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HomeAnswersRheumatologyrheumatoid arthritisWhy is there sudden worsening of rheumatoid arthritis even on medication?

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

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At November 26, 2019
Reviewed AtJuly 14, 2023

Patient's Query

Hello doctor,

I am a 26-year-old and was 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.


Welcome to icliniq.com.

Well, it is a possibility that the 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.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Naval Mendiratta
Dr. Naval Mendiratta


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