Amoxicillin & Methotrexate

[TheBoys]

Latest one from me on my journey.

I ve had a cold for three weeks now..i took nasal spray to help clear my nose but the bug settled on my chest.

Has anyone taken amoxicillin with methotrexate?

Best wishes

Paul

[charisma]

No! Always told to stop MTX when taking antibiotics. You might be best speaking to the Rheumatology team in charge of your care. Three weeks is rather long. There’s the risk of pneumonia with MTX and infections. Please do seek better medical advice. 🙂

[crashdoll in reply to charisma]

Yep, I was told to stop MTX when on antibiotics for an active and acute infection. MTX lowers your immune system and could hinder fighting the infection. Please be careful with your lungs. Who prescribed the antibiotics? If your GP, please ask their advice. If not, call your rheum nurses please. Better safe than sorry and I wish you better.

[helixhelix]

It is very individual, as depends on many factors such as age, other medical conditions, previous history and so on. I have never stopped MTX whilst on antibiotics, on doctor’s advice. Talk to your own doctors who know your medical history and follow their guidance.

There is an antibiotic that you absolutely mustn’t take with MTX - trimethoprin - but apart from that it is on a case by case basis.

[sparklyshazza in reply to helixhelix]

Rule of thumb... any infection requiring antibiotics you should stop mtx. The lady above explained it quite clearly

[ruth_p in reply to sparklyshazza]

I have never stopped mtx when taking antibiotics either and have never been told to by my rheumatologist or GP in the past 24 years of having RA.

[sparklyshazza in reply to ruth_p]

Jist because its something done historically doesnt always mean its right

[helixhelix in reply to sparklyshazza]

I follow my doctor’s advice, not that of someone on a forum.

[sparklyshazza in reply to helixhelix]

Gps sometimes give the wrong advice

[Fighting4me_17 in reply to helixhelix]

Good evening helixhelix, I have always been told by Rhuemotology nurse and GP stop methotrexate injections when got antibiotics. Especially septrin because they react with each other. Then continue methotrexate once Infection and antibiotics are finished/gone.

Hope you recover soon 💞

[helixhelix in reply to Fighting4me_17]

As I said above, it is a very individual thing as to whether you stop or not, apart from if you are taking the antibiotic Trimethoprim - when you must stop. Septrin is a brand name for trimethoprim, they are the same thing.

But you should always follow your own doctor’s advice.

[Fighting4me_17 in reply to helixhelix]

Thanks for that helixhelix x

[KittyJ]

I’ve never stopped mtx when on antibiotics but my GP always checks which ones are ok to take with it before prescribing it. I do think it does vary reading past posts on here as to whether people are told to stop or not.

[nomoreheels]

I've taken amoxicillin with MTX in the past but if I need antibiotics nowadays I halt it until I’ve finished the course then restart it the following week or days depending on which day the course is finished. I only do do this to have that bit better chance of letting the antibiotic work it's best. I’ve never had any ill effects but the general rule is to halt MTX as the amoxicillin could increase the effects of MTX, side effect & toxicity wise. Obviously we're not able to say yay or nay but this is what I’ve done. As has been said you'd be best to seek proper medical advice, we don't know your medical history & obviously aren't qualified.

[TheBoys]

It feels as if most Drs dont have a clue . I feel i m not being looked after and will speak to my GP in writing

NHS seems crap these days.

[Azabat in reply to TheBoys]

I’m lucky in my care team now but it sucks to not be heard or to be treated as an inconvenience. My rheumy is hit or miss, and her bedside manner is atrocious. Writing is a good thing as is taking someone with you to appointments.

[sparklyshazza]

You should stop mtx if commenced on any antibiotics

[Shalf]

Should we all not be singing of the same hymn sheet here? Sparklyshazza, the only thing this member SHOULD DO is get advice from the Rheumatology department.

[sparklyshazza in reply to Shalf]

I agree but gps are not always on the ball with dmards and biologics and i have much experience in this field

[Shalf in reply to sparklyshazza]

I agree with you re gps however Rheumys should know the best course of action for the person they are treating.

[sparklyshazza in reply to Shalf]

Definately.

[TheBoys in reply to sparklyshazza]

Tnx all. I guess thats the correct route.

I m going to email the secretary of the rheumatology dept now so theyll have it for monday morning.

It feels like there are real variations in NHS care.. i really like my Rheumatologist but i feel a bit vulnerable as maybe Barts is too stretched.

Tnx all !

Paul

[helixhelix in reply to sparklyshazza]

Non-professional experience, or actual training and qualifications? Yes doctors do sometimes make mistakes as they are human - but far fewer than non-qualified people who make judgements without having full medical history.

[TheBoys in reply to Shalf]

Hi all. Thanks for the input and advice. I will check with the gp but i wont take mtx on top of amoxicillin. If nothing else, the one will undermine the other.

I think its fair to say that from varied responses, some hospitals offer a good degree of support to patients. Mineis Barts in London and it doesnt seem to. They may have all the latest kit but seem very weak on the human support side.

