Did you stop your methotrexate before surgery?

I'm scheduled for a hysterectomy 22nd April and have been advised by my rheumatology nurse that there's no need to stop mtx prior to surgery or after. I'm feeling a bit nervous about this as I thought it lowered our immune system? He did say that if my dose was due the same day it might be best not to take it. Mine is due on the Sunday and the op is on the Monday so I'm thinking of skipping that one. Anyway he said there is no evidence to support the need to stop. I was just wondering what advice you lovely lot have been given prior to surgery? Obviously my decision will be based on medical advice.

Paula x

20 Replies

  • Yes, I had a hysterectomy 8 years ago and my consultant , doing the operation advised me to stop and wait a few weeks after until my wound was healed before restarting. Had to get a steroid 6 weeks post op to tide me over but other than that no probs. good luck, operation changed my life for the better x

  • Thanks for your reply and it's good to hear your op was such a success. It's a scary prospect but doing nothing is not really an option anymore. x

  • Hi, I had my gallbladder removed and had to come off MTX for a few weeks before my op and started taking it again once my scars had fully healed. Hope all goes well for you :)

  • Thanks Julie

  • Good luck with op think it is usual to stop x

  • Thank you, I'm thinking about getting a 2nd opinion on this as there seems to be mixed advice. x

  • Hi, I had an op on my neck 7 weeks ago, and I did ask about the MTX at the pre med the week before and was told to carry on with it as normal. Apparently if you were to stop your MTX it will take longer for you to heal up. Not only that but your immune system is at a steady level which your body is used to, if you were to come of the MTX you would be more likely to get an infection. If you are unsure talk to the hospital or your GP.

    Good luck with the op. xx

  • Thanks, maybe continuing with the mtx is a recent change then. I'll make sure with the surgeon beforehand and do as he advises. I hope your op went well and you've made a good recovery. x

  • yes hospital is your best place to get advice or opinion re this as they are responsible for your care x

  • I had a hysterectomy at the end of last year (with fab results - one less thing to worry about). I now take lefluomide but was not told to stop taking at all. I just carried on as normal and healing was fine. Good luck with the op


  • Thanks Sally, it always helps to hear about others positive outcomes x

  • Hi Paula,

    All the surgery I had last year was pre methotrexate. I would be guided by the surgeon and the anaesthetist too. Also , if it is abdominal or vaginal surgery. Both of my friends opted for vaginal surgery and had guicker recovery.

    I generally take selenium prior to surgery, a great healing agent. However be sure to ask your specialist nurse for advice first.

    Best wishes for a speedy recovery.

    I will PM you.


  • Hi Carole, I believe the surgery is laparoscopic and my ovaries and cervix will be left in place. The surgeon said I'll just have 3 small incisions, one near the belly button and one either side of the bikini line. He said recovery is quickest with this method and is generally about 4 weeks with an overnight hospital stay. I already take a vitamin supplement for hair, skin and nails which includes selenium, what strength do you take? x

  • I had a total hysterectomy last year and was not told to stop MTX. I am the same as you as I take mine on Sunday and I did take it even though my op was the next day. I have to come off my anti-TNF before and for a while after the operation,so I felt I needed something. I also take leflunomide and took that on the Sunday as well.

    It did not cause me any problems at all.


  • Thanks for sharing this Jo. I know I should just trust my nurse but I've been given so much incorrect information in the past I find it very hard to just believe what Im told. Your experience is a big help x

  • Wow, I've always had to stop all of my RA meds for 2 weeks before any of my surgeries & hold off for one week after too. It is so hard to move after about 2 days of no meds, but I struggled through somehow.

    Good luck on your surgery, Paula.


  • Thanks Christine :-) I'm getting over the shock of it now and starting to think about the practicalities. Bought some nice new slippers as a start lol

  • I hope all goes well with your operation. It is nearly one year since I had my total hysterectomy and I feel fine now. If you have any practical questions which I might be able to help you with just drop me a line.

    Just to add, I had spinal surgery in January last year and have just had a total knee replacement 8 weeks ago and I did not stop MTX or leflunamide for any of my three major ops. No problem with healing at all.


  • Hi for my spinal surgery I was told to keep taking ARava as it doesn't leave your system for six months and stop the Humira injections, hope all goes well, my hysterectomy was the best thing I ever got done!

  • When I went into hospital for mine was told to take all my drugs with me - went in on crutches and came out with a skip in my step. Thought I had found a cure for RA! Drs put it down to the bed rest in hospital. I also found the following organisation helpful.


You may also like...