Antibiotic and Actemra

[ILbbHpmr]

Hello folks,

I have an infection in my tooth and need to take an antibiotic for 10 days. If I'm understanding the guidelines for Actemra correctly, apparently, I am supposed to stop my Actemra injection (which is every two weeks) while I am on an antibiotic.

My question is, is that really necessary? What if I had just given myself the injection yesterday? I assume I would still be starting the antibiotic today anyway.

So, am I supposed to start the antibiotic today or tomorrow, skip my injection on Friday and be a week late with the injection? I'm pretty sure, I will have a flare if I do that, unless of course, I increase my prednisone. Or do I hold off starting the antibiotic and take it in the 14 days between injections?

Maybe I'm making a mountain out of