

Well, its been 2 days on the methotrexate and it's 9:30 in the evening and I've had a raging headache for the last 4 hours.  Hopefully this won't continue.  I'll keep you posted during the next week or so. Definitely check in to that muscle weakness in regards to the plaquenil. I've always had intense body pain but never any weakness like on the plaquenil.  After that drug was out of my system, my strength immediately returned. Hang in there and keep me posted too.  Annie

[krndhn]

I'm curious about how you do on the methotrexate - let me know.  For some reason I thought that would have worse side effects.  Hope it works for you.  I'm pretty much resigned to taking the plaqenil indefinitely - until I can come up with a different rheumy - this one is the only one within 70 miles!  I didn't realize my muscle weakness could be a side effect of plaquenil!!  I have what the orthopedist calls "walking intolerance"  and even gave me a handicapped hanger for my car.  The rheumy said the muscle weakness was was due to a vitamin D deficiency, but the megadoses of Vit. D didn't help, so  went to an orthopedist.  She put me through physical therapy, and a series of 3 epidural injections, none of which has helped,    I'm going to research this some more now - thanks!    Karen

[anniebarry]

Thanks for responding, I do appreciate your input.  I ended up taking both the plaquenil and the sulfasalazine together and each one independent of one another to see which one was giving me the most side effects. It turned out that Plaquenil was the culprit.  I was sooo sick from that drug that I absolutely had no choice but to discontinue it. I had the intense gas, yes, but worse was the extreme and I mean extreme muscle weakness.  I seriously could barely walk upstairs in my house! That was a week ago Sunday. I had had enough!  I stopped it abuptly and emailed my doc.  It took almost 3 days for me that drug to get out of my system.  Fast forward to today.  I had an appt with my rheumy this morning.  He explained that 1 out of approx 20 people simply cannot tolerate plaquenil.  He now has prescribed Methotrexate, I'll start it tomorrow.  I'm feeling a bit scared after everything I've been through the last month. You mentioned that you have Lupus and that you can tolerate Plaquenil. At least you have found something that works and that you can live with. Hope you are doing OK for now.  All of this is so hard, I know.  It's one day at a time, I guess.  Again, thanks for you concern

[krndhn]

I was prescribed plaquenil in Apr. 2007 for lupus.   There were bad side effects - he worst being very loud and uncontrollable gas, stomach upset and crampiness, and nausea.  I stopped taking it and the the sided effects went away.  I told my rheumatologist that I had stopped the med, and he was not happy and I think was going to dump me as a patient - he said I needed to be on it!  So I went back on it - twice a day- and after about a month the side effects were manageable and nearly gone.  The worst problem I have with plaquenil is hair thinning - but that I can live with.  If the plaquenil is helping and they say you need it, I'd take it - the side effects will go away.  I've not had experience with sulfasalazine - but from what I've read, the side effects of that med are about the same as those of plaquenil.   BTW - sulfasalazine is an anti-inflammatory.

One more thing---my rheumatologist prescribed plaquenil over 3 years ago for me for Sjogrens Syndrome.  I was too stubborn to take it - decided I'd deal with dry eye and dry mouth myself without taking pills!!  So when I told him I wasn't going to take it - he said if you're not going  to take my advice then there's no point in coming back!  I didn't, until last year when I started having pericarditis attacks - after multi tests my cardiologist sent me back to him - I now had lupus!..My rheumy was kind of smug  - he remembered me - and said if I had taken the plaquenil back when he prescribed it I probably wouldn't be having the attacks now.  Maybe he was right - I don't know.  But I do know that the medicine effects are a whole lot easier to deal with than the disease effects, and the damage done by the pericarditis attacks, which are irreversible!

So you be the judge and good luck.  I do sympathise with you though - please let me know what you decide.