Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
145 Doctors are Online

Suffering with Wegeners disease. Going to start on Cytoxan and Rituxan. Allergic to Prednisone. Alternative treatment?

I was diagnosed with Wegeners disease 2 weeks ago after being in remission for about 4 months. They just started
me on Cytoxan which I am to start tomorrow, and My doctor
has prescribed intravenous Rituxan to be started next week. I am allergic to prednisone. Is there a different med to take in its place? I read all the side effects for Vatican and Rituxan. Also, what are granulomas?? Should I be having
a second opinion as far as these drugs that have been prescribed. I am 59 years old and the anca is 1_640.

Thank you
Asked On : Wed, 9 Oct 2013
Answers:  1 Views:  1123
Report Abuse
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Drug/Medication
General & Family Physician 's  Response
hello there!
4 months of remission followed by recurrence shows you were not compliant with cytoxan and steroids and rituxan. Did u take all 4 doses weekly for a month of rituximab? what ever past is past
now that you have been started on these three meds i recommend to take them as prescribed and chances are your disease will go back to remission 90- 95 %. it would have been better if you would have stated the stage of the disease whether it is Localized, early symptomatic, generalised, or severe, or refractory.
we call the disease severe when the creatinine levels rise more than 5.6 and genralised when a vital organ like kidney etc are involved. .
minimize your exposure to ill contacts as you are immunosuppressed. and your prednisone issue yes you can replace it with methy prednisone IV 0.5 mg /kg/day .
there are some other treatment addition too for the comorbidities like deadly pneumocystis pneumonia a complication of immunosuppression. for that Trimethoprim-sulfamethoxazole thrice a day to be used for at lest six months after last dose of rituximab.

And Plasma exchange is also used it the disease is severe that is creat level >5.6 and disease is deterioriating.

ANd METHOTREXATE can also be used if the disease is localized or less severe 20-25 mg per week but it takes longer to reach remission with it.


IVIGs intravenous immunoglobulins, mycophenolate mofetils (2g/day) , etanercept, infliximab, 15-de oxyspergualin , antithrombocyte globulins, alemtuzumabs, abatacepts and stem cell transplants are some other treatment option but costly .

let sumarise
To induce remission you need
cyclophosphamide
rituximab
Pneumocystic TMP-SMZ prophylaxis
glucocorticoids
methotrexate (if local)

To mantain remission you will need
Azathioprine
methotrexate
leflunamide
glucocorticoids

I wish you good luck and get well soon.

regards
Dr Shafi ullah khan
My Patient is my family
Answered: Fri, 18 Oct 2013
I find this answer helpful

1 Doctor agrees with this answer

Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]
 

 

Loading Online Doctors....
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor