Remicade, mtx and Sulfasalazine for a 5 yr old?

[Farmwife]

Has anyone heard of adding Sulfasalazine to Remicade (every 4 wks) and Methotrexate (1 injection a wk) combo?

I've tried to research having children on all 3 but can't find any.

I guess I'm just craving reassurance as I'm concerned about how much medicine can my little girl take before it harms her.

Plus the doc is putting her on a 20mg of Pred for 10 days.....we hope it won't be longer.

 

[Maya142]

M has been on Remicade (15mg/kg), Imuran (75mg) plus Sulfasalazine (2000mg). Sulfasalazine didn't seem to be doing much, so we eventually replaced it with Methotrexate (a low dose, 7.5mg). That helped a little, but we already knew M responded to MTX better than Sulfasalazine, because we had tried Sulfasalazine when she was first diagnosed.

I was very worried about M being on so much medication (and I still worry!) but everything so far has been ok. No increase in infections, all bloodwork is still fine.

Also, M has been on steroids (yes, with all the above combinations!) since July. Mostly a pretty low dose (started at 15mg and tapered to 8mg within two weeks). I also looked for studies but there aren't many done on kids with those combinations.

You could look at replacing MTX altogether with something like Arava (although that wouldn't work for the IBD). Or Imuran, that used to be used quite a lot for JIA.

I hope Grace feels better soon!

 

[my little penguin]

Ds was on Asacol (5-ASA similar to sulfanazine ) plus remicade
Later asacol plus humira - it didn't do much so we dropped it.
I far as I know the sulfanazine is really mild so not a big deal to add to anything .
Just might boost the work the other heavy hitters are trying to do .

 

[Brian'sMom]

We did Humira+Mtx+Pentasa and then also had Cimzia+mtx+Pentasa. You most likely know this.. but Pentasa is also a 5-ASA like sulfasalazine

 

[DustyKat]

No experience with any of those drugs at our end Fw but wanted to send much love and squishy hugs your way. :ghug:

Dusty. xxx

 

[Farmwife]

So I'm confused.:shifty: I picked up her Sulfasalazine script today
and the bottle said to give it 1/2 pill 4 times a day.
I swear I was told by the doc to do 1 pill twice a day.

Is it normal to take this pill 4 times a day?

I won't be giving it until I talk to her doc on Friday.

 

[Maya142]

We did twice a day too, but definitely ask her doctor. M is much older than Grace, but did 2000mg both times, she's about 90lbs.

 

[Sascot]

No experience , just wanted to send good thoughts your way. Hope the meds work really well and Grace doesn't get any side effects

 

[Pilgrim]

It's probably too late to switch it but we were able to get a liquid formulation of the sulfasalazine when H took it. They can flavour it to taste good.

 

[my little penguin]

It may have been what the insurance will cover sorta thing
I know with asacol the doc had practice x amount three times a day but insurance covered a similar amount total twice a day so we did the twice a day

 

[Farmwife]

Thanks everyone. Your a big help.:hug:

Here's another question.
On the paper given for Sulfasalazine, it says the Folic Acid might interact with this drug.
Anyone heard of this?

Why is the simplest drug the one that gives me the most questions.:ybatty:

Oh and Happy Thanks Giving to all in the USA!

 

[Pilgrim]

When we were using it, all I heard was that she needed to have a folic acid supplement. I was told to crush a tablet and mix it in food for her once per day.

So, no, never heard of that. Maybe someone will have some insight.

I am an American who married a Canadian. I still miss American Thanksgiving. I hope it is a happy, restful day for you and yours. Although there is no day off when farming, right?

 

[Farmwife]

Lol Pilgrim, my hubby tried to reason with the cows on not being milked on holidays
but all they did was stare at him. :ylol2:
Ya, farmers work everyday but the promise of good food gets them in a bit faster.:kiss:

Grace already takes a half .5 pill of folic acid. I might ask if she can take a whole pill instead. I do know it helps stop her nausea from the mtx.

 

[my little penguin]

The Rheumo raised Ds folic acid when he had side effects from Mtx
From 1 mg to 2 mg
But we split the dose morning and night
That seems to work for him and reduce the mouth ulcers and nausea .

 

[Maya142]

M also takes 2mg of folic acid. We also raised the dose when she was on MTX and kept her on it even when she was off MTX and on Sulfasalazine.

M had no real side effects with Sulfasalazine - except when they tried to give her the adult dose (3000mg) she got very nauseous. Some kids also get headaches in the first few weeks.

Good luck and Happy Thanksgiving !

 

[Farmwife]

Grace is on 1,000mg and is 41 lbs (dropped 4 lbs).

Off to the party. I burnt all 4 pie crust. :ymad:So I'm telling everyone that crustless pies are all the rage.:rof: