Methotrexate and sore throat

Hi, I was told by the rhumatologist on Thursday that I have sero-negative RA, and yesterday took my first dose of methotrexate (15mg). Had a bit of a headache yesterday but otherwise OK,but woke up this morning with a sore throat. The leaflet on the drug says tell the Dr if you have a sore throat - does that apply every time? Can I assume its just a normal, slight infection/cold and leave it or do I have to run to the doctor every time I have cold symptoms?

9 Replies

When I first started taking MTX several years ago I did get nervous about side effects (and got nervous about taking them) But now I just treat myself as normal, and so I'd only go to doctor if something seemed serious like a chest infection, and/or had lasted for ages. The first couple of months on MTX I did have some problems, headaches and so on, but (fingers crossed) they went away eventually. I'm sero-neg too, and drugs are doing their job quite well. Polly


Hi Lin welcome to the site.

I think if you have gone straight onto 15mgs - which some people including me build up more slowly to (ie 7.5, 10, 12.5 etc) - then you should take the sore throat a little more seriously than those of us who have been on the MTX for a while. It's too powerful a drug to mess with and the sore throat is probably just a virus and not related but I would do as it says on the leaflet and tell your doctor if you can just to be on safe side. Tilda X


Hi Lin, so you are newly diagnosed like me :-) welcome to the club and I hope the treatment helps you soon. I'm sero positive but I think basically it all adds up to the same thing. I'm on my third week of mtx now. I did find my throat felt a little dry and I got a few headaches too but now I make sure to keep my fluids up. I drink lots of water and squash especially the morning after my meds and it does seem to help. It also helps stop me feeling nauseous. Good luck with your treatment.

Paula x


Well said all on advise. I would just re iterate to all newbies, contact GP if you suspect an infection as it might be best to skip mtx until the infection clears. Also, you may require an anti biot. My experience is that I skip a weekly dose occasionally if I have any infection, which is rare, and it does not seem to make ny difference.

Xx Gina.


This has happened to me. Last summer I put up with a sore throat for weeks, hoping it might go away.

When I finally saw the GP he said I should have gone to see him sooner. I was put on antibiotics which then caused oral thrush. And my throat was still sore. So I stopped the MTX until I saw my consultant.

I think that MTX slows your self-healing ability. So what might be a simple virus can take ages to go away.

So my philosophy matches Gina's. If in doubt, leave the MTX for a week or so.

And don't let problems linger as they get trickier to solve.


It is difficult to be sure if mtx causes sore throats, if like me, you read too much into side effects then u can be sure it does.

Try chewing some throat pastilles at first, often when you take new medicine your body needs time to adjust, but if it is persistent then go see ur doc.

I think we all know our bodies pretty well, if your sore throat is connected to a cold you will have other cold like symptoms.



i would have a mild sore throat after taking mtx but it only lasts about a day


Hi - I know all surgeries are different but my GP said to contact them if I had any sort of infection, and to take sore throats seriously! After being on MTX for about 6 weeks I had a sore throat which didn't seem too bad, but went to see them anyway (although came close to not going to see them). They took my blood count to make sure white cells weren't too low, and turned out I had a really low white cell and neutrophil count and was taken off MTX indefinitely! So glad I took their advice and have done since even though I sometimes feel like I'm a pest! So especially since you've only been on the MTX for a short time I would probably get it checked out as you don't know how it's going to affect you and everyone is different. After being on it a while you will know how it affects you with these things...


Thanks for all your replies, I'm really appreciative of having people out there who understand the worries. I decided to leave it a few days just to see how it went. My throat is still sore but not as bad as yesterday, so I think its clearing up. If it doesn't by end of tomorrow, I'll go see the doc.


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