Rheumatoid Arthritis

Is your medication still working for you?

Like a lot of people with multiple chronic diseases, my medication list is long. Some medications, like insulin, are a no brainer for me- they are absolutely necessary. But sometimes I find myself wondering if I still need everything on my list.

When my rheumatologist realized I was losing a lot of time to my methotrexate “hangover”, she asked me to try a half dose and see if that made a difference. It didn’t. I still slept away my Sunday. She asked me to skip a week of injecting methotrexate. And we learned, I still slept away my Sunday. And I felt awful without my weekly dose of that magical yellow liquid. So lesson learned- methotrexate helps me and regardless of my medications, my body needs a day each week to rest and do nothing else.

When I started Rituxan last summer, I quickly learned that it is an excellent medication for me. I’ve noticed over the past 3 months that I have less pain. I still flare and have pain in my damaged joints that I need my breakthrough pain meds for. But I’ve wondered if I really need my Butrans patch?

You might be asking- if your pain is controlled and you’re feeling better, why would you want to change things up? When I initially was prescribed Butrans, my pain was a mess. My pain owned me. I was managing multiple medications during my work day to try to keep my pain somewhat under control. My evening breakthrough meds weren’t always able to bring my pain down.

We decided to try Butrans to get a low opioid dose in my system all day, without having to take even more pills. The hope was that this patch would give me enough relief that my breakthrough meds could really help me. And that is exactly what happened.

Since starting on the patch, I had major knee surgery and started Rituxan. I’ve also lost some weight and worked on my diet (still very much a work in progress).

I mentioned discontinuing Butrans to my pain management physician and she agreed with trying to lower my dose or get rid of the patch completely. But she did ask me to get through the holidays and my next set of infusions before attempting a change.

So here we are. Today I’m going to drop my dose down by 50%. If that goes well for 2 weeks, I’m going to try not using a patch at all. Although I’m staying optimistic, I also realize that my pain may come back rearing its ugly head. And that’s ok. I’ll know that my body needs this medication and it’s worth the cost and side effects. I won’t have to wonder if I need it, I’ll know. And knowledge is all I’m looking for.



  1. Cathy Buckley

    I failed to wean off prednisone numerous times over several years before I was ultimately successful. I try to extend the time between my biologic injections from time to time. The disease has reared it’s ugly head to remind me I need to stay on course with the biologic, so far. I will probably try again sometime. I do “listen” carefully to my body to self-monitor the disease management.

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