Methotrexate and sinus/nasal issues

[Gottarelax]

I've been on MTX for a year now and over the months I keep saying I feel like I'm coming down with a cold but it doesn't happen. I get a blockage in the back of my nasal passage and that causes post nasal drip and a sore throat. I was taking sulphasalazine but have stopped that as I felt so tired on it. When the tiredness and nasal symptoms were combined it really was like I had a cold. Now I am just taking MTX, I have just realised that I take the MTX on a Thursday evening and wake up with the sore throat on the Friday morning. The nasal symptoms slowly reduce but not fully until I take my next dose of MTX.

Is this familiar to anyone? It's not enough to consider stopping MTX but perhaps I could take/do something to reduce the symptoms as the sore throat is uncomfortable.

[AgedCrone]

Just a guess…but It could just be if you are on oral Mtx that you are not taking enough water when you swallow the pills, as well as staying well hydrated the rest of the week.

[Gottarelax in reply to AgedCrone]

That is a strong possibility. I’m injecting MTX so no additional fluids there and I’m a bit of a shocker for drinking too little.

[AgedCrone in reply to Gottarelax]

Your symptoms rang a bell …when I was on Mtx..I glugged down water on “the day,”…but the other 6 days 😫

I now keep a jug of a drink…water or squash…on my kitchen work top & grab a drink as I pass.

It’s the silly little things that cause a lot of symptoms…& I think we get accustomed to blaming the drug we take instead of thinking it through!

Get drinking ….I hope it works!

[welsh12 in reply to AgedCrone]

Yes in have dry skin sinus nose etc worse since on it I do drink water but need to up it

[AgedCrone in reply to welsh12]

I don’t like just plain water all the time so I buy those little squeezy flavourings & just a little squeez takes away the “ water taste” sounds silly but it works for me!

[Gottarelax in reply to AgedCrone]

I'm trying to drink more. I'm a bit strange with drinking because I can't stomach plain water (makes me feel sick), I don't like sugary/sugar-free sweet drinks so end up drinking carbonated water. Problem is that I'm now getting sensitive teeth and in the past my dentist has suggested that I shouldn't drink carbonated drinks (I thought it would be OK if it was water). So I'm left with tea and coffee but have to have decaf because of an intolerance to caffeine (gives me cramp even at low dose). Then I find that there is something in decaf drinks that is inflammatory...but I'm sticking with the decaf drinks and a little sparkling water for now while I find a drink that is suitable for my teeth, my stomach and my joints!

[AgedCrone in reply to Gottarelax]

You could always try alcohol free beer,😂

[Gottarelax in reply to AgedCrone]

You know what, that's not a bad idea!

[AgedCrone in reply to Gottarelax]

SanMiguel do a very nice one…we drank it in the Summer, but haven’t been able to find it lately….so we just had to drink alcohol +

[Boxerlady in reply to Gottarelax]

I drink a lot of fruit tea, peppermint tea and hot lemon or lime. I squeeze lemon or lime and keep it in the fridge and use a little with boiling water. I also drink sugar-free lime squash - other flavours are available 😁

[Gottarelax in reply to Boxerlady]

I'm such a fussy drinker 🤦whereas with food, I pretty much eat everything and anything. I should get back into herbal teas though as there are a few that I like (licorice and peppermint for example) but I'm not keen on squashes or fruit drinks.

[ruth_p]

A prescription for something like Nasonex might help. Maybe a saline spray? Have you spoken to your rheumatologist? Are you on daily folic acid?

[Gottarelax in reply to ruth_p]

I’ll try that. And no I’ve not spoken to the nurse as I’ve not seen her in a long time and it seems a little trivial for a consult.

[RAGuy in reply to Gottarelax]

A point for advice here. Try not to leave it too long before checking with a nurse. It is always advisable to check where your health is concerned. Minor symptoms can be a diagnostic tool that prevents later issues. Not checking could become a bad habit.

Please do not think you are wasting their time. You are worth looking after

[welsh12 in reply to RAGuy]

I get that but mine is an email box get back to you in three days

[RAGuy in reply to welsh12]

That is appalling! Can you ask for a phone appointment? Have they forgotten that patients are people?

Meanwhile, I would still email them for a nurse appointment. MTX needs checking. It is can cause problems and should be respected.

Good luck

[Dawn7]

Hi there, I am on 25mg metoject and I regularly complain to my daughter of a niggly sore throat which she points out has a pattern every week - I am more aware of it from a Friday (take the injection on Sunday eve), for me seems clearer on Monday. I am snuffly every morning, which lessens as the day goes by... I have put it down to the Mtx- as has my daughter. with me it is almost as if my body is saying "come on I'm running out of Mtx" -It is not as bad as you are describing but I constantly query if I have a cold, start of flu, covid.... but no, it is the same symptoms week in week out.... not sure this will help you !😬I hope it does 🙂

[Gottarelax in reply to Dawn7]

that’s interesting, it seems the opposite way around for you. I wouldn’t say mines that bad, It was worse when compounded by the exhaustion from sulphasalazine …it’s more an irritation now

[Runrig01]

My rheumatologist when she started me on methotrexate, told me to report any sort throat to her. It also states in the BNF that you should inform them :

“the patient or their carer is warned to report immediately the onset of any feature of blood disorders (e.g. sore throat, bruising, and mouth ulcers), liver toxicity (e.g. nausea, vomiting, abdominal discomfort, and dark urine), and respiratory effects (e.g. shortness of breath).”

Also throat ulcers are listed as a common side effect in both oral and parental administration.,

[Gottarelax in reply to Runrig01]

Thank you,. I’m one of those ‘don’t want to make a fuss’ types but perhaps a call is in order.

[CagneysMum]

This rings so many bells for me … annoying dry cough, nasal drip, dry throat, shortness of breath. All just niggly little things individually that I’ve ‘normalised’ because my RA is really well controlled … by which I mean my joints aren’t swollen or painful 🤔

[KathleenMary]

I have been taking methotrexate for a long time now and regularly get colds,coughs etc ,which are really persistent.I recently had a dental scan which revealed totally opaque (abnormal )sinuses,dentist referred me to hospital and a year later still waiting to see someone .

[Gottarelax in reply to KathleenMary]

Sorry you’re suffering. Interesting that your sinuses are abnormal though. Hope you get it checked out soon. Is it an ENT or Rheumatologist appointment you’re waiting for?

[KathleenMary in reply to Gottarelax]

It's what they now call department of oral surgery I'm waiting for