Methotrexate and Sulfasalazine

TheSquire Member Posts: 5
edited 28. Nov 2023, 14:10 in Living with arthritis

Hi, just wondering is anybody on these? Just started MXT today having been on SS solely for 2 yrs. My rheumy wants me on both but I'm reluctant as I'd like to see how MXT works initially before adding SS (perhaps unnecessarily).

How have they been going for you?



  • noddingtonpete
    noddingtonpete Moderator Posts: 826

    Hello @TheSquire and welcome to the Community. We are a friendly and supportive group and I hope that will be your experience as well.

    I understand that you are currently on Sulfasalazine and about to start methotrexate. There are are many people on here who take methotrexate so I am sure that they will share their experiences and support with you. From what others have posted I think you need to persevere taking them for a couple of weeks until you get used to them, but have a look at the following from our website, hopefully it will help.


    Please keep posting and let us know how you are getting on and I am sure that others will share their support and experience as well.

    With very best wishes,

    Peter (moderator)

    Need more help? - call our Helpline on 0800 5200 520 Monday to Friday 9am to 6pm

  • jamieA
    jamieA Member Posts: 605
    edited 9. Jul 2023, 09:07

    Hi @TheSquire

    I've been on sulfasalazine since October 2020 when I was diagnosed with psoriatic arthritis. MTX was added in February 2021 and then the adalimumab biosimilar Amgevita was added in July 2021. I felt a significant improvement in my condition by September 2021. I don't like taking drugs so in February 2023 asked my rheumatologist if I could cut back and she agreed to reduce the sulfasalazine from 3gms to 2gms daily. About a month later I had my worst flare since I started the combination of all 3 and had to go back up to 3gms. My rheumatologist said the drugs work together and give a better outcome than each on it's own. I think the term is synergistic or as she descibed it 1+1+1>3.

    I know everyone is different so it may not be the case for you but that's my experience. I hope you get a combination that works for you.

  • TheSquire
    TheSquire Member Posts: 5

    Thanks Jamie,

    Its great that it seems to be working for you. I actually think its PA i have as well although its never been labelled.

    Have you had any side effects from the treatment?

  • jamieA
    jamieA Member Posts: 605
    edited 9. Jul 2023, 12:35

    Hi @TheSquire

    I was a fit and healthy retiree then I probably had covid in March 2020 and suffered repeated chest infections afterwards. I was then diagnosed with PsA that October and then pneumonia in November 2020. I was put on MTX in February 2021. I then had a heart issue in May 2021 - atrial fibrillation and tachycardia. I had no previous history of any of these. I then had tachycardia again in October 2021, was admitted to hospital and was seen by a rheumatologist - not a cardiologist. The rheumatologist halved my MTX from 20mgs to 10mgs and I didn't have a repeat until 2 weeks ago. That episode 2 weeks ago was put down to a reaction to an injection of contrast agent I had during an MRI scan. I asked my cardiologist whether the original AF and tachycardia was caused by the MTX but he said it was more likely because of previous covid infection. I have my doubts though as why would the rheumatologist reduce my MTX.

    Other than that conjecture on my part I've not had any side effects that I know of. I'm very careful as I realise that I'm now immunocompromised so am extra careful with cleanliness and avoid crowded areas.

  • TheSquire
    TheSquire Member Posts: 5

    Thank you for your reply, it was very helpful.

    I'm sorry to hear that you have had such a bad run of health recently but stay positive.

    Hopefully, things settle and better times are ahead.