Does anyone know why it is you should not come into c... - NRAS

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Does anyone know why it is you should not come into contact with chickenpox whilst taking methotrexate,

Also is it true you should not take ibruprofen whilst on methotrexate.

9 Replies

Hi diamondlights,

As you are probably aware methotrexate belongs to a group of medications called DMARDs( disease modifying anti rheumatic drugs) and is a medication used to dampen down the over activity of the immune system in someone with RA and other inflammatory conditions. However it may also reduce your ability to fight infections and this can be a problem for some individuals.

Chicken pox and shingles can be quite severe in people that are taking treatments that affect their immune system such as methotrexate. However it is not always possible to know if you have come into contact with someone that has chicken pox as they are most infectious 1-2 days before the rash appear and until the spots have crusted over ( usually 5-6 days from the start of the rash)

If someone on methotrexate suspects they have come into contact with chicken pox or develop symptoms they need to contact their GP or rheumatology team as soon as possible. They may be given anti viral treatment and methotrexate may be stopped if they do develop chicken pox and restarted when better.

Regarding taking ibuprofen which is an anti-inflammatory and methotrexate, you will find that lots of people do take anti-inflammatories and painkillers alongside their DMARDs (like methotrexate) but it is always best to check with a health professional as everyone is different. The GP or a pharmacist should be able to answer this question for you.

Hope this helps diamondlights

Best wishes



Many thanks, it was my pharmacist who told me not to take ibuprofen with methotrexate.


My understanding is that its something to do with potentially getting shingles because your immume system will be low (due to the MTX). Hope that helps


It's my understanding that ibuprofen increases the toxicity of methotrexate so pharmacists will often warn us not to take both. Unfortunately though anti inflammatories like ibuprofen are an important part of treating the pain of ra so we can be advised to take them by our rheumatologists. While having treatment with methotrexate we have regular blood tests which will hopefully pick up any potential problems in the early stages. We have to weigh up the benefits against the risks so I take ibuprofen but try to keep it to a minimum.


hello paulywoo and all, I am on ibuprofen and methotrex, but have heard that regular use of ibuprofen can bring on a heart attack, and not sure of this info, so is any-one clued up as to the authenticity of this claim? bluetit33


Hiya bluetit33. From what I've researched, for my own peace of mind since questioning etoricoxib it seems only if you have a history of heart problems. The NICE guideline page!scenariorecommendation:5 explains further about MTX & NSAID combinations.

Hope this helps.


I believe there is an increased risk of heart attack from using nsaids such as ibuprofen but again we have to weigh up the benefits as opposed to the risks. There's a little information on the NHS Direct site if you follow this link

I just try to keep my ibuprofen use to a minimum. Compared to the side effects listed for my Leflunomide ibuprofen looks pretty benign. x


thank you nomoreheels and pulywoo and the link, very useful. as despite having r/a for 42 years, still get down with the constant pain. considering on all the heavy meds. but as suffered a duodenal ulcer in the past from nsaid having great trouble finding a pain killer that works, but does not give some other suffering. anyway, we are all in pain, so once again thanks for help. XX bluetit33


Thanks to all of you for the information. Wish you all well


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