Methotrexate if taking antibiotics?

I get the impression from reading all the blogs that if you are taking antibiotics most people stop their regular treatments for RA. Last year I was prescribed antibiotics for a chest infection but the GP didn't tell me that I needed to stop my MTX. What is the consensus of opinion?

8 Replies

  • I've been on Mtx. for years (tablets) but only on a small dose (7.5mg) a week. I have never been told to stop the mtx. while taking antibiotics, so took them and had no side effects.


  • I have had to stop my mtx while i've been on antibiotics. I have had 4 courses of a/b since xmas. I've had trouble with my breathing. I have taken off it until i go to see rheumy on the 28th march. I have not had any for 7 weeks now. i am in agony due to lack of mtx. There is a lot of side effects to mtx as i have found out. I have had terrible light sensitivity and my breathing is not good even now.

    My vision has improved since i stopped mtx,but i can't say the same for my breathing though. It is worth looking at the side effects to make an opinion or ask your rheumy when you next go.


  • I'm having problems at the moment I was on mxt orally and got a bad chest infection. I stopped mxt for a number of years and I have since been put on mxt injections. I have been on them approx 3 months and now have an other chest infection. I did not have any problems with my lungs when not on mxt. I think it's a side effect of the drug .

  • I don't think taking antibiotics automatically excludes taking MTX. I would trust your GP on this one because they know whether the antibiotics they are prescribing will conflict with the MTX or not. Some antibiotics are okay with MTX and others are not so it's not black and white. TTx

  • I think that they're a couple of antibiotics that are a complete no-no with MTX - which are on the patient leaflet. Apart from that it's not clear cut as others have said. I imagine it depends on how much MTX you're taking, how bad the infection is and how aggressive the antibiotic is. I'm on 20mg of MTX and have never had to stop as yet. Px

  • This is something which comes up regularly and there are many blogs about it. Most antibiotics are safe to take with MTX. There are a couple which you should avoid so my GP tells me but she makes sure I get the right ones.

    I did avoid penicillin last year when I had an infected tooth only to be told by my rheumy consultant that on the dosages of MTX we take, penicillin is quite safe!

    Best thing is to speak to your pharmacist about drug interaction if you need to take antibiotics again. They know more than the doctors do about it! So my father (who was a pharmacist) used to tell me! Best wishes. LavendarLady x

  • Hi, MTX is initially a cancer/anti rejection drug and taken in a much higher dose.

    Arthritis patients take a low dose in comparison and while some antibiotics are a NO NO the majority are fine.

    I've been given quite strong antibiotics over the years and never had to stop my DMARD (whichever one I was on). Also, these days if there's a drug interaction it flags up on the computer.

    But just to be safe, I always check with the pharmacist when new drugs are prescribed.

    The warning (information sheet) is there to cover the manufacturer therefore, the possible side effects goes to all patients and covers every possible reaction even if the risk is very low.

    Beth x

  • Many thanks to all, for your responses. As you say I think that the best bet is to ask the pharmacist. Thankfully mine is extremely efficient and although sometimes I worry about things being 'lost in translation' (I live in France) we get there in the end. x

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