NRAS
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Amoxicillin and Methotrexate

It's been a while but I have a 'middle' ear infection and a doctor I hadn't seen before prescribed me with Amoxicillin to take 3 pills a day for 5 days... is it okay to take this? I am freaking out because I've read that your kidney stops secreting the methotrexate and its toxic/fatal?

(I take 25mg methotrexate on Mondays)

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Trimethoprim is the antibiotic that is completely contra-indicated with methotrexate. Penicillins (and Amoxicillin is one of that group) are possible but only on a doctor's say so as they should judge risk/benefits etc depending on the rest of your medical history & general health. Did the prescribing doctor know you were on MTX?

If you don't know then can you call the surgery and ask to check? Or take the easy option and just not take your MTX this week!

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Ah I see, I did tell him but he is a new doctor at the medical centre I go to... he also searched up my rheumatologist aswell. I have only taken 1 pill so far so will wait till tomorrow and call my rheumatologist :) I shouldn't google things I stress myself out!

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Thankyou :)

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Googling isn't all bad - as learning about this disease is generally a good thing. I think it's important to be an active patient (even if it can drive some doctors mad). But just stick to the reputable sites - I think there's Creakyjoints offshoot in Australia, as well as your national health system. U.S. Sites tend to be much more alarmist than UK ones, and avoid everything that is trying to sell you something...especially if they say it will "cure" you.

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I have just had a saga with Amoxycillin 500mg. Also take 25mg mtx. The G.p I saw was unsure. I rang my Rheumy Nurse and I had to with hold the injection until I had finished the course. Unfortunately it did not clear my chest infection so had a further two weeks on doxycycline. Also no mtx while on this.

It is best to double check with your Rheum team if in anydoubt.

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My rheumatologist just said to take it so I guess he thinks it will be fine. I hope it works and clears the ear infection. So many pills ahah.

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Always best to check. We are all different and infections. Hope it works for you and clears it quickly.

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It is a regular do-you-don't-you question. In the past I've always not injected whenever I've been prescribed a course of amoxicillin (other antibiotics too) but last time my Rheumy nurse said that wasn't necessary unless you're prone in bed. Common sense tells me that if I temporarily stop MTX it'll give the antibiotics better chance to sort the infection so unless it's likely to be a long term or stubborn problem I don't inject until I've finished the course. Always best to check with the prescriber or your Rheumy though as no one person's the same. I hope you respond well, ear infections aren't pleasant.

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I take 20mg of mtx a week in tablet form. I also have a chronic lung disease and asthma so have been on doxycycline since Christmas 2015, with amoxicillin as an emergency med. I have never been told to stop the mtx, and my kidney function is ok so I guess it depends on the person. Hope you get sorted.

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Yeah guess it depends on kidney and liver function! Hope you're doing okay.

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