Low neutrophils on methotrexate

[Canadiangeese]

Hi there. I’m on triple therapy ie. methotrexate, leflunomide and plaquenil for over 2 years now and in what is called a “medicated remission”. However my white cell count is low. Have lowered my methotrexate from 25 mg since October 2018 to 10 mg as of March 2019. So far my neutrophils is below 1.0. I have been functioning normally in the higher dosage. With the lower dosage, I do feel some pain here and there at times. I know one of the side effects of methotrexate is low white cell count. Hate to lower it further or get off it when it has worked so well for me in the past two years. Anybody experienced this and what course of action was taken?

[sylvi]

Sorry can't help you darling.xx

[Sarahg62]

I had the same problem while on Methotrexate, Leflunomide and Humira. I was taken off Leflunomide last January. I was on quite a low dose of mtx and just had it upped to 12mg this January. Having bloods taken fortnightly, so far so good, but am feeling very tired the last week or so. It’s very annoying isn’t it, solve one problem and cause another !!!

[Canadiangeese in reply to Sarahg62]

Thanks for the response. Hmm, now I’m beginning to wonder if the leflunomide is causing the low neutrophils. Hope you feel better.

[Sarahg62 in reply to Canadiangeese]

Think you. Nothing two weeks sleep and a long holiday wont sort 😂😂😂. Take care

[Mmrr]

A slightly different angle, but it might give you some encouragement. My neutrophils are low when off MTX, higher when on it. The haematologist informed my rheumatologist, that neutrophils could go as low as 0.5, before there is a 'real' risk of infection and just to keep monitoring. I'm quite relaxed about the low counts now, and just take a few, non invasive precautions of regular hand washing, keeping a hand sanitiser with me when I'm out and generally forget about it.

I've just started biologics , due my first blood test next week.

[Canadiangeese in reply to Mmrr]

Thanks for your reply and tips. Your situation is indeed the opposite of most of us on methotrexate. Hopefully, the biologics will do wonders for you.

[Joy_1]

A friend has a low neutrophil count. She told me the point at which it gets flagged is 0.5. She has been fine with no more colds than the rest of us. She has been having blood tests every 2 weeks so they can monitor closely.

[Canadiangeese in reply to Joy_1]

Thanks for the info.