How would I know if MTX is affecting my lungs?

I have been on MTX for 3 months and doing well. I also have bronchiectasis as a result of lung damage from whooping cough when I was 3 years old and had a partial lobectomy (part of lung removed ) when I was 16. I am now 63. I have a productive cough all the time but how would I know the difference from my normal cough and a MTX related cough. Anyone had this problem?

15 Replies

  • I suspect you would have a temperature if it was a lung infection due to mtx lowering your immunity xx

  • I suspect you would have a temperature if it was a lung infection due to mtx lowering your immunity xx

  • Mxt definitely makes me breathless but this kicks off with a cough every time. When I am taken off the Mxt it all removes in about two months. Certainly if you have an ongoing cough see the doctor and or call your rheumy nurse.

  • unfortunately I have had an on going cough for 60 years due to the lung damage so you can see my problem as to what is my normal cough and what is an MTX cough. I think probably the best thing to do is to ask my Rheumy what early signs to look out for in my case. I'd rather not get to the breathless stage before I report it as a problem.


  • I've wondered about that too. As RA can effect lungs, perhaps lung capacity checks should be added to the tests we have yearly? Any views anyone?

  • When I was first diagnosed last year, I was given the usual x-ray and my chest x-ray came back showing I have nodules on my lungs so I was referred to a chest consultant as also suffered with a cough since December last year since having a chest infection, I have had lots of test and CT scans and have been told that it is part of the RA and the nodules have been caused by the RA and have been told that I may get more with every chest infection I get.

    I am being monitored every 3 months and being given different medication to try and help with the cough in trying the keep my throat and nose clear which then can reduce the irritation to help the cough.

    I have been told that my chest consultant will work along side my RA consultant and I have to say they are really good as I need someone to be good as my G.P is no good as they never listen as I really don't feel that they understand this condition.


  • I'd certainly ask your rheumy at next appointment. But I wonder whether you've answered your own question - as if the cough hasn't changed, and is your "normal" cough then it sounds as if the MTX hasn't made any difference? Hope not! Polly

  • Thanks for all the replies and I shall certainly talk it through with my Rheumy next time I go to the hospital and perhaps ask if I can have an X-ray a few months down the line just to check that everything is okay. I have done so well living with bronchiectasis for the last 60 years I hate to think that MTX could mess it all up.


  • Hi,

    Only just got to your question. I had pneumonitis due to MTX and the cough was non productive and sort of tickly rather than a full blown cough. Kind of a breath catching cough, if that makes sense. Severe breathlessness at the same time. Not a pleasant experience. But cleared up after a short course of steroids and anti biotics as a precaution.

    I'm now taking part in a country wide assessment to see if pneumonitis can be predicted in MTX patients genetically.

    All the best


  • Thanks for your reply Carolyn. I have had a hard tickly cough on a few occasions but it has cleared up on its own so again not sure if it is MTX related or just me. Had no breathlessness though so perhaps its just me. Woken up to a sore throat this morning so keeping an eye on that. May have caught it from my grandson as he has a cold at the moment.


  • For me the methotrexate always makes me very breathless and wheezy for 24 - 36 hours after injection. it's as if my lungs are full of sand and I have a dry tickly cough, I feel as tho I cannot get any air into my lungs, I can't do anything without blowing and puffing like a steam train, been taking mtx 11 years and its always been the same so I know it's the mtx. Last year diagnosed with bronchiectasis, ct scans confirmed it is the ra that has caused it and not the mtx (although it can), so now I too have a permanently productive cough and have had chest infection after infection, so now loads of antibiotics as well, not sure if this helps you, but that is how mtx affects my lungs.

  • Sorry I forgot to ask you, what do you take to control the bronchiectasis, I'm curious, I have been given a steroid inhaler to do twice a day and a ventolin inhaler, but I think that's more to do with asthma, been to respiratory physio a few times to learn how to clear my lungs of fluid, thanks Lorrayne

  • I don't need to do anything on a daily basis although I do know how to clear my lungs of fluid and do so when sometimes I feel like I am breathing through treacle. I am also allowed to have antibiotics at home on repeat prescription so I can self medicate if I feel I have a chest infection. Before being able to treat myself I used to wait to see if it would clear up on its own ( ever the optimist ) but it never did so by the time I got to the doctor the infection would have got a good hold and take longer to clear up. Having lived with this condition for so long I know how my chest feels but of course I am careful not to overdo the antibiotics but my doctor trusts me.

    Since retiring from work in a big office environment I have not caught so many colds so have not had as many chest infections. I also have a lung function test once a year.


  • Thanks Jean, I too am ever the optimist and always wait to see if chest infections clear up on their own, of course they never do! and so I also now have a box of antibiotics in the cupboard. Breathing through treacle, I love that description. Take care Lorrayne x

  • Its not just infection that can harm lungs - pulmonary fibrosis can also happen along with rheumatology disorders and that causes that dry irritating cough and shortness of breath. The best way (I think) to identify that is with a chest xray - it will look like there is a little snowstorm on the xray plate. I think if you have had lung problems in the past, and you haven't had a chest xray for a few years, then it might be worth asking your GP about doing that.

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