Should I stop taking my methotrexate before having my 4th Covid jab

[Exsailor]

Should I stop taking my methotrexate before having my 4th Covid jab

[KittyJ]

We can’t answer that but I’ve just done what I did for all my other jabs. What did you do before?

[Madmusiclover]

Asssuming not urgent I suggest you ring NRAS helpline on Monday. Also found this page: nras.org.uk/resource/inform...

[Sheila_G]

I did, for 2 weeks but that was just my personal choice. I also missed the following one.

[StormySeas]

I just omitted the next dose of MTX following the covid jab X

[greynot]

Again, this is personal.

Also I know I can miss a week or 2 of Mtx (I'm on 20mg) without adverse effects.

So I chose to miss the week before and the week after my spring booster.

[oldtimer2]

The answer it - it depends!

If you are likely to have a flare if you stop for a couple of weeks, then don't stop, as the risks of a flare outweigh the chances of the methotrexate reducing the response to the vaccine.

If you have missed doses before without problems, then the chances of a reduced response are lessened - but the reduction of response only happened in some of the people in the only trial that I can find.

[Lolabridge in reply to oldtimer2]

Yes oldtimer2, this is exactly the advice I’ve seen on the BSR website for Rheumatologists to advise their patients.

[Exsailor in reply to Lolabridge]

Thanks for advice. Will check BSR website

[Fergie432]

Oops, had my 4th jab a week ago, didn’t cross my mind to skip my Methotrexate, but I did abstain from alcohol the day before and on the day.

[Knip in reply to Fergie432]

😂 You have made me giggle Fergie! Take care, ❤️

[mairtea]

I saw my rheumatologist on 20 May and asked if I should miss methotrexate for my booster due on the 30th. He said not to as I could risk a flare - guess it depends how well controlled your RA is at the time?

[jf211]

No - I haven’t for any

[sunnydown]

This was for my own personal choice - for all my 4 COVID jabs I stopped my MTX (20mg) 2 weeks prior and then 2 weeks after.

I just didn't want to risk further medication/side effects issues from a new vaccination. Touchwood, I've been well so far and therefore have trusted this process for myself.

[Exsailor in reply to sunnydown]

Thanks

[Jora]

I wish I was in a position to give you meaningful advice, but honestly think there are others who could be more helpful. I have so many co-morbidities that even I get confused.I had to stop taking Methotrexate as it damaged my kidneys. My feet and legs became so swollen that I could barely walk.

I was then on a course of diuretics .

The good news is that , thanks to the many blood tests, they found a small clot in my leg. Blood thinners dealt with that.

The bottom line is that the routine blood tests are extremely important.

I hope that’s useful information.

[Knip in reply to Jora]

You are very clearly a person who looks for an upside in everything. It's great news that the blood clot was found through one of you blood tests...they might be a nuisance sometimes but they are for a reason and your reply proves that. Take care, Kx

[gilox]

I just stopped the one after the jab

[Knip in reply to gilox]

Me too.

[Crowe1882]

Just my opinion but I don't think a fourth covid jab is necessary, for me stop taking my drugs and increasing the risk of a flare is far more scary than covid haha, but I have had covid twice so believe my body has developed anti bodies to it anyhow. Each to there own tho

[bpeal1]

Official advice from British Rheumatology Society is that you should pause methotrexate for Covid vaccinations. This is because the Octave study showed that methotrexate doesn’t alter the response to the vaccine but having uncontrolled disease does. However, some rheumatologists have advised patients they know are very unlikely to flare if they pause methotrexate for a few weeks to stop it before and/or after. I suggest you contact your own rheumatology team to ask their advice because they will know you and your medications best.

[Knip in reply to bpeal1]

I wouldn't want to risk stopping it for long. I don't think our RA's are really sure, it's probably different advice for all of us depending on how we are at the time. It was explained to me that if you stop for too long your body is so busy fighting your RA flare that it can't fight, and thereby produce, antibodies agaist the Vaccine. Kx

[Hidden]

No. Having a flare will be far worse. I ‘postponed’ my Mx by one day [now my new day], so that my Covid jab was half a week before/ after my Mx. I suppose it depends on how active your RA is.

[Lotttie4]

I was asking the same question a few weeks ago. I was nice and stable on Methotrexate, was intending to leave it off for 2 weeks. Didn’t actually make it to the the 2 weeks, before I took the Methotrexate. I have had a horrid flare and the fatigue was off the scale. This was my 5th jab, previously only skipped a week. I won’t be doing that again.

[Piggyinthecraftroom]

I didn’t for any of mine. Had some reactions but largely extreme tiredness

[Hannah-NRAS]

Hi Exsailor,

As many people have already mentioned (thank you everyone!), it is very dependent on the relative activeness or control of your your RA. Because of this it is advised you reach out to your rheumatology team to discuss whether or not it is appropriate in your circumstance to skip.

For many, it is advised they do so but this is a decision which should be made in conjunction with a healthcare professional.

I hope this helps.

Best wishes,

Hannah - NRAS