Methotrexate cough

[Twinke]

Hello everyone, I've had RA a number of years and been on MTX and hydroxychloroquine. I've had a cough since April following a cough virus. I've now connected it to MTX as the cough goes when I stop MTX for covid and flu injections. Anyone else had this?I've contacted the doctor who is now writing to the RA team as they've dismissed this possibility up to now.

[GranAmie]

get in touch with your GP!! I ended up back in wheel chair as MTX damaged my lungs, long story which you can read on this site . This was pre-Covid but am aok now and on biologic RTX /Truxima. Wish you well xx

[Twinke in reply to GranAmie]

Thanks, I'm waiting for a response from the rheumatoid team. Hope you stay well. Take care

[Grumpyoldmare]

Speak to GP and get chest X-ray, CT scan and respiratory referral URGENTLY. I have been on MTX for years but when my RA flared they upped the dose which us when I developed the cough and shortness of breath. MTX (and RA) can cause lung damage. I was diagnosed with Interstial Lung Disease. As soon as I reduced the MTX dose my breathing returned to normal but there is some small permanent lung scarring.. I have a yearly lung function test to keep an eye on things.

[Twinke in reply to Grumpyoldmare]

Thanks, both xray and CT scan are clear, but will pursue lung and respiratory issue.

[Lifesforliving]

After reporting a cough this year which had gone on for 2 years, I had extensive tests, and the respiratory consultant has advised me that I too have interstitial lung disease, which may be the outcome of a combination of MTX (which I've been on at 10mg weekly for a long time) and the RA itself. The gastroenterologist also reported moderate liver fibrosis which he has attributed to long term use of MTX. So about 2 months ago they took me off MTX and I am now only having a monthly biologic (golimumab) which by itself is proving insufficient to control flares. I'm currently on a reducing dose of steroids to counteract this short-term.But I do notice that I've stopped coughing almost altogether since no longer taking MTX. The respiratory consultant feels that MTX to some extent actually protects the lungs, and as I'm intolerant of other RA ordinary drugs and too old for JAK inhibitors, nobody is sure what to offer as a replacement. However, I agree with other responses, do go and get this checked out as soon as you can: it took a high resolution CT scan to be able to assess the lung damage, an ordinary CT scan didn't clarify it sufficiently.

[Twinke in reply to Lifesforliving]

Thanks lifesforliving, I'll check the CT scan resolution, and definitely pursue cough issue as don't want lung issues as well. Hope you get your drugs sorted too.

[JenniferW]

In addition to the advice given here about methotrexate (which is definitely the most urgent thing to push to be checked out), there is also the possibility of asthma. A lingering cough after a virus can be an indicator of asthma, which is also an auto-immune condition.

Asthma is dealt with by your GP, usually specifically by an asthma nurse. It's worth asking for a chat with the nurse if the problem turns out not to be methotrexate.

[Twinke in reply to JenniferW]

Thanks, will do