Methotrexate and antibiotics

I have been taking mtx for just over 3 months, and about 10 days ago I was prescribed antibiotics (Clindamycin) for an infection in my foot after breaking three toes (long story!). After speaking to the rheumy nurse, I skipped last Saturday's dose of mtx, but it didn't occur to me to ask when I should start taking it again. So, now it's Saturday again, and having had my last antibiotic at teatime on Wednesday, I'm not sure if I should take the mtx tonight 🤔 Can anyone advise?

8 Replies

  • I have had to stop Methotrexate several times, in order to take antibiotics for an infection. I've always re-restarted the MTX as soon as the course of antibiotics has finished. I suppose you need to be confident that the infection has cleared and that you won't be prescribed a second course.

    I hope that helps, though of course, I'm not giving medical advice.


  • You can take your MTX now. You can't take MTX while on antibiotics.xx

  • When I was taking penicillin, I had to stop for a couple of weeks to help body recover . Has your taking your last today possibly leave till next Saturday. Again it depends on medication.

    I'm only saying what I was advised to do.

    I hope this helps x

  • I would leave it another week as you need time to recover after the effect the antibiotics have on your system. It might be an idea to take a course of probiotics to put back what they took out. Good luck!

  • I guess the answer is? How do you feel arthriticly speaking? If you can go a few more days without taking the methotrexate I'd keep on. When I get sick and take antibiotics I always stop my r/a meds allowing my immune system to get a little stronger and usually skip two doses with doctors approval of, call the doc.



  • The only person who can really advise this is your own doctor as we do not know how severe your infection was ( especially with broken bones) or if it's actually cleared, sometimes when taking antibiotics you feel better in a few days, but doesn't mean the infection is actually gone in 3 days, which is why doctors tell everyone to finish them even if you feel better...your doctor should assess to ensure your infection is gone and you can resume Mtx. As you see all the answers in here are different because we each react so differently to drugs. Having an infection whilst having RA is a serious matter as it can turn poorly very quickly. I would ring your doctor and ask them.

  • Thanks for all your helpful replies - much appreciated.

    I eventually decided on balance to take the mtx as the prospect of a 'rebound' flare up of my psoriatic arthritis on top of everything else would be just too much to cope with. Rather frustratingly, my foot is padded and bandaged up so I can't actually see how things are looking, but it feels ok. I have a GP appointment this week, and I'm also expecting to get a home visit from the NHS podiatrist, so at least there are existing arrangements to get it checked, and if all else fails there's NHS24 and A&E!

  • I find my pharmacist is very knowledgeable on these things and gives great advice (better than most of the docs!) re meds and when to stop and start etc.

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