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Q. I am taking medicines for rheumatoid arthritis, but recently it is flaring up. Why?

Answered by
Dr. Naval Mendiratta
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 26, 2019

Hello doctor,

I am 26 years old and diagnosed with rheumatoid arthritis when I was 23. Since then I have been on 15 mg of Methotrexate and Hydroxychloroquine. Since I have been on medication, I hardly have no symptoms, but recently arthritis seems to be flaring up for three weeks now. I have pain in my feet again, some stiffness and tiredness. Does this mean the Methotrexate is no longer working? My ankle also clicks every time I walk. I am worried about my joint damage? I did my blood test, liver and kidney function tests. All tests are normal. Please advise.

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Hello,

Welcome to icliniq.com.

Well, it is a possibility that Methotrexate dose is not sufficient enough to stop the disease. 15 mg is the dose we use for starting and we normally go higher up. In my experience, 15 mg normally proves inefficient in the long run. But since your disease is flaring, and as you said liver functions are good, you need to increase the dose to 20 mg or 25 mg. Secondly, for the flare you are having, you can take a short course of steroids, Prednisolone 10 mg to be tapered over three weeks and stop. That will help to stop the disease.


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