Methotrexate and seasonal illnesses

[chungy111]

Hello there I'm asking for my son who takes 8 x 2.5 per week. We have been told that if he gets an infection or high temperature to not take the tablets that week . How serious are we talking ? Colds? Cough? Tickly dry throat? In other words anything that is common this time a year. Any advice is greatfully received

[sylvi]

If he is given antibiotics then he should not take his mtx. Thats the only stipulation.xxxxx

[Hidden]

Hi chungy111

I have been told not to take MTX when feeling unwell ie sore throat etc.

If something is developing, MTX is not helpful.

If refrain from taking it on due day because of feeling unwell, especially if there’s a fever or productive cough, the body should fight off the infection.

And absolutely no MTX if on prescribed antibiotics.

If in doubt, I ask via our RA helpline run by local hospital Rheumatology Dept.

[helixhelix]

I know what I do, but I'm a pretty sturdy adult so am reluctant to advise for a child, or someone frail. Basically my rule of thumb is that I seek medical advice when I have a temperature of over 100 for more than 24 hours, or signs of an infection that last for more than 3 days. Otherwise I just carry on as normal.

If you do end up going to the doctors and being advised to take antibiotics make sure that the doctor knows he is on MTX. There is an antibiotic called trimethoprim, and sulpha based antibiotics that are not good to take alongside MTX. I have never been advised to stop MTX whilst on other antibiotics, but as I said I am a sturdy adult. For the old, frail, or people with multiple medical conditions it is different. So basically we each have to seek medical advice that is specific to us - there is no general rule.

[Hidden]

I have been advised to stop mtx whilst on antibiotics.

I've been on mtx for 20 years and know that sometimes I can feel more ill when I have a virus so if I'm poorly I omit my mtx too. I use my judgement because I have had RA for 24 years and know my body.

[Eiram50]

Hi

Other than when prescribed antibiotics, I continue with my Mtx.

However, the point HH makes is crucial. We are adults, and although you don’t say what she your son is , it would not be wise to base what we do in terms of what he should do. If your sons young, his body will still be developing and may have different implications?

My advice would be to seek clarity from medical professionals.

Marie

[helenlw7]

I’ve been on mtx for11 years. I am now also on antibiotics as a prophylactic so I queried the taking of mtx with the antibiotics to my rheumatologist and he said it ok!

[oldtimer]

As I have said before, it doesn't seem logical to stop methotrexate which is a long-lasting drug. Only if you have a really severe infection for which you want your body defences to be as good as possible is it worth stopping, or if you are going to need antibiotic treatment for a long period perhaps. There seems to be no standard advice and every rheumatologist seems to have their own reasoning, some say stop and others say carry on. Perhaps it doesn't matter too much!

But perhaps the answer is to ask the rheumatologist for their advice and ask him/her why they give that opinion. If it seems a reasonable answer then follow it. With any long-term condition, it's important that it's a partnership between the expert on the condition (the consultant) and the expert on your own body (you).

[nomoreheels]

As adults we usually know when we have more than just a cold, just as I have at the mo, & whether to continue our MTX or not. For the mo I am continuing it because, unusually for me, it's not gone directly to my chest for which I usually need antibiotics. As a mum you'll need to make the decision whether your son's temp is high (over 38°) or there's the chance he has an infection & whether you need to contact his Rheumy nurse for advice. Or, if he has a cold with a cough best to pop him down to his GP just to be on the safe side as MTX can be problematic with anything lung related.