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Hi everyone, have had a persistent cough for over a week now, not painful or anything, just annoying. I know this is mentioned in the possible side effects of Methotrexate so as I had a Physiotherapy appointment yesterday I mentioned it to her to see if I could go down and see the Rheumatology Nurses who are in the next corridor. I had ultrasound on my neck and shoulders and exercises for my knee, and the Physio said I sounded quite wheezy. She went to have a chat with the Rheumy Nurse who said I had to stop the Methotrexate immediately and get an appointment to see the Doctor before the weekend. She said we need to make sure I don’t have a chest infection. I left the Hospital and went straight to the Doctors, luckily they weren’t too busy and I saw a Doctor within 30 minutes. He said my oxygen level was slightly low and my temperature on the higher end of normal. My lungs sounded clear. He then said he wanted me to go back to the Hospital and get a chest x-ray to make sure all is ok, as I had inflammation of the lung in December. I now have to wait for the result to come through, should have the result within the week. Just wondering If I will I be able to restart the Methotrexate (increased to 20mg three weeks ago) when the cough clears, whether it is or isn’t a chest infection, or will I possibly have to change to something else, I can’t remember if I read somewhere that if you get a cough you can’t stay on it, or have I dreamt that. Seems like I am joining in with some of you and adding something else to the recipe of this disease. Oh well at least I haven’t been wiped out today with Migraine from the Methotrexate, always look for a positive lol.

Hope you are doing ok.


15 Replies

I've had a "crackly" cough since mid-May, my GP put me on a course of antibiotics (can't remember the name) which didn't clear it then another (different one) which doesn't seem to have worked completely either. Had to go for a follow-up chest x-ray yesterday so I should know fairly soon if I need another course of them. It turned out to be pleurisy and the doctor even mentioned the possibility of pneumonia.

All through this I've stayed on the Methotrexate, not even reduced my dosage.

I've never had asthma or anything like that, and am not prone to chest infections.

Hope you feel better soon happygranny!


I've only recently restarted Methotrexate and AntiTNF Enbrel injections following a chest infection and endless tests. I was working towards a double knee replacement for which the RA needs to be well controlled ( even though I have to stop the Enbrel two weeks before op and until wounds have healed).

But now I've got another infection. Cough, fluey ache and increased fatigue. GP prescribed antibiotics but agreed I should only take them if the fever persisted. It didn't, though I still feel mildly fluey and I still have an unproductive cough and wheeziness and pain in the ribs. I won't take the Enbrel this weekend and will check with Rheumy before the MTX is due again next Wednesday. That probably doesn't help much, but you have my empathy! Jora


Mo-warden- I am surprised you have stayed in mtx when you had pleurisy. I have always been told to stop mtx whilst on antibiotics. I would definitely ask your rheumy next time you see them. Does not seem right.

Sue- Because you have a chest infection does not mean you have to stop mtx forever. I have been on mtx 20 years and had a few chest infections and other infections. I restart when I'm better/finished antibiotics.

You say you have had an inflamed lung in Dec, sounds like your gp is being very thorough in light of this as I have never had my oxygen saturation levels taken at the docs or been sent for an X-ray. Coughs can be caused by loads of things not always infection. I've had a cough since December. It's caused by a nasal drip I have ( rhinitis) which I've had for 3 years. GP not in the least concerned and neither am I.

So don't worry. Wait for your X-ray result and advice from your GP.

Take care



I developed pneumonia and couldn't shake it off, finally after three different X-rays and numerous Doctors, I was advised to stop my methotrexate for two weeks, chest cleared up almost immediately


Thanks for your replies. Good to know I don't need to come off methotrexate forever because I do feel as though it is starting to help. The medical team are certainly keeping a close eye on me which is good, I read a lot about people not being happy with their medics but I certainly have a good team. I'm not on antibiotics or anything at the moment, waiting for x-ray results. Don't feel too bad, just the cough and wheezy, didn't sleep much last night. I'm not worried about it, just putting it down to the weather, as I do suffer with hay fever and allergies. Hope you get your knees done soon Jora, must be frustrating getting one infection after another.

I have two weeks holiday from work now so will be visiting the Yorkshire show next week and days out and about, will have rest days in-between trips. Hope it's sunny where you are, if you can tolerate the heat without it causing you problems, have a lovely day.



I've been on MTX 6 years now Sue & had to stop it a handful of times due to chest/lung problems but always gone back on it once the problem has cleared so don't worry yourself too much, stress isn't good for RD either. Maybe you'll need to reduce the dose, just for a while, or need a course of antibiotics, just be guided by your Rheumy, he knows what will be best for you & there are other options if it's the MTX which is causing your problems. Interestingly I was told at my last Rheumy nurse appointment that I don't need to stop my MTX when I need antibiotics unless I'm prone in bed.... no matter which, even penicillin based ones. I had a spontaneous pneumothorax years ago so prone to chest problems now & again & used to have regular chest x-rays as a result but often don't need to stop it though obviously that's not the case with you just now.

