Methotrexate when suffering from a cold?

[Marijo1951]

At the moment I have a very heavy cold with a terribly sore throat and a painful chesty cough. I've been told that I should skip the MTX while the cold lasts. Do others agree and, if so, could anybody tell me the reason why? Information I've found online is sketchy, contradictory and confusing!

[SheffieldJane]

As far as I have gathered, it is because it is an imusuppressant and your body needs to fight your illness with all it has got. It is apparently fine to stop Methotrexate and then start it again when you are better. Get well soon!

[Marijo1951 in reply to SheffieldJane]

Thanks for that. Again I wonder why we're not told these vital details when we're prescribed medication. I still don't understand why I wasn't advised not to take calcium/vitamin D supplements at the same time as pred. For weeks I took them in the morning with my pred because it was easier to take everything at once, until I read sage advice on this forum...

[SheffieldJane in reply to Marijo1951]

Yup! That’s a key reason to be on here.

[HeronNS in reply to Marijo1951]

Same with me. At the very time my pred dose was highest, at the very time pred has the most effect on our bones, I was happily swilling my calcium with my pred. Then the forums taught me otherwise.

[Bird-67 in reply to HeronNS]

I have been taking vitamin D with my Pred for 9 months now and nobody has said I shouldn’t.

I am so glad I joined this forum.

[HeronNS in reply to Bird-67]

I don't think there's a problem with Vitamin D. The problem with calcium is it may interfere with the absorption of the pred, plus pred itself affects the way we metabolise calcium, so best to separate them by a few hours. There are other things we shouldn't take at the same time as calcium, like iron or magnesium if you need separate supplements for those. I simply take pred with nothing else, except my iron supplement, and calcium I do take with my other vitamins and glucosamine (for osteoarthritis) and hope for the best. Otherwise my day would be one long pill swallowing session....

Vitamin D is really a hormone, not a vitamin as such, which if we still lived on the African savannah we would be making daily from sunshine.

[Bird-67 in reply to HeronNS]

I have now changed my time of day for taking my Vitamin D. Thank you HeronNS and piglet the for your help.

Bird 🦅

[piglette in reply to Bird-67]

The vit D/ calcium tablet box I receive from the pharmacy actually says I should leave two hours between taking them and things like steroids.

[HeronNS in reply to piglette]

Well done whoever designed that packaging!

[piglette in reply to HeronNS]

It is just typed on a label with the info on when to take it etc and stuck on the package. I thought all pharmacists did it!

[HeronNS in reply to piglette]

My pred prescription only has a label saying to take with food and I don't think the multi-page info sheet I got with the first prescription says anything about avoiding taking with calcium, I think I would have noticed as I read the info quite carefully. Our vitamins aren't prescribed but sold off the shelf as casually as shampoo or pencils and no warnings on either of the two calcium + other stuff supplements I take.

[piglette in reply to HeronNS]

I got mine on prescription, otherwise it would not have been mentioned.

[PMRpro Ambassador]

Were you not told to do so when you were first put onto mtx? As far as I know that should be standard practice. Also if you are put onto antibiotics for any reason.

However, MrsNails is the mtx guru here - has probably had more experience with it than the rest of us put together!

[Marijo1951 in reply to PMRpro]

Nobody told me verbally and, as you can see from my response to Mrs Nails, only one of the three booklets I was given mentions it. As for antibiotics, I recently took several courses of strong antibiotics, Clarithromycin and then Clindamycin without thinking about possible interactions with MTX. I had told the doctors what medication I was on so I assume they didn't prescribe something riskly.

[PMRpro Ambassador in reply to Marijo1951]

It isn't an interaction as such - it is that the immune respone is being suppressed and so the body isn't able to fight the infection as well.

[Hidden]

Hi, if you have a cold or any infection you must stop the Methotrexate. I haven’t taken mine this week due to a Virus in my throat leading to a cough.

You can either wait until next week to restart or as l’m doing restarting once l’m better.

There is conflicting advice around but it tells you this in the Patient Information Leaflet.

Get Well Soon.

MrsN 🌷

[Marijo1951 in reply to Hidden]

Thank you. I've checked the booklets I received from Arthritis UK and the Royal Free Hospital and, while they advise to stop taking MTX if suffering from chicken pox or shingles, neither mentions the risk posed by other viruses. However the NHS booklet sent to me by my GP does say 'If you have any infection, stop your MTX and get prompt advice from your doctor or nurse', though it doesn't mention any reason for this. I probably didn't read it very carefully after absorbing the other two.

I don't think I'll bother about the 'prompt advice' - what can they say apart from keep warm, rest, drink plenty of fluids and take paracetamol?

[Hidden in reply to Marijo1951]

There’s always the risk that a lowly virus can attack us more vigorously than someone with an intact immune system. Prednisolone also lowers our resistance to coughs, colds & the likes so we have a double whammy.

I don’t know if you have Grandchildren but we need to take precautions if/when they have the ‘flu nasal ‘vaccine’ as that is live & the same when they have their Polo Jabs (however they get it these days) don’t change their nappies up to six days later.

Our biggest risks are if we come into contact with the Childhood type diseases Measles, Rubella, Chicken Pox.

There’s also some debate as to wether we should have the Shingles Vaccine.....

My personal choice would be ‘No Way’

I’m a bit more cautious as l’ve had Chemo & know the risks of a wiped out immune system.

