Amoxicillin and methotrexate

[Frankiefocus]

Hi everyone I cant seem to get through to my rheumy at the moment but thought I would just ask anyway, I have been on amoxicillin for dental work and finish this Saturday and my usual methotrexate shot is Sunday night. My GP said its OK to take but the pharmacy dudes said give it a miss for a week..Any opinions on this?

[Hidden]

I would personally take the pharmacist’s advice over the GP’s, purely because the pharmacist’s job is safely dispensing and understanding medication. Neither the hospital pharmacist nor the GP told me I should stop my mtx to take flucloxacillin: when I went to see the GP because I felt like I was dying having taken both (and discovered I shouldn’t have done via google) the information you should stop mtx at all was news to them. I don’t know what the pharmacist’s excuse was, but I hope it was just a very bad day at the office.

[Hidden]

Personally I give it a week after antibiotics

[helixhelix]

I would give it a miss. One week without MTX shouldn’t be a problem for your RA and will help your mouth heal. It’s rare to have a bad interaction, but why risk it?

[summer32A]

Pencillin type antibiotics of which amoxicillin is one alter methotrexate levels in blood plasma so not usually recommended.

Iam due to the pandemic back to being your registered pharmacy professional.

[Shelby37]

I would most definitely leave it and listen to the pharmacist. Drug indications often pop up and GPS are not always up to date on it. I saw recently they discovered Azithromycin reacts with hydroxychloroquine.

[Esmereld]

Aren’t we lucky having all this experience to call on. I think you have your answer. A week off won’t make any difference to you. Well I doubt it will. I’ve had the occasional month off mxt and not ready felt the effects.

[Pamelah5]

When I’ve been taking Amoxicillin 500mg I’ve always missed a week. I would play it safe and leave off for a week, with certain medication such as Ciprofloxacin I’ve had to leave for 2 weeks.

[sparklyshazza]

withold until infection resolved and antibiotics.completed

[Dan13rheumatoid]

It still causes me disbelief how little a gp knows. My one has only now after a year but my shared care for blood tests etc on the system, every month I have had to fight to get one. My pharmacist never asks about blood tests when dispensing my methotrexate they have also on occasions not supplied the patient information leaflets. Regards your drug interactions use caution and believe the one saying rest off it for a week and still try your rheumatologist, do you have a helpline for them might be quicker than ringing actual department.

[Hidden]

I took amoxicillin and ibuprofen and then had anaphylactic reaction so I would say proceed with caution. When I had the amox/ibu in Feb wit no MTX I was fine.

[Mall]

I was given this anti biotic for a chest infection last year. Even though I didn’t take methotrexate the week before or the week of taking the antibiotics my next liver blood tests results sky rocketed and took a few months to recover to previous levels. I wish now that I had a further week without methotrexate. There is a warning in the literature that accompanies the tablets. If you feel you can cope with missing metho for a week or two follow the pharmacists advice and don’t put the extra strain on your liver.

[NN55]

It may depend if the Amoxycillin was prophylactic or for an infection?

[RA2002]

I also had dental work recently and had to take amoxicillin - I contacted my rheumatology advice line and they told me to stop methotrexate and etanercept until the course of antibiotics was finished and to have a blood test before resuming the two injections. Unfortunately I couldn’t get a blood test for two weeks but felt ok so resumed the two meds. So far, so good.