I hope your migraine has eased, horrible things, I sympathise & hope it eases away soon. Have a lovely fortnight & hope the weather stays good for you. x


Thanks for your reply nomoreheels, hopefully I will go back on methotrexate once this cough shifts and we get x-ray results back. Sorry to hear you suffer with chest/lung problems on top of your other issues. I won't worry about it, pleased to say I am not the worrying kind, just carry on best I can, so hopefully won't cause any additional pain by stressing. Looking forward to time away from work, can be hard sometimes working full-time, so change of routine will be good for me I'm sure. Had a lazy afternoon, it's been very muggy here, so haven't much go in me today, that's my excuse anyway lol. Clouding over now though. Hope your feet are behaving today. X


Sorry Sue, only just come across your reply. It would be a shame if you couldn't go back on MTX, particularly as you feel it's starting to work for you but you can only do as your Rheumy advises because of course it will be best for you, but let's try to keep positive & that it's not the MTX causing it. I do wonder if you're similar to me though in that I don't tolerate going up to 20mg but it's my liver that reacts not my lungs, could be worth asking when you next see your Rheumy. My chest rarely bothers me except for when I have a cold as it always settles there but my GP throws antibiotics at it so it never results in anything. I do still have a tightness in that lung though so I know if something's afoot usually. It was my first Consultant who was uber careful & had it written in my notes for the x rays which my further two Consultants adhered to. This was in Spain of course & there's no limit to testing, imaging etc, here I've just had the one set of x rays & a DEXA scan in 2 years but hey ho, if anything happens no doubt I'll have them!

I hope your cough has eased somewhat & you're relaxing as much as possible before you go on your days out. Enjoy them & I hope the weather is kind, it will be fine tomorrow as it's my birthday & it never rains lol!!! P x


Maybe I will stay on mtx but as you say a lower dose. No noticeable change with the cough but have been really tired today. Just been watching Wimbledon so taking it easy. Best wishes for a lovely birthday tomorrow. X


Aw, thank you for your birthday wishes Sue, not impressed though it's been raining all morning & only stopped this last hour hump but on the plus side I have had some lovely pressies!

Sorry there's no change in your cough, was there anything your GP could suggest to help it, or maybe it would be worth a trip to your local chemist & ask the Pharmacist, as long as he/she knows what you're meds are then they should be able to recommend something which might ease it a little. I hope this won't scupper your fortnight off.

Hope you were happy with the Mens's result. I would have been happy for either of them to have won but secretly I would have liked Federer to have won.

Take care & I hope things improve soon. P x


Never rains on your birthday? Rained here on and off all day too. Pleased you are happy with your pressies. Not taking anything for cough, yet. Doctor said to wait until we know results, then if necessary will go on to antibiotics. Just about the same, can't say there's any change yet. I wanted Federer to win but to be fair I think Jokovik played better. Just been to see my granddaughter, she turned one a week ago and is such a happy little girl. Won't be long before before she's walking now, just at the hanging on to finger stage. Going to Yorkshire show tomorrow, love it. Take care.


Aw, love it. I remember my Goddaughter when they visited in Spain, I was on edge whenever she was on the move because of course everywhere was tiled so I put all the chairs & settee together so she could hold onto those as she'd just started walking but not so steady on her feet. Thankfully we had no falls of note!

Our doctors are careful with antibiotics now. My h has had a chest infection since his op in Feb & has been given a pot to give in if his cough worsens. He's already had two lots of antibiotics so they're holding back until absolutely necessary. I hope it goes of it's own accord & you don't need them.

Enjoy Yorkshire, lovely county, I have an affinity with it as we went many weekends when we were courting. x


Hi happy granny, I've had RA for 16 years,and I also developed a nagging cough about 5years ago.i had chest x rays,and a cat scan,which showed I had developed bronchiaiastatis, a side effect of RA,where the tiny tubes in the lower lung get blocked with mucus,coughing is the bodies way of trying to clear the airways,I see chest consultant,and have regular lung function tests to see how things are.at first sign of cough getting persistent ,I.e.,all day I take a antibiotic 3times a week to try and stop any infection, sometimes it stops infection, but other times have had real bad chest and long course of antibiotics to clear things,problem being, all infusions stop for weeks until chest clear. I hope you find this useful, and you find out what the problem is. Good luck.


Thanks for your reply. No noticeable change yet. Just waiting for x-ray results to come through then Doctor will decide if I need antibiotics. Hope it's not the Methotrexate causing the problems. I will post again when I get results. Take care. X


My response is rather late. I too had to stop both Methotrexate and Enbrel because of a chest infection. I'm onto the second course of antibiotics. Like you, my chest sounded clear, but my fever was as high as 38.9. It is normal now, so I'm assuming the Clarithomycin is working. This is the second infection I've had in. A short space of time, so it's unlikely that I will be able to restart BOTH drugs. But I expect your rheumatologist will let you restart MTX,


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