Methotrexate or Fumaderm?

[Fred]

Bill, my dermatologist seemed to be pushing Methotrexate a bit more during our conversation, she pointed out the side effects of Fumaderm and it didn't sound pleasant, hence why I made the thread the when I got home so that I could get advice from people who are actually on the treatment. Excuse my ignorance.

You don't need to excuse your ignorance, Bill is fine, it's just that you will find some of our members from different parts of the world have different ways of getting their point across.

I must admit I was thinking the same as Bill as the wording in you post, "side affects used with Fumaderm and Methotrexate" to me the side effects are much worse with Methotrexate.

But now I understand you are talking about the unpleasant side effects of Fumaderm in regard to the possibility of needing the toilet a bit quick, as opposed to the side effects of Methotrexate being a poison that will ruin your liver and can terminate a pregnancy.

Caroline will probably be able to help with that, she did mention in another post about taking Fumaderm with yoghurt.

[Caroline]

Fred, Caroline and Jiml. Seeing your replies are now making me lean towards fumaderm. Bill, my dermatologist seemed to be pushing Methotrexate a bit more during our conversation, she pointed out the side effects of Fumaderm and it didn't sound pleasant, hence why I made the thread the when I got home so that I could get advice from people who are actually on the treatment. Excuse my ignorance.

Would anyone have any advice on how to help the side effects? (I work with kids, so tummy cramps and other stomach problems will be difficult to deal with in an environment where I can't just leave the room to use the bathroom due to adult:child ratios) Any advice would be appreciated.

Hello Ccar,

Your dermatologist should use it MTX himself for a while, than he will speak differently.
Today I spoke to the chairman of one of the psoriasis associations in NL. He said he had a friend who was a dermatologist and this friend got rheuma. He was put on MTX, he said to this chairman that he now understood what people with psoriasis on MTX had to go through and stated that he would never prescribe it again, accompanied by the words that it basically had to be forbidden.

On Fumaderm, or DMF, the dermatologists know very little about this medication, strange enough. The side effects are far overrated by them, they are much less worse as said.
I don't know exactly on fumaderm, but there are three possible side effects.
1) Flush: Totally harmless, basically funny
2) Stomach cramps: this would be something on Fumaderm, I have never experienced them with Psorinovo, best thing is to do as Bill does, take them during eating.
3) Inconsistent intestines. These are not really cramps. You must see them as that your intestines are just unstable, after getting used to it, you can feel it coming, and take your actions in time and go to the toilet.
Example, sometimes I feel that is well, possible getting inconsistent. If you are easy going on the toilet then just go. I am not, so then I step on my motorcycle and drive to the office. This is between 35 and 55 minutes depending on the route I drive. On the road there is no problem, I feel some pressure, that is it. Once in the office, I really need to go quickly…. So quick out of the leathers and to the toilet.
What a story about toilets…..
Sometimes it is just on the edge, but never had a real problem.
After having been to the toilet, mostly the rest of the day there is no problem at all anymore.
Perhaps this seems a little worrying, but this only happens occasionally. Once in two weeks or even less.
Mostly I detect it in time and there is no problem at all.

Now this holds if you react well to DMF. That is in 72% of the patients that use it. The ones that are not able to cope with it, just because their body doesn't want DMF, we are all different, but in that case DMF will not be the route to go and you should have to stop anyway.

Hope this gives you enough info . Anyway don't go for MTX, it's terrible.
Caroline

[ccarr06]

Thanks so much guys, you have really helped ease my mind a little.

I supposed I should have been more clear what I meant by being wary of side effects! Just to explain a little bit more, before I was on this forum, I was under the impression that both had equal possible damaging consequences on the liver and on pregnancies? I was told that on both I wouldn't be able to have children until a year after coming of the medication if I go down that route in the future (as I'm only 27 and don't have have kids yet, which is why they want me to take my time about deciding to go down the path of oral treatment) I was also told alcohol was a no no for both, so the way she explained it, both were bad and had the same side effects, but fumaderm also causes stomach issues and hot flushes. I can see that that it's not the case. I definitely think I'll go for fumaderm. Methotrexate sounds terrible!

[jiml]

Thanks so much guys, you have really helped ease my mind a little.

