Methotrexate can cause nausea and may affect the production of blood cells. Long-term use can cause liver damage. People who have liver disease should not take methotrexate, and you should not drink alcohol when taking it. Methotrexate can be very harmful to a developing baby, so it's important that women use contraception and do not become pregnant while they take this drug and for at least 3 months after they stop.
The safety for men fathering a pregnancy while taking methotrexate is less clear. As a precaution, men are advised to delay trying for a baby until at least 3 months since their last dose of methotrexate. Ciclosporin is a medicine that suppresses your immune system immunosuppressant.
It was originally used to prevent transplant rejection but has proved effective in treating all types of psoriasis. It's usually taken daily. Ciclosporin increases your chances of kidney disease and high blood pressure, which will need to be monitored. Acitretin is an oral retinoid that reduces skin cell production.
It's used to treat severe psoriasis that has not responded to other non-biological systemic treatments. Acitretin has a wide range of side effects, including dryness and cracking of the lips, dryness of the nasal passages and, in rarer cases, hepatitis. Acitretin can be very harmful to a developing baby, so it's important that women use contraception and do not become pregnant while taking this drug, and for at least 3 years after they stop taking it.
However, it's safe for a man taking acitretin to father a baby. Apremilast and dimethyl fumarate are newer medicines that help to reduce inflammation. They are taken as daily tablets. These medicines are only recommended for use if you have severe psoriasis that has not responded to other treatments, such as biological treatments.
Biological treatments reduce inflammation by targeting overactive cells in the immune system. They are usually used if you have severe psoriasis that has not responded to other treatments, or if you cannot use other treatments.
Etanercept is injected twice a week, and you'll be shown how to do this. If there's no improvement in your psoriasis after 12 weeks, the treatment will be stopped. The main side effect of etanercept is a rash where the injection is given. However, as etanercept affects the whole immune system, there's a risk of serious side effects, including severe infection.
If you have had tuberculosis in the past, there's a risk it may return. Adalimumab is injected once every 2 weeks, and you'll be shown how to do this. If there's no improvement in your psoriasis after 16 weeks, the treatment will be stopped. The main side effects of adalimumab include headaches, a rash at the injection site and nausea. However, as adalimumab affects the whole immune system, there's a risk of serious side effects, including severe infections. Infliximab is given as a drip infusion into your vein at the hospital.
You'll have 3 infusions in the first 6 weeks, then 1 infusion every 8 weeks. If there's no improvement in your psoriasis after 10 weeks, the treatment will be stopped. The main side effect of infliximab is a headache. However, as infliximab affects the whole immune system, there's a risk of serious side effects, including severe infections. Aspirin can help reduce pain, swelling and stiffness.
Otezla inhibits an enzyme known as phosphodiesterase 4 PDE4. This enzyme controls much of the inflammatory action within cells, which can affect the level of inflammation associated with psoriatic disease.
Learn more about Otezla. Aimed at reducing psoriatic arthritis inflammation, Xeljanz targets a specific part of the immune system Janus kinase to reduce the overactive response associated with psoriatic disease. The oral treatment also aids in reducing joint tenderness and swelling.
Learn more about Xeljanz and Xeljanz XR. NPF Patient Navigatiors can answer your questions about oral treatments, including understanding their side effects and helping assess potential risks.
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Helpline Methotrexate Trexall belongs to a drug class called antimetabolites. This drug is given to people with severe psoriasis who have not had much success with other treatments. It can slow the growth of skin cells and stop scales from forming. Your doctor may recommend a folic acid vitamin B supplement to help protect against some of these side effects.
In rare cases, this medication can cause serious, life-threatening side effects. The risk of having these side effects increases with higher doses of the medication. In , the U. According to the FDA , the more common side effects people experienced during clinical trials included:. People who were taking this drug also reported depression more frequently during clinical trials than people taking a placebo. Systemic treatments also include injected prescription drugs.
Still other treatments include light therapy and topical medications. Some injected drugs alter the immune system. These are known as biologics. Biologics are approved for treating moderate to severe psoriasis.
This treatment involves controlled exposure to natural or artificial ultraviolet light. This can be done alone or in combination with other medications. Topical medications are applied directly to your skin.
These treatments generally work best on mild to moderate psoriasis. In more severe cases, topical treatments may be combined with oral medication or light therapy. If you have psoriasis, discuss your treatment options with your doctor. As the disease progresses, you may need to change your treatment. In these cases, oral medications may be a good option. Also talk with your doctor about how these medications may affect you. More Information Psoriasis care at Mayo Clinic Psoriasis and clinical trials Psoriasis treatment options Photodynamic therapy Psoriasis: Get the most out of your treatment Show more related information.
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Gluten sensitivity and psoriasis: What's the connection? Is the Mediterranean diet good for psoriasis? Psoriasis: How can I protect my skin during a workout? What's the best way to manage scalp psoriasis? Show more related information. Share on: Facebook Twitter. Show references AskMayoExpert. Mayo Clinic; Dinulos JGH. Psoriasis and other papulosquamous diseases. In: Habif's Clinical Dermatology. Elsevier; Accessed March 5, Psoriasis clinical guideline. American Academy of Dermatology.
Natural Medicines. Accessed March 6, Bolognia JL, et al. In: Dermatology. Saunders Elsevier; Richard EG. Accessed March 16, Feldman SR, et al. Treatment of psoriasis in adults. Fish oil. Kermott CA, et al. Time; Oregon grape.
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