Antibiotics Methotexrate and Benpali

[Jackadoodle]

Hi could anyone explain to me why you cannot take antibiotics, Methotrexate and Benpali at the same time. Many Thanks.

[oldtimer]

If you need antibiotics, you need your own antibodies against infection to help your body to fight back against the infection.

Drugs to reduce Rheumatoid Disease act to reduce your antibodies which are attacking your joints (or other bits of your body). So they reduce your ability to fight off infection.

However, as drugs like Methotrexate have a long term effect, I can never see the point of stopping them in the short term and opinions seem to vary between medical advisors.

[Hidden in reply to oldtimer]

I agree with all this. I was told that you absolutely cannot take biologics and antibiotics. I asked about methotrexate as I'm taking antibiotics regularly and my rheumatology nurse said "it's really not ideal but it's your call". Some antibiotics cannot be taking at all when you're on MTX. Not all GPs know, so you need to get them to check.

[New50 in reply to Hidden]

I’d like to live at least till I’m 90 plus

[helixhelix]

There are a couple of specific antibiotics that are contraindicated with methotrexate - so they cause a bad interaction. Apart from that it's a case by case decision, as depends on the severity of the infection, your general state of health and so on. I generally have been told not to stop my methotrexate, as old timer says 1 week doesn't make a deal of difference. However, I did stop this week just because I felt so rubbish! No antibiotics involved.

As for Bengali, I don't take it so no experience with that and antibiotics.

[Jackadoodle]

Many thanks for the replies.

At the moment I have injections for Methotrexate and Benepali but take a maintenance dosage of Ciprofloxacin 500gr every night,as I don't want to become immune to the antibiotic as I am informed that it is a strong antibiotic I am a little concerned and was wondering if this is common practice.

[nomoreheels]

There are some antibiotics that it's advised aren't taken concomitantly with MTX, generally those that are penicillin, tetracycline & sulfa based because they may inhibit the elimination of MTX & allow a build up in the bladder & kidneys, increasing the chance of toxic side effects. Specifically the BNF states - excretion of methotrexate possibly reduced by ciprofloxacin (increased risk of toxicity).

I don't think there are any current guidelines for Benepali, or being a biosimilar of etancercept the guidelines for that apply? If that is the case as far as I'm aware no no antibiotics are listed as interactions.

I would think you'd be best advised by your Rheumy, particularly as you're on a maintenance dose of a listed possible MTX/antibiotic interaction.

[New50]

Biologics is another drug

[New50]

Taking drugs full stop is a downward spiral

[Jackadoodle in reply to New50]

A head in the sand comment, if you had suffered are are suffering from Rheumatoid Arthritis you will know that the relief from pain with these drugs allows us maintain as normal a life as possible. I am mobile with my prescriptions where before I was restricted in my movements.

[New50 in reply to Jackadoodle]

I just want to know about the drugs as I’m terrified to take them. I too am limited in movement and have been misdiagnosed for over 18 months and still waiting to be seen by a rheumatologist. How do they make you feel physically? Do you have to take other meds with them?

[Jackadoodle in reply to New50]

Everything is not rosy when you take drugs but if you see your rheumatologist they will put your mind at rest and you should be able to get some relief from pain,you do not get immediate relief it does take a few weeks for medication to get into your system so just be patient and I hope that you are successful in your pain relief.

[nomoreheels in reply to New50]

I'm sorry you feel that way but it is a huge generalisation. For many, no most of us they keep up upright & relatively pain free. I had experience for example of 3 months off mine through no fault of my own after 4 years of being well controlled, I would go as far to say very near normality. Those 3 months were hellish, 2 so bad I great difficulty doing much at all. I've never got back to where I was before, even with the addition of low dose steroids for a little over 6 years.

If you've had a bad experience them I'm really sorry for you but persevere with trying the ones your Rheumy prescribes, there will be one or a combination out there for you. Unfortunately with RD not everyone responds to the same meds but as long as we try, eat healthily, avoid any foods that can exacerbate joint pain & inflammation, aren't sedentary & exercise as we are able then we stand a better chance of having better control.

There's no cure as yet, it's being worked on but there isn't one yet. So, the option is meds or trying dietary plans which some respond to, others don't & unfortunately you've no way of knowing & most take real perseverance & time. Meantime you've no way of knowing what longer term problems there may be.

I hope someone (Rheumy, Nurse or even your GP) is able to help explain that meds really aren't anything to be frightened of taking. Whilst it's true they're not Smarties neither are they prescribed for you if they're not really necessary. It can be difficult if you've not needed any specialised meds before, I appreciate that but accepting that they're necessary doesn't you'll be set on a downward spiral. It's a differing experience for each of us so no one story will be the same but please don't be afraid of trying. If you're in a position to attend at short notice do ask your GP to request you're put o. the cancellation list for Rheumatology, especially as you've had one misdiagnosis. The earlier you are seen & started on treatment the better the prognosis.

I hope you understand & your GP is successful in either bringing an appointment forward of adding your to the cancellation list.

[Hidden]

I’ve never been told to stop taking methotrexate when on antibiotics but I have always had to remind the dr that I’m taking it and then they prescribe one that doesn’t interact with it. I’m on benepali too but luckily haven’t had to take antibiotics yet whilst on it.

[nomoreheels]

I know for MTX it's because some antibiotics inhibit how it's flushed through the kidneys & can lead to toxicity. There are some sulfa-based antibiotics sulfamethoxazole-trimethoprim & erythromycin-sulfisoxazole are a couple of the commonly prescribed. Also penicillin-based aren't to be taken with MTX except amoxicillin. If any of the ones are not recommended but are the best antibiotic for the infection we can can halt MTX until the course is finished, some say not to restart it until at least two days after.

I'm afraid I don t know about any interactions with Benepali but I would think being the biosimilar of Enbrel it would be similar though I'm not sure. Similar to MTX though halting it whilever the antibiotics are doing their work would make sense, giving them a better chance to fight the reason their prescribed.

[New50]

I just hate how I feel, I just want to feel normal and do things like I used to without pain and feeling so tired. I could understand if I was a few stone over weight or didn’t try to eat well, don’t get me wrong some feelings have subsided but I’m not back to normal and the thought of taking the drugs is not my first choice xxx

[New50]

Have you looked at how many people feel more fucked up from taking the drugs more negative reply’s than positive on this site are you selling the ideal of the drugs