I supposed I should have been more clear what I meant by being wary of side effects! Just to explain a little bit more, before I was on this forum, I was under the impression that both had equal possible damaging consequences on the liver and on pregnancies? I was told that on both I wouldn't be able to have children until a year after coming of the medication if I go down that route in the future (as I'm only 27 and don't have have kids yet, which is why they want me to take my time about deciding to go down the path of oral treatment) I was also told alcohol was a no no for both, so the way she explained it, both were bad and had the same side effects, but fumaderm also causes stomach issues and hot flushes. I can see that that it's not the case. I definitely think I'll go for fumaderm. Methotrexate sounds terrible!

I don't think you will ever regret that decision and really hope it works well for you.
By the way I enjoy a drink.... Or two and it hasn't affected me at all
I always have a drink with my dinner and it's not water and often a couple in the evening.. .... Mmm does that sound bad.....
But no enjoy a drink if you like it.... Life's to short not to enjoy it
Jim

[Caroline]

Thanks so much guys, you have really helped ease my mind a little.

I supposed I should have been more clear what I meant by being wary of side effects! Just to explain a little bit more, before I was on this forum, I was under the impression that both had equal possible damaging consequences on the liver and on pregnancies? I was told that on both I wouldn't be able to have children until a year after coming of the medication if I go down that route in the future (as I'm only 27 and don't have have kids yet, which is why they want me to take my time about deciding to go down the path of oral treatment) I was also told alcohol was a no no for both, so the way she explained it, both were bad and had the same side effects, but fumaderm also causes stomach issues and hot flushes. I can see that that it's not the case. I definitely think I'll go for fumaderm. Methotrexate sounds terrible!

I don't think you will ever regret that decision and really hope it works well for you.
By the way I enjoy a drink.... Or two and it hasn't affected me at all
I always have a drink with my dinner and it's not water and often a couple in the evening.. .... Mmm does that sound bad.....
But no enjoy a drink if you like it.... Life's to short not to enjoy it
Jim

O. And I love a drink also. Not much of course, my max is three glasses of wine and only when I will not drive. With that amount, things already begin to blur around me… hihi.
About pregnancy. As far as I know DMF does totally no harm to your reproduction organs, me too once will go for kids, and of course at that time I will have to stop with the DMF for a number of months. I already wonder how that will be.
Really, those dermatologists do not know what they should be trained for, they do not know their documentation and have totally no view on the experience of already 25 years of field use with DMF.
Figures we, over here in the Netherlands, do have. But medicine refuses to look at, basically because it is either out of the protocol or they are plain stubborn.

[Bill]

Take Fumaderm with a big meal if you are worried. Never take it on an empty stomach. That is asking for trouble. I take an 800mg dose once every three days. It gives me flushes and upsets my tummy a bit, but is quite bearable.

DMF is the active agent so you might take Caroline's lead and try Psorinovo as Fumaderm contains other fumaric acid esters which have side effects but are not active against psoriasis.

Best wishes.

Bill

[Caroline]

Take Fumaderm with a big meal if you are worried. Never take it on an empty stomach. That is asking for trouble. I take an 800mg dose once every three days. It gives me flushes and upsets my tummy a bit, but is quite bearable.

DMF is the active agent so you might take Caroline's lead and try Psorinovo as Fumaderm contains other fumaric acid esters which have side effects but are not active against psoriasis.

Best wishes.

Bill

Top !
That is the shortest and clearest explanation of the difference I have ever seen.

[jiml]

Yes very well explained Bill.
But I doubt if CCAR can get Psorinovo in Ireland. I may be wrong but I don't think it has approval in the British or Irish health systems

It's a shame because it is a less expensive drug doing exactly the same job

[Caroline]

Yes very well explained Bill.
But I doubt if CCAR can get Psorinovo in Ireland. I may be wrong but I don't think it has approval in the British or Irish health systems

It's a shame because it is a less expensive drug doing exactly the same job

There is no approval probably, but you can order it of course. Only the insurance will not pay for it.

[Bill]

DMF is a cheap industrial chemical out of patent for the treatment of psoriasis. Unsubsidised, the raw material costs me about 13 cents per dose, compared to over £13 for its Fumaderm equivalent. To me, a mark up of over 100 fold seems a tad excessive.

Cheers,

Bill