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Taking medicine for RA. Unable to bend knee. Safe to take rituxan infusion along with methotrexate?

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Practicing since : 1999
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I was diagnosed w/Rheumatoid Arthritis 4 yrs ago. I've been on mult meds, incl: Methotrexate injections, Sulfsalazine tabs, Arava, Plaquenil, Enbrel, Prednisone x yrs (just 'weaned off completely 40 days ago) I also have Orthopedic problems. Right Knee replacement July 2009 & same replacement 'fell apart' in my knee 3 yrs later. This past summer (June 2012) had total Revision replacement on same knee. Rountine xrays of left knee shows need for replacement of that need now too, which makes sense after the 'wear & tear' it's sustained these past few yrs . So, in addition to RA pain/discomfort, I have RA pain & discomfort. In the morning, I simply cannot bend my legs. I'm 59 yrs YOUNG and wound like some repair to keep me going another 30 yrs at least!

My question: Tmw, I am beginning Rituxan Infusion. Prior, was on Orencia Infusion, Plaquenil & Prednisone, in addition to Percocet. From what I've read, Rituxan is to be taken with Methotrexate. That was the first drug/injection I started and the nausea & hair loss was very difficult on me. Dont mind self-injection...just the side effects. Sorry for going 'Around the block ' to get back to my questions.......Is it mandatory for Methotrexate to be take with Rituxan?
I respectfully thank any of you that take the time out of your busy day to help me with my concerns. It seems I'm more concerned about the RA meds, than the actual disease itself. Prednisone for 2 1/2 yrs straight just about was the end of me!
Any reponse will be deeply appreciated. Most sincerely, XXXXXX
Posted Mon, 15 Apr 2013 in Lupus
Answered by Dr. Divya Agarwal 9 hours later
thank you for writing in.
Rituxan infusions are a good option. Unfortunately, they work much better if you take it along with methotrexate. However if you are completely intolerant to it the medicine will still work and so it will still help your arthritis.
The other thing could be to take methotrexate in a lower dose, maybe 10-15 mg, which is less than the usual dose of 25-30 mg and may be some symptomatic medicines like ondansetron for the nausea and leukorin for the hair loss.
I hope I have been of some help, feel free to get back to me with any query you have.
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