Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Arava Question

Has anyone had a reaction to Arava??? I just spent a couple of days in the hospital due to dehydration from vomiting my guts out. To avoid being real graphic, I'll just say the liver was really taxed in this episode. No other symptoms. I had just started the drug and completed the mega dosing as prescribed, and on the first day of my normal dose, it hit the fan. There is the stomach flew going around, but the Doc said I didn't match the symptoms, and was "most likely" a reaction to the new drug. As a result, I'm not taking any DMARD and my next Rheumy appointment is in the middle of January (remicade infusion) and I seem to be going down hill fast. Just interested if this is a fluke, or there is something to it. Thoughts please..

I've heard that some people can get nauseous from Arava but it's described as nausea without vomiting. The only side effect I had was abdominal cramping, it didn't otherwise make me feel sick, and that went away in a few weeks. I felt very sick on MTX and also sulfasalazine so I was really afraid it would make me sick, and I was fast running out of options - - at least options that didn't involve needles Hope you feel better soon, that must have been awful, but there is also a virus going around - - it's hit the cruise ships but this time of year it hits everywhere - - with repeated vomiting, no fever, no other real symptoms, the old fashoned so-called stomach flu.

I'm confused about the liver, though, was that due to the dehydration? I've been told Arava isn't particularly hard on the liver, not like MTX, and I've been on it for over a year with no liver enzyme probs.

Also are you taking it along with something else? You mentioned infusion. Could it be a drug interaction?

Cheryl



Sugar Magnolia wishes everyone a happy holiday season

Edited by Cheryl on 12/27/02 04:33 PM (server time).

Are your blood labs normal? No strange stuff except vomiting? And is it over with now?



Patty

"One day can make your life. One day can ruin your life. All life is is 4 or 5 big days that change everything."
- - - Riding In Cars With Boys

bruce , sorry to hear about your episode with Arava ,i have been using it most of this last year with no side effects . i didnt understand about the megadose tho . my regiment of drugs consists of 200 mg celebrex 2 times /day , 20 mg arava / day , 1 mg folic acid /day , tylenol ,tylenol-3 , + darvocet as needed . a year ago this time i was confined to the house and mostly to bed . hopefully you can find what works for you without much delay . keep looking up . we live by faith , not by sight ....Ed

Well, I'll try to answer all of the questions in one. First of all, I had a similar experience when I was put on MTX over a year ago (not nearly as severe), and since have been on Azulfadine. I've been doing ok with with it, but the Rheumy was looking to do a little more for me, and was confident that Arava would do the trick. Anyhow, the vomiting lasted for about 8 hours (about every 15 minutes) , and there was SIGNIFICANT liver bile (that's about as nice as I can say it). Anyhow, all of my labs were all normal. There was one other symptom I forgot to mention before, and that was a rash all over. It went away in a day. But the part that I struggle with, is since I started the Arava, I seemed to have a "taste" in my mouth, and still have it. And when I started the episode, that is what I tasted coming up. As far as the mega dose, I was told to take 5 (20 mg tabs) a day for three days, and 1 a day thereafter. It was on the forth day that I got sick. My Primary Care Doc told me to stop taking it, and talk to the Rheumy when I see him. I'm ok with going back to Azulfadine, but if it was the flu, then I could be passing up a potentially better treatment. If no one else has had this type of episode, I'd be more willing to try it again. Want to be armed with info when I see the Rhemy, but I DO NOT want to repeat those few days again. Thanks for your comments.

Uh oh, the rash, you forgot to mention that, a classic allergic reaction, one of the things to look out for with Arava - - with most meds, actually. That loading dose seems excessive, I'm trying to remember but I think I took the loading dose for one day and then the 20 after that. And I was on no other meds except Soma. The bile was what one would expect after barfing (I do love these medical technical terms)so frequently for so many hours. It almost sounds as if you had a bit of an overdose to begin with, but perhaps I'm wrong and this is normal protocol. But with that rash thing, I'd be very leery of trying it again. With me it was Arava or Enbrel, if I washed out on Arava I was going to be put on Enbrel next. Has this been suggested to you?

Cheryl



Sugar Magnolia wishes everyone a happy holiday season

Sounds like my history, just over a year ago I couldn't walk any distance without using a cane, was in more or less constant pain, had bombed out of just about everything else except hadn't been put on Enbrel or Remicade, and now I am living a more or less "normal" life, still can't overdo - - did Disney for two days with my kids and grandkids and paid the piper for that one, ended up having to have a shot of cortisone in my bad ankle joint, but if I don't push the envelope I am pretty much pain free. I'm on just Arava and Soma now, and it's working out well. The only thing I still have is a bit of stiffness that wakes me up during the night (I take another Soma) and then in the early morning, but it's light years away from what I used to go through.

Cheryl



Sugar Magnolia wishes everyone a happy holiday season

ah yes , how soon we forget , now i remember the rash . it went away quite quickly tho . i remeber the first day i took Arava , my Dr said to take one a day and if i missed a day DO NOT MAKE IT UP just skip it and continue on the next day . i still have a daily struggle with buldging discs and pinched nerves , but that is another issue . hopefully if Arava is not for you , your Dr will be open to suggestions . others here ie Cheryl , have a wealth of informatoin that is real life experience , hard to get from a book . anyway, you will find that any treatment is almost patient specific . well , coffe is finaly done sooooooo.......gotta wake up and go to work . Keep looking up .. we live by faith not by sight . Ed

Bruce,
Sorry to hear about your problems. I sure hope things get back on track. Take Care, we'll be thinking of you...

Keep Kickin'AS
Chris

Thanks Cheryl and alll,

That was the info I was looking for. I am on Remicade, but Doc also had me on Azulfadine (changed to the Arava). I do have a little problem with the Remicade (doesn't last long enough, and goes away to fast and my blood pressue sky rockets during the infusion unless it is done very, very, slow). Somehow the Azulfadine or Arava are supposed to help prolong the duration to the full 8 weeks. I really notice it now since I've quit them both. Getting really, really stiff and hurting and I have a couple more weeks before next infusion. But the blessing to all of this is that I'm 1000% better than I was just over a year ago with the whole Remicade treatments. I can easily bare this little detour from relief. Thanks again to you all.

Bruce