Hi, Ive been taking Methotrexate 20mg weekly for Psoriatic arthritis since June ‘23 this has helped a little but still relying heavily on painkillers. My Rheumatology Nurse has given me Sulfasalazine alongside it. How have people got on with this combination. I’m due to go abroad on Monday, would it be better to start them after my holiday in case of any side effects?

Thanks 😊


  • stickywicket
    stickywicket Member Posts: 27,686

    Hi @Coka . It would have been better to ask your rheumatology nurse but, hey, hindsight is always 20/20 vision.

    I have RA and get by well on methotrexate and hydroxychloroquine but a friend,,with PsA, did OK on meth and sulf for years.

    As you'll know, all,these DMARDS can take up to 3 months to work well whereas side effects can, if they're going to, kick in immediately. Personally, I'd wait until after the holiday but I don't know how bad things are for you. Is there still time to check with your helpline?

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  • jamieA
    jamieA Member Posts: 661

    Hi @Coka

    I think I'd preface my answer by saying I realise we are all different and what works for one person may not work for another.

    I was diagnosed with PsA in late 2020 and initially put on 3gms of Sulfasalazine daily - which didn't work. I've had no side effects from sulfasalazine. 3 months later MTX was added and increased quickly to 20mgs weekly. In my case the combination didn't work and 5 months later an adalimumab biosimilar was added. The 3 drugs together have worked for me. My rheumatologist describes the working of the combination of drugs as 1+1+1>3 or synergistic. I did ask my rheumatologist last year if I could reduce my drug intake and she agreed to reduce the sulfasalazine to 2gms per day. I then had a significant flare so it was put back up to 3gms. She said this proved the synergistic effect of the 3 drugs working together.

    I think the NHS regards MTX as more significant than sulfasalazine regarding immunosuppression.

    I hope the combination works for you.

  • Welsh1
    Welsh1 Member Posts: 50

    I would wait till you return. Interesting how different Rheumatology start people on sole medication or double. I hope you find something it's sounds like you do need another if you are still using painkillers.

  • Jompa
    Jompa Member Posts: 1

    Sorry to answer late on this.

    I've just started on Sulfasalazine, having been taken off methotrexate due to getting infections. I have to have a blood test every two weeks for at least 6 weeks.

    I am wondering did you not have to do that?

  • noddingtonpete
    noddingtonpete Moderator Posts: 952

    Hello @Jompa 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 have just started Sulfasalazine so the following from our website may be of interest

    Please keep posting and let us know how you are getting on.

    Best wishes


    Need more help? - call our Helpline on0800 5200 520Monday to Friday 9am to 6pm

  • Coka
    Coka Member Posts: 11

    Hi Jompa, yes I’m doing the blood tests, back to every 2 weeks with this new drug.😊

  • Coka
    Coka Member Posts: 11

    Thanks everyone, I think I will start it after my holiday. Hopefully with this added I won’t have to rely on painkillers so much. 😊