I was switched to Humira and Arava (Leflunomide) back in July 2011. My lab tests in September 2011 showed my liver was being stressed. My ALT was 44. So we cut my dose from 20mg to 10mg. After a HUGE insurance mix up, I was finally able to see my rheumy again on Monday.
My liver continues to be stressed. My ALT is up to 56 from 44. He's suggested I cut my Arava dose in half again. That's 5mg. I wonder what the point of taking 5mg of this drug is.
I've just finished an email to him asking if I can switch back to MTX. Last year I stopped MTX because of a supposed reaction to it. I was getting these red bumps that felt like burns on my head and face. It was annoying and yes it hurt. But honestly, I'd rather put up with that than a stressed liver.
To be honest, I am not sure how much of that was related to the MTX, or to the emotional state I was in at the time. I was in such a bad place, fighting so hard against this disease and against accepting the "new outlook" on what my future would be. When I found out that MTX was used as an oral chemo, and also used as an abortion drug, I panicked. I panicked even more so after I asked if using the drug would make me infertile and received, "We don't really know," as an answer. I began having nightmares where I'd have miscarriages, or I'd have babies with horrible deformities, or really sick babies born prematurely. It was horrible! And of course, the nightmares caused so much stress that I stayed flared up and in constant pain.
Since then, the doctor has tried his best to explain to me how MTX and Arava are alike in that they inhibit the body from metabolizing folic acid. His encouraging words, and my own effort at educating myself about the drugs I choose to put in my body have calmed my fears and put those nightmares at rest - although I do get the occasional drug related nightmare every now and then, but I chuck that up to normalcy.
I'm ready to try MTX again because I never had a problem with it as far as my labs were concerned. And that's a peace I look forward to again. I just hope he'll allow me the switch.