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Shingles and use of Methotrexate

Hi. I'm new here, 65 yr old active female, have Ra for 15 years and am on methotrexate for 8 months now. Got shingles 3 weeks ago and suffering with rash and pain. RA dr says stay off metho for 2 weeks so I go back on Sunday but am reluctant because of immune sys suppression en Iam not healed from shingles yet. Anyone else dealt with this.

5 Replies

Yes, I used to get repetitive shingles attacks (up to three a year) and am also on mtx. My advice would be to stay off the mtx until you feel the shingles has completely cleared up. This is usually when the lesions are dry and scabbed over (like chicken pox). However the itching, the pain in the nerve line affected and general depressed feeling may continue considerably longer. You will need all your energy and full immune system to fight the shingles so don't start back on mtx until you feel right in yourself. I have stayed off my mtx for up to 6 weeks with no ill effect before now. If this worries you have a chat with your doctor or rheumy nurse. Were you given anti viral meds to help you cope? If you were, make sure you take the full course for best effect because they do speed up recovery rate. However if you weren't given any, they are not very effective started later on, ie if the lesions are already present - you have to start them at the first signs of itching and soreness.

Perhaps I should just say, don't be worried that your shingles will repeat like mine do - I am an unusual case and most people only get it bad once. I am now on a prophylactic to help suppress mine.

Best of luck, shingles is a horrible illness. Hope this helps you decide.

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I'm still recovering from shingles. Had it on my face. Still got tingling and pin prickly feelings in my face. I was taken off the methotrexate and Humira while being treated and told to go back on it 2 weeks after course of antiviral treatment finished. I was very reluctant to go back on it for fear of shingles returning. Left it a couple of weeks but my RA has started flaring now. I was admitted to hospital with my shingles so the hospital are keeping and eye on me. Got what is my final check up at the maxillofacial dept later today. They do their best to put my mind at rest telling me the tingling is normal, but I am living in fear of it coming back.


Thans or responding. Sorry to hear you are having a difficult time and hope you get relief soon. If it helps any, I have a friend who is now 102 and fully recovered from a bad bout of facial shingles 3 years ago. She is a joy to be around and still active with no lingering pain from the shingles.

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Hello, I have had RA for 28 years. I am now 68, and have had a problem with chronic shingles the entire time I have had RA. It always breaks out along my sciatic nerve on my left buttocks. If you take methotrexate, my brochure that comes with my prescription says do not stay in the sun for an extended period of time while using Methotrexate. I have found, just being overheated, or stressed can cause a breakout. I also get a headache just before I breakout. I do not have any other problem with getting headaches. Also, I take Zovirax once daily for maintenance, then if I break out, my prescriptions says I can take five daily. I have gotten where I can feel the tingle when a breakout is about to happen, so I take extra Zovirax, and it keeps me from having a really bad breakout. If your breakout was/is on the face, I am sure the doctors are making sure it does not get to your eye. I am not a doctor, so you might want to ask your doctor about wearing sunscreen on your face, all the time, even if you are just driving your car and running errands. I am sure different people have different experiences. Most people will only breakout with shingles once in their life. But since RA is an auto-immune disease, we are different "animals". But, if I were you, and I felt any tingling in my face, I would definitely consider that a sign of an imminent breakout. I even got the shingles vaccine when it first came out. My breakout are not usually as bad since then, but I also have figured out the signals. Now they say there is a newer vaccine. When I got my vaccine, I also had Lyme Disease. I have had Chronic Lyme for thirteen years; 12 of those years, I felt like I had the flue everyday. It has really been a difficult time for me. I won't go on, as it is off-subject, and I could write a book. Please know that I hope your bout with shingles was the only one you will ever have to experience. I hope some of my experience will help you to talk to your RA doctor.


I too have just got over an episode of shingles. Have had it 3 times in 18 months so when latest episode started saw GP same day and got the antivirals which meant it didn't develop fully. You have my greatest sympathy as it can be a dreadful condition as I found out when I first had it 5 years ago.

I too am 65 and have had RA for over 40 years. Take metho, prednisolone and have Rituximab infusions amongst other things. Stopped the metho for 5 weeks this last time as I was also on antibiotics for concurrent campylobacter infection. Have now found out I have hypogammaglobulaemia and require immunoglobulin infusions. This explains my repeated infections.

I would encourage everyone who is on immunosuppressant drugs to monitor their own immunoglobulin levels. I had to see my rheumatologist privately to discuss my repeated infections and when he reviewed my blood results he found that I did have significant immunosuppression issues.

Best wishes.



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