methotrexate

[Dexter1414]

with methotrexate it lowers your immune system has anyone else had colds while on it and caught any bugs and do you stay on it if you are unwell come off it for a week while unwell or do you just keep on methotrexate as you can’t take ibuprofen can you Thankyou for everyone commenting helps my anxiety as I worry

[helixhelix]

very individual as also depends on your overall age, general health and medical history. I only ever used to stop if I had a temperature for over 24 hours. But not 14 years older I check with my doctor

[helenlw7]

I’ve been on methatrexate for more than 10 years, and as far as I can remember I have never had a cold. However I had many chest infections until my lung consultant put me on an antibiotic, Azithromycin, as a prophylactic. Since then I have only had chest infections when I had to stop the Azithromycin, the last time being March 2024, when chest infection turned to pneumonia and I spent 7 weeks in hospital. When I had a chest infection or any other infection I stopped the methotrexate and any other RA meds.

[AgedCrone]

No …..I was on high dose Mtx for years & I felt well …it didn’t cause any infections at all.

Do start looking for the benefits it brings …..even if you do catch a cold it’s unlikely to last a long time…..or be anything to worry about.

Do consult your rheumy team if you have a raised temperature…but not just because you sneeze a couple of times 🤒

[JenniferW]

Generally speaking you only come off methotrexate for the more serious infections, you wouldn't just for a cold. However it would depend very much on you, for example some people get chest infections easily when they have colds and need antibiotics, in that case they would probably be advised by their doctors to stop it for a week.

It's okay to contact your doctor and ask, it takes a while to figure out what's best for you. They always say to contact them if you have a sore throat when on immune suppressants, so feel free to ask each time you are ill to begin with. If you can just send them a message online, that makes it easier.

I usually end up skipping it for a week about once a year. I find one week off doesn't cause a flare up, but two weeks or more does.

[oldtimer2]

The idea is that the methotrexate reduces the OVER-activity of the immune system. At the doses we take (unlike those used in cancer treatment which are much higher), generally methotrexate doesn't affect our suceptibility to infection too much. It's sensible to try and avoid exposing yourself to people who are coughing, sneezing or have upset stomachs etc, though!

Generally the advice for people on methotrexate is that if they have a flare when they stop it, then don't stop it.

Otherwise the advice is that you stop for the time you have an infection and a week afterwards which was shown in some people to assist with the formation of immunity against that infection.

Personally that doesn't make sense to me considering the time that methotrexate takes to clear from your body, and it wasn't shown in everyone in the trial. When I was on methotrexate I never bothered to mess about stopping and starting, but others have found it helps.

[Feelingpoorly]

It can be very easy to go down the anxiety road when dealing with medication ‘do and don’ts) and I can sympathise with this.

As previous posts have mentioned it can be different for every person …. this is my experience, I hope it helps 😊

I take 15 methotrexate by injection every week ( I switched from tablets which didn’t agree with me) this drugs works very well for me and although I have a few aches and pains and a little stiffness on waking, I am fully mobile and enjoying life each day. I don’t take ibuprofen as it’s not recommended but I do take paracetamol when needed which definable helps (check you don’t take more than recommended dose especially cold remedies which often include paracetamol )

I do get a lot of colds, certainly more that I use to but I’m not sure if that is because of my age or medication. Either way I do take precautions such as washing my hands a lot, wearing a mask in very crowded places etc.

I try to be guided by how stable my joints are and how I feel generally before deciding to miss a dose. If my cold is bad and I feel poorly then I will miss a dose until the worst has passed. If I need antibiotics then I usually miss a dose so that the antibiotics can do their job.

Again providing my joints feel stable I have also missed a dose when travelling overseas to a wedding.

Everyone has their own way of dealing with long term medication . The priority is of course to protect your joints from further damage, to stay mobile and enjoy your life. I think if you are worried or needing advice at any time please reach out to your Rheumy Team as they are the very best font of knowledge

Sending my warm and kindest wishes to you ♥️

[welsh12]

I am generally healthy but had a lingering horrendous cold and sinus issues last year for over a month. Not the norm for me. GP didn't prescribe anything I didn't stop the methotrexate as I didn't feel that stable on the medication then however now I would take a week or max two off after seeking advice from GP on my condition.

[Runrig01]

I personally have a lot less viral infections on my methotrexate and biologic. Before starting FB them I was always picking up infections. I worked as a nurse in the frontline, and constantly picked things up. However, before treatment my immune system was in overdrive, and my body was busy trying to put out the fire from the inflammation, that it missed infections sneaking in. Once MTX and the biologic had the fire under control, my body was able to go back to stopping infections sneaking in.

I only stop mtx for infections where I need antibiotics, after vaccines I hold off for 2 weeks, or when I have surgery. We are all very individual though, and some patients find that the dial is turned down more than other patients. Speak to your rheumatologist for guidelines on what’s best for you.