
Reply: Question about Leucovorin for side effects
For those patients I prescribe folinic acid (leucovorin), I tell them to take it...
Posted by Scott Zashin, MD
For those patients I prescribe folinic acid (leucovorin), I tell them to take it 8-12 hours after their once a week MTX dose,, If they forget, it still may help to take it in the first 24 hours to help prevent MTX side effects such as fatigue, mouth ulcers, as well as other problems. .I also keep my patients on daily folic acid 1mg.View Thread
Posted byScott Zashin, MD
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Reply: Humira and "live" vaccines
Thank you for your question. I have forwarded it to Abbott labs the manufacturer...
Posted by Scott Zashin, MD
Thank you for your question. I have forwarded it to Abbott labs the manufacturer of Humira to get their response. Please check back in 2-3 weeks if I have not responded.View Thread
Posted byScott Zashin, MD
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Reply: question about my child
Unfortunately, I don't have expertise with this type of problem. Consider seeing a...
Posted by Scott Zashin, MD
Unfortunately, I don't have expertise with this type of problem. Consider seeing a pediatric Rheumatologist if you have not done so Often they can be found at hospitals associated with medical schools.View Thread
Posted byScott Zashin, MD
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Reply: Help! In denial....Seronegative RA?
Some other tests I would check on a patient who gave me that history is a...
Posted by Scott Zashin, MD
Some other tests I would check on a patient who gave me that history is a CCP(another RA test) and an HLA B27 gene to look for a different type of arthritis. A positive gene test can be found in 8 % of the population so a positive test is not diagnostic. I will use MTX in the 15-20% of my patients with RA who are seronegative (no RF) if they have swelling and high measures of inflammation to help symptoms and decrease the risk of damage, deformity and disability.View Thread
Posted byScott Zashin, MD
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Reply: recently diagnosed.....clueless!!!
Fatigue is a tough problem with many possible causes. You might enjoy reading my...
Posted by Scott Zashin, MD
Fatigue is a tough problem with many possible causes. You might enjoy reading my article written for the Sjogrens Syndrome Foundation newsletter The Moisture Seekers. Possibly if you contact them, they will send you a copy. Two things I always check in my fatigued patients. First is their thyroid function and second is to make sure they don't snore which could indicate sleep apnea. Plaquenil may help fatigue, but it may take up to 6 months to see benefit and it does not work all the time.View Thread
Posted byScott Zashin, MD
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Reply: What is the best way to deal with the pain when na...
In RA patients, I often use corticosteroids like prednisone to help my patients...
Posted by Scott Zashin, MD
In RA patients, I often use corticosteroids like prednisone to help my patients until DMARDS or biologics work. They are given in place of NSAIDS. In OA, analgesics such as tylenol or tramadol are often used.View Thread
Posted byScott Zashin, MD
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Reply: mi shots
An IM corticosteroid shot may help RA, but does not typically help OA. On the...
Posted by Scott Zashin, MD
An IM corticosteroid shot may help RA, but does not typically help OA. On the other hand, injecting the medication in an affected joint may help the pain of OA. Steroids are anti inflammatory meds often give to help decrease inflammation and subsequent pain. In RA, they may also be given orally.View Thread
Posted byScott Zashin, MD
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Reply: Cholesterol & Triglycerides
Kim I did further research and did not find an association with Enbrel....
Posted by Scott Zashin, MD
Kim
I did further research and did not find an association with Enbrel. Nevertheless, as you say, it is quite possible that any drug can cause a problem that is not readily apparent in many patients.,In my patients, I sometimes discontinue a medication to determine if there is a relationship between a med and possible side effect. You should talk to your doctor as to whether the benefits of stopping Enbrel or switching to a different drug to see if there is a cause and effect outweigh the risks of doing so.View Thread
Posted byScott Zashin, MD
I did further research and did not find an association with Enbrel. Nevertheless, as you say, it is quite possible that any drug can cause a problem that is not readily apparent in many patients.,In my patients, I sometimes discontinue a medication to determine if there is a relationship between a med and possible side effect. You should talk to your doctor as to whether the benefits of stopping Enbrel or switching to a different drug to see if there is a cause and effect outweigh the risks of doing so.View Thread
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Reply: mi shots
You may be referring to an IM shot. This is a shot that is given in the muscle,...
Posted by Scott Zashin, MD
You may be referring to an IM shot. This is a shot that is given in the muscle, often the upper arm, but may be given other places.The flu shot is given IM. Hope this is what you need.View Thread
Posted byScott Zashin, MD
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Reply: could use some help
Raynauds is not common with RA. I will diagnose my patients with a postive ANA,...
Posted by Scott Zashin, MD
Raynauds is not common with RA. I will diagnose my patients with a postive ANA, raynauds and swollen joints to have an undefined connective tissue disease. I use Plaquenil commonly in this situation.View Thread
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