medication and infection

[Noni71]

Just a bit of advice from you knowledgeable people. I have GCA and currently taking 7.5mg Pred, 7.5 Methotrexate and Tocilizumab. I have a sinus infection/sore throat/earache/headache etc which is uncomfortable but not bad enough to seek intervention from GP. Was wondering what to do with regards above medication. Do I change anything, increase steroids, not take Tocilizumab/Methotrexate?

[PMRpro Ambassador]

Whose opinion is it that you don't need intervention by the GP?

Being on that mix of drugs must be suppressing your own immune response to the infections and as a result your body is probably not fighting it off as it would normally. I was told to miss TCZ if I had signs of an infection and that is the usual advice for patients on MTX too. It also means you may need intervention at a lower threshold than normal.

I would contact my rheumy dept via our advice number to get their view. It wouldn't necessarily be MY rheumy, but someone would answer.

[Noni71 in reply to PMRpro]

Thank you. I’ve contacted my rheumatology help line and one of the nurses just got back to me. Her advice is to miss the Tocilizumab and Methotrexate this week and go up to 10mg of Pred for a week. If I think I have sinusitis then I should contact my GP.

[PMRpro Ambassador in reply to Noni71]

That is exactly what I would have said - glad to know I was correct!!! And pleased you have a good helpline.

[Noni71 in reply to PMRpro]

Yes exactly. Good to know you were correct in your thinking! The helpline is an invaluable resource.

[PMRhealth in reply to Noni71]

We don't have helplines like that in South Afrìca

[PMRhealth in reply to Noni71]

Thank you for that!I started a throat infection today and was due for weekly MTX tonight. So I'm guessing I should skip the MTX for this week and get lots of rest

[PMRpro Ambassador in reply to PMRhealth]

Certainly delay the MTX until you see what the throat infection does.

[PMRhealth in reply to PMRpro]

Does it matter what day of the week I take it, when I do resume?

[PMRpro Ambassador in reply to PMRhealth]

Don't think so - I used a delay like that to change the day to a more convenient one. Don't take it early though, must be a week between. And if you need it weekly - it needs to be regular.

[PMRhealth in reply to PMRpro]

Thank you!