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Shingles and methotrexate

Hello all,

Some advice please. Due to take my methotrexate today but had to go to docs with suspected shingles. Diagnosis was confirmed and have started on antivirals so hoping disease will not develop. This is the 3rd. time I have had shingles over the last few years and guess it is due to the fact that I am immunosuppressed due to rituximab.

Know not to take metho when on antibiotics, but does the same apply to antivirals? GP didn't know! So hoping the antivirals work like last time 'cos the first time suffered for months. Please advise if you have experienced this issue. Thanks.

Also, does anyone know if I could get the shingles injection given my medication. Am only 64 so would probably have to pay as only give it if you are over 70. Read on line this evening people with RA are twice as likely to develop shingles, maybe due to immunosuppression caused by various medications.

Thanks for help.


9 Replies

Hi scorer.

I find this absolutely amazing that your GP, didn't know about antivirals ---I have read that right haven't I?

Who did they think was going to tell you if he didn't know.?potentially this could have been quite dangerous.

Sorry I can't advise you as i haven't been in your situation but it may be worth putting in a call to your local pharmacy in the morning and ask for the advice of the pharmacist- they may be able to help.If not then try your out of hours surgery.

Unless someone else on this forum has any experience of antivirals or better advice to give you I would treat with caution until you have the answer.

Hope you get sorted soon.

Take care.



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Ring your rheumy at the hospital or as Crusee said speak to your pharmasist.xxxx


Hi Pam,

I'm so sorry to hear you have shingles, it is a horrible thing. Funnily enough I just posted a reply to another sufferer yesterday. I have suffered repeated attacks of shingles since I was 21, (I'm now 61), well before the RA set in.

To cut a long story short, you are safe to take the antivirals , in fact that's what will help reduce duration of the shingles quicker, however they will not work as well if you start them after the lesions appear as the attack will be quite advanced by then.

Definitely stop the methotrexate whilst taking the antivirals as you need your immune system at full strength to cope with it and don't re- start until you feel better or at least until the sores have dried up. Perhaps at this stage also see the doctor as the leaflet in the methotrexate packet tells you to! (Well actually it says chickenpox, but it all amounts to the same illness!)

The nerve pain from shingles can go on for a long time after the attack has finished and paracetamol, ibuprophen or co codamol are best for that. It can make you feel very tired and debilitated.

If your sores/rash are really itchy you can also use anti histamine and bathe them in salt water for relief. I always find creams no use to soothe the heat and tenderness but calamine lotion works well.

Once I was put on mtx my doctor allowed me to go on aciclovir at a low dose permanently as a prophylactic because I was getting shingles up to three times a year - as you say it's probably because of our faulty immune systems. You could ask about that if your attacks become regular. I was told it is a very safe drug and the relief of not getting the shingles all the time is wonderful.

Hope this is useful to you, get well soon!



I don't think that it will make much difference whether you take your MTX or not. It is in your system for so long building up that the immune suppressant affect doesn't just turn off if you miss a dose. You should check with the pharmacist that there is no interaction between MTX and your antiviral medication. They have a site or reference book they can consult.


I would certainly ask a pharmacist - they are generally more informed about medicines and their interactions (it's their Job!) than some GPS. Or a call to your rheumatology department.


Maybe ask your pharmacist but I think you need to stops MXT while on antiviral shut not 100% . I know there are quite a few drugs that interact with MXT.


What I suggest is Google MXT interactions and see if your anti viral is mentioned. There are 3 groups start with red and work down to green.

Hope you feel better soon. I had shingles a year before RA diagnosis and 18 months later I continue to have symptoms.


I'm just getting over shingles, posted the other day about it. You may fare better than me as you seem to have got treatment early. I was given antibiotics and antivirals and the doctors treating my shingles at hospital spoke to my rheumy and was taken off methotrexate and Humira to give my immune system a better chance. Back on them next week now my antibiotics and antiviral are finished. All doctors have different ideas it seems so talk to your Rheumatology Dr or nurse if you can.


Hi I also have had shingles 3 times could not take my methotrexate while taking antivirals they helped a lot. I have Psoriatic arthritis have taken Methx

For over 2 years I was told no shingles injection till I'm 78 but they gave it to my husband who has never had shingles, I have a year to wait for mine. I feel for U and hope U are on the mend soon, we have enough to put up with our arthritis. Kind regards Marian


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