I had a blood test at my rheumatology appt on aug 13. I should see him in December but the appt is feb 24th. So thats six months between tests. Theres no helpline or any contact.

I ll ask my GP for their view on my treatments and maybe seek rereferral over to the Royal Free at least its in my area.

I dont think i am getting the help I need from my rheumatology team which makes me reliant on your good selves and Dr Google..

Many thanks

[Shalf in reply to TheBoys]

Frightening situation when there is a lack of support from gps and Rheumy departments. I personally would kick up blazes and try transferring elsewhere.

Best of luck.

[TheBoys in reply to Shalf]

Many thanks. I normally am good at moaning but seem to have lost my mojo.

[sparklyshazza in reply to TheBoys]

If you are on mtx u should have 3 monthly blood tests

[KittyJ in reply to sparklyshazza]

I have bi-monthly blood tests sparklyshazza

[sparklyshazza in reply to KittyJ]

It varies on how long u have been on it if they increase dose or.abnormal bloods... 3 monthly bloods is norm.for stable meds and bloods and dose

[KittyJ in reply to sparklyshazza]

I’ve been on it 20 years 😊

[sparklyshazza in reply to KittyJ]

You gp monitored

[KittyJ in reply to sparklyshazza]

It’s my rheumy who wants bloods bi-monthly and I have them done at my surgery.

[TheBoys in reply to sparklyshazza]

Hi.. nope he doesn't monitor at all. I ll contact them tomorrow

[Hodc in reply to sparklyshazza]

Mine have to be done 4 weekly, or else dont get mxt

[sparklyshazza]

unusual ... normally 3 monthly after that length of time

[Hodc]

I am currently on my 5th antibiotic, having had a chest infection for nearly 3 months. Most of thevtimqe, ive been off mxt, because of it's effect on the immune system. At the end of the 2nd antibiotic, i restarted mxt the next day. Within 5 days i was back on antibiotics.

I am supposed to be going on amgevita, and haven't been able to, because of this infection. Barely got time to get better before the winter! And ,of course, being off mxt is causing flare-up.

Rant over!

[medway-lady in reply to Hodc]

Don't just take them ask for a sputum test so the bug an be identified and the right antibiotic prescribed. Thats what my RA nurse advised and it turned out that the hot tub on a cruise had MRSA and that needs a particular antibiotic. I have a similar experiance but aso saw a Respitory Consultant who did lung tests etc to make sure all was ok.

[TheBoys in reply to medway-lady]

Crikey.

I left a sputum test in with the hospital in July . No outcomes are discussed until you chase it up or see them in a face to face.

I d had a series of tests (ct, echocardiogram, ecg, spirometry) o ended up writing to my MP to facilitate getting those results.

Wonder if anyone else has had similar issues at Barts. Their website on rheumatology makes them look great but they are sadly lacking.

[medway-lady in reply to TheBoys]

Sad to read that, I think I'd ask for a CT scan of lungs by the way MRSA is treatable with right antibiotics and I'm fine now with a rescue pack of Doxyclycline in the cupboard. Around here the Community Respititory Teeam come out very quickly and I had excercises to relieve cough when it was bad. Ask about it as I'm not with Barts and by the sound of it I'm glad about that ! but RA team and GP did really help

[sparklyshazza in reply to Hodc]

Request a chest x ray to rule out any underlyung issues

[Hodc in reply to sparklyshazza]

I've had two. 6 weeks apart. The second one showed a significant improvement, but not entirely clear. Was also asked by two Drs for sputum test, but I wasn t coughing anything up. That's only really happened in the last week-7/8 weeks later.

[Mall]

I developed a chest infection after a cold just recently and was prescribed amoxicillin. I had stopped taking methotrexate for a week before starting the anti biotic and didn’t take metho during the weeks supply of anti biotic. Then I restarted methotrexate. I had a blood test a week later and my liver function test had gone through the roof. A further blood test 2 weeks later show this is improving but not back to my normal levels.

This is an anti biotic which doesn’t sit well with methotrexate and is hard on the liver. It is very good at clearing chest infections. If/when I have another infection I will ask my gp if there is an alternative one which may be a little kinder on my liver.

[TheBoys in reply to Mall]

Thanks..thats very useful. Paul.

[Cal48]

The doctors computer usually flags up meds. And contraindications . Always ask the GP.

[Hobbledehoy]

I contracted severe pneumonia and was told that they nearly couldn't save me. No RA medication whilst on antibiotics, it works against them. I use inhalers, and sometimes get thrush treated by antibiotic mouthwash; even then I have to drop my RA med. for the duration. Good luck.

[TheBoys in reply to Hobbledehoy]

Thanks for that. I ve had pneumonia and sepsis before so desperately will.want to avoid that. Oh for a nice hot climate!

Paul

[Craftywonky]

Most antibiotics are for a week. If you’re lucky you could fit it in between mtx doses

[Sherloch in reply to Craftywonky]

I don't think the body functions quite like that?