Monday, July 8, 2013

I wish things were the way are on the TV show House

I wish things were like they were on the TV show House, you get diagnosed with a rare disease and of course that may take a while but once diagnosed they give you a cocktail of drugs and you are noticeable better within forty eight hours.  Actually having a rare disease is nothing like that, except the part where it takes forever to figure out what you have.  I have tried many different drugs for this disease, some of them you need to take for six months before you can tell whether they were working or not.  The drugs are of course dangerous and I guess that is reflected on TV, they always say there is a chance that the treatment could kill you.  The way the treatments could kill you is a lot more vague than sudden death.  Below is just the warning on the interaction of two drugs I am taking it is not even their individual potential for killing.  The best part is that the current recommendation is that you should take both of these drugs at the same time if you have sarcoidosis.  Crazy.

 Major Drug Interaction

methotrexate interacts with the infliximab in Remicade (infliximab)

MONITOR CLOSELY: The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections and sepsis, including fatalities, have been reported with the use of TNF blockers, particularly in patients on concomitant immunosuppressive therapy. Agents that may be significantly myelo- or immunosuppressive include antineoplastic agents, radiation, zidovudine, linezolid, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents (greater than 10 mg/day to 1 mg/kg/day, whichever is less, of prednisone or equivalent for more than 2 weeks), and long-term topical or inhaled corticosteroids. Concomitant use of TNF blockers with other immunosuppressants such as azathioprine or mercaptopurine may also increase the risk of a rare and often fatal cancer of white blood cells known as hepatosplenic T-Cell lymphoma (HSTCL), which has primarily been reported in adolescents and young adults receiving treatment for Crohn's disease or ulcerative colitis. Cases of HSTCL have also occurred during use of these agents alone. Because individuals with rheumatoid arthritis, Crohn's disease, ankylosing spondylitis, psoriatic arthritis, or plaque psoriasis may be more likely to develop lymphoma than the general population, it is difficult to assess the added risk of TNF blockers, azathioprine, and/or mercaptopurine.

MANAGEMENT: Patients receiving a TNF blocker alone or with other immunosuppressive or myelosuppressive agents should be monitored closely for the development of infections. TNF blocker therapy should be discontinued if a serious infection or sepsis occurs. Close monitoring for signs and symptoms of HSTCL (e.g., splenomegaly, hepatomegaly, abdominal pain, persistent fever, night sweats, weight loss) is also recommended during use of TNF blockers, particularly in combination with other immunosuppressants such as azathioprine and mercaptopurine.

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