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Pain Management Health Center

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Track DMARD Effects

DMARDs are often standard treatment. Even if you've been taking them a while, you still need to track how well they work and watch for side effects. Set aside time to review what to expect from DMARD treatment and the precautions you need to take.

Treat Nausea

Do methotrexate pills upset your stomach? It's a common side effect. Symptoms may be worst the first day or so after your weekly dose.

Ask your doctor which treatments can help. A folic acid supplement after your methotrexate may ease nausea. Another option is to see if you can take methotrexate by injection instead. When injected, the drug no longer goes through your stomach. Some people find that helps with nausea.

Plaquenil and Eyes

Anyone taking Plaquenil should see an eye doctor on a regular basis for an eye checkup. Although it's rare, Plaquenil can sometimes cause degeneration of the retina, which could lead to vision loss. A regular eye exam -- even if you don't wear glasses -- can help catch any potential problems early and avoid serious consequences. Ask your eye doctor how often you need an exam. It's usually annually, but frequency varies based on your risk factors.

Folic Acid Help

Folic acid may help with many of the common side effects from methotrexate, such as fatigue, headaches, hair loss, and oral ulcers. Ask your doctor if folic acid might help you -- don't just start taking it on your own. Many people using this DMARD take daily folic acid supplements. Some people may take a prescription form of folic acid called leucovorin that you typically take once a week. Talk to your doctor about what's right for you.

DMARDs and Pregnancy

Some DMARDs can cause serious birth defects. Anyone using these drugs needs to use birth control to prevent an unexpected pregnancy.

If you're thinking about getting pregnant, talk to your doctor before you start trying. You may need to stop taking some meds for several months before trying to conceive. Your doctor may switch you to other meds to help control your RA symptoms.

DMARDs and Illness

DMARDs increase the risk of infection. Call your doctor if you notice any of these signs of infection:

* Fever

* Chills

* Sore throat

* Cough

If you do have an infection, you may need to get treated right away. Your doctor may also recommend that you stop taking the DMARD until you're better. However, never stop taking your DMARD -- or other prescribed medication -- without your doctor's approval. It could affect your RA and other health issues.

DMARD Testing

Make sure you go to checkups so your doctor can keep tabs on your overall health. How often you need one depends on which DMARDs you take. Every 4 to 12 weeks, for instance, most people taking methotrexate need blood tests, tests to check kidney and liver functions, and blood counts.

Also keep doing the things you need to stay safe:

* Keep up with vaccinations

* Be sure to follow your doctor's advice about alcohol. Drinking more than recommended could be dangerous and lead to liver damage.

Changes in Symptoms

Sometimes a DMARD that has been reducing your symptoms starts to be less effective. If your symptoms are getting worse, call your doctor.

The good news is that you still have many med options. Your doctor may adjust your dosage or add a different medication. It may take some time, but you and your doctor will find another approach that helps.

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