UTI and methotrexate

[AW600]

any ladies in your 40s who have suffered with UTIs? Which antibiotics do they give you if you take methotrexate? And do you have to stop taking methotrexate whilst you take the antibiotics?

[Runrig01]

I’m in my 50s, but have nitrofurantoin when I have UTIs. You should always stop MTX when on antibiotics, it’s usually written in your clinic summaries, stating stop Dmards and biologics if commenced on antibiotics

[AW600 in reply to Runrig01]

Well I took my methotrexate as normal this morning, got prescribed the antibiotics this afternoon and both nurse and pharmacist say it’s ok to start them. I thought they would say leave it for a couple of days

[Ruth12345 in reply to AW600]

I've had uti and left it too long and ended up in hospital. So in my experience take the medication ASAP. I wish you well very soon.

[Runrig01 in reply to AW600]

Yes they won’t postpone starting antibiotics, as the risk is your infection will worsen. The MTX does not interact with the antibiotics, it’s just that your body will struggle more to clear the infection, due to taking your immunosuppressants. Hopefully you won’t feel worse, but if you do, contact 111.

[medway-lady]

I don’t take MTX but AZA and Etanercept and was advised stop them.

[JenniferW]

I found vagifem helped a great deal, your hormone levels start dropping in your forties and it affects your bladder lining. Vagifem is a pessary that can be used even if other forms of HRT are a problem. It seems to start early on, I got the vagifem a good year and a half before starting other HRT.

menopausetreatment.co.uk/cy...

[Tkat10 in reply to JenniferW]

I was going to mention this too.

[Cien in reply to JenniferW]

I used to use Vagifem for post menopausal dryness and frequent UTI which seems to help but less effective for the virginal dryness. Now my GP prescribed vaginal estriol and I found my symptoms of dryness has much improved. Before starting the HRT My Gyne-urologist (paid privately) had prescribed 3 months of Hyprex for UTI. I suspect my frequent UTI was cleared by it and the HRT is helping the vaginal dryness.

[Boxerlady]

I agree with JenniferW that it might be worth investigating vaginal estriol; I use a cream rather than a pessary but it all has the same effect and it's known to help with UTI's.

[Cirrostratus]

It seems to me that people have been given quite different advice re: MTX and ABx together. I am of the understanding that SOME ABx are fine with MTX and some are not. So very careful prescribing is vital. If the doc has said it’s ok to take them, and is fully aware of the MTX, then surely it’s ok.

[becksland]

As far as I know there is one antibotoc that you need to avoid while on methotrexate is trimethoprim. They are very dangerous together and is should flag up on gp records if they try to give this while on methotrexate. Hope you are better soon xx

[AW600 in reply to becksland]

Thank you, I had read that also so if they had offered me that by mistake I could say no thanks!! X

[madme1]

Yes I was advised to stop Methotrexate whilst on antibiotics. I've had erythro and clarithromycin, also nitrofurantoin. I was told to leave at least a week to 10 days before starting metho again.