resuming methotrexate injections following Covid

[Avon14]

Hi

I’m wondering if anyone can help? I was advised to stop my methotrexate injections as I’ve had Covid but not sure when I should restart the injections. It’s been 2 weeks since my last injection. I’ve been ill with Covid for a couple of weeks but have felt much better over the last few days and stopped testing positive a week ago. I’m also taking 9mg of prednisolone on a reducing regime.

I was diagnosed with GCA in April 2021 and relapsed in July 2022. I have a phone appointment on 9th February with the rheumatology nurse but not sure I should leave it that long.

[PMRpro Ambassador]

If you feel reasonably well and are testing negative you are probably OK to go back to the methotrexate next week. But I'd pause the pred reductions for another couple of weeks to be sure you are feeling recovered.

[Avon14 in reply to PMRpro]

Thank you PMRpro, if I continue to feel well I will resume the Methotrexate next week but will delay the pred reduction for a few more weeks. Very grateful for your speedy response.

[PMRpro Ambassador in reply to Avon14]

We try not to hang around here!!!!

[MarkWin in reply to PMRpro]

Hello. This is really interesting. I was phoned and instructed to stop my MTX (20mg/wk in tablet form) by a doctor who was phoning from the COVID PCR centre where my result showed positive. I was not to resume MTX for at least 2 weeks after I had had a clear COVID test. I complied. Despite asking, I was never informed at any stage whether I should up, carry on, reduce or stop Pred. I therefore carried on 2mg/day with seemingly no ill-effects.

My Rheumy is now suggesting I get off Pred ASAP and reduce to 1mg/day, from 1.5mg/day - so 33% in one go - but a new and very sensible GP has agreed that I may reduce more gradually, and which I propose to do.

There seem to be very mixed messages about all of this from different 'compartments' of the medical profession, but I am now listening to my body, being a bit more assertive and am immensely grateful for this forum.

[PMRpro Ambassador in reply to MarkWin]

Well - I can only say I'm glad you have a more sensible and presumably more experienced GP! Go from 1.5 to 1 by all means - but using one of the slowed tapers and possibly even slow it further. MTX might let you go faster - but the chances are it wouldn't allow that sort of approach!

[MarkWin in reply to PMRpro]

Thank you.

[Avon14 in reply to MarkWin]

hello

I didn’t actually report my Covid positive result other than to mention to the rheumatology nurse who phoned me for a scheduled appointment. He advised to stop methotrexate for a couple of weeks but didn’t say anything about increasing my prednisolone so I just carried on with the same dose. I find it so hard to get through to anyone in rheumatology and my GP is not that helpful and difficult to contact so I tend to rely on my instincts and the very kind, supportive, knowledgeable and speedy responses from the people on this forum.

We are so fortunate to have this forum.

[Avon14]

Much appreciated!