Any questions, l’ll be happy to answer if l can & will update my Methotrexate Story soon.

Take Care 🌷

[Marijo1951 in reply to Hidden]

I have 4 grandchildren, 19 year old twins and two others aged 15 and 12, so no nappy risks! As for the shingles vaccine, I'll be offered it free from March 2021 when I reach 70. If I'm still taking pred, I certainly won't risk it.

[HeronNS in reply to Hidden]

Polio should only be an issue with the oral version, not the injection. But surely we are all immune to polio anyway as we've all been vaccinated? They don't even give the decennial polio boosters any more, so sure they are that the adult population is immune. I believe that childhood polio immunization is still essential, unlike smallpox, because there are still small reservoirs of wild polio virus in a few places.

[Hidden in reply to HeronNS]

People with compromised immune systems should avoid babies who’ve just had the Polio. In the UK it’s the oral version as far as l am aware (not even on sugar anymore) I was advised when on Chemo to avoid interaction & personally would say its the same if you are on Methotrexate.

medicinenet.com/poliovirus_...

[Marijo1951 in reply to Hidden]

The only baby in my life at present is my great nephew who lives about 200 miles away and I see in person very rarely (Whatsapp is different!). This has reminded me of hearing at least 25 years ago about a father who contracted polio from changing his baby's nappy. He was the cousin of a friend of a friend, so I never heard about the long term outcome for him.

[HeronNS in reply to Marijo1951]

Had that father been vaccinated? I mean, this is very disturbing when you think that polio has been declared eradicated in several areas of the world, including all of the Western hemisphere, Europe and nearly everywhere else.

[Marijo1951 in reply to Marijo1951]

As I said I only heard of this incident second or third hand and never knew any further details. I remember I was surprised it could happen at the time, but I'd almost forgotten it until reminded now. As I said it was a long time ago.

[HeronNS in reply to Hidden]

Well then, why aren't we still being given polio booster every ten years along with tetanus, diphtheria and pertussis?

I'm not sure oral polio vaccine was ever the norm in Nova Scotia although my father got some and made sure I received it. I was in uni at the time. It was actually developed by a friend of his, Hilary Koprowski, another Polish ex-pat who had settled in the US.

The Salk vaccine was introduced soon after I immigrated to Canada. I still remember one of the first summers I lived here, I guess I was seven, when we couldn't use the public swimming pools because of fear of transmission of the disease. I think we were even being told not to eat lettuce.. There were older (probably middle aged, they seemed old to me) women in the community who walked with braces, victims of polio when they were children.

[HeronNS in reply to Hidden]

This is interesting:

cdc.gov/vaccines/vpd/polio/...

Oral polio vaccine has not been used in the US since 2000 to reduce the risk of actually transmitting the disease. Nor is it available in Canada any more.

canada.ca/en/public-health/...

I understand the oral form was more convenient to administer but has been associated with cases of paralytic polio. As our countries have been polio free for quite a long time not providing live vaccine helps to keep it that way.

So I think we're both right. If oral form is still used in UK and on the continent anyone would have to be careful around a newly vaccinated infant. But here the vaccine given is no longer live so I can't imagine there would be any risk, any more than I can catch the flu from a dead flu virus.

[Blearyeyed]

All answered above , so I just thought I'd send you a big hug and my wishes that you feel better soon XXX😘😘😘😍💐🌻🌼🌻🌼

[Marijo1951 in reply to Blearyeyed]

Thank you. Actually I do feel noticeably better than I did yesterday so I should shake it off before too long.

[Brantuk]

I had a bad cold recently and I stopped the mtx for two weeks in order to give my body a chance to fight it off. Mtx suppresses the immune system in order to stop it attacking you from the inside, particularly if you have GCA like me. Unfortunately that also means mtx weakens your body's defences against common infections like (e.g.) a cold or tooth infections.

So it's a question of achieving the right balance once you get an infection. When I had my heart surgery the doctors stopped my mtx for 2-3wks before the operation. I did get a chest infection after the surgery and they had to pump me full of strong antibiotics for a week to fight it off. I restarted the mtx about a month later once I was clear of infections. Be very wary of infections especially if you have had heart surgery of any kind. I was warned that the effect of a tooth infection on my heart graft can potentially be fatal if not immediately recognised and dealt with.

[Marijo1951 in reply to Brantuk]

Thank you for your response. I didn't take my MTX on Friday and I'll skip it again this Friday. I have both BCA and PMR and was prescribed MTX originally because of a couple of GCA flares. I'm wondering if it has affected me in another detrimental way which I'll probably post about shortly.

[Blackcat1M]

I take 20mg mtx , and when i had a cold i did not take it, butnobody told me not to, as i know i have not to take it with antibiotocs,

I take pred, then 2hrs later take folic acid, then wait two hours and take vitimin D, that leaves me the rest of the day for paracetomol, and magnesium.

[Poshcards]

My consultant and gp say not to take your metho whilst poorly like this, as metho lowers your immune system and to recover from your illness requires you and your immune system to gain strength. Hope this make sense. I had to do this for 4 weeks when I had pneumonia x

[Marijo1951 in reply to Poshcards]

I'm glad to learn that some doctors give this kind of advice - mine never warned me! Nasty that your illness developed into pneumonia. I hope you're much better now.

[Poshcards in reply to Marijo1951]

it was a few years now, I hibernate during the winter months, nobody comes in and I don't go out. It's the only way I can try to avoid infections. Stay well!! x