Doses of methotrexate and leflunomide PMR and in RA

Bhaskar Dasgupta

Are doses of methotrexate and leflunomide the same in polymyalgia rheumatica (PMR) and in rheumatoid arthritis (RA)?

Bhaskar Dasgupta: Yes, it is the same. We are using exactly the same dose, 15 mg weekly methotrexate that we start with. One interesting thing is that in PMR you can often use lower doses of leflunomide than you need in RA. My initial starting dose of leflunomide is 10 mg daily; sometimes I even start with 10 mg on alternate days. So you can get away with lower doses of leflunomide in PMR. There are some patients in whom I use even weekly dosing of leflunomide. And we have to tell the patients that they are likely to get some common side effects of leflunomide, such as diarrhea or loose bowel movements. But it works very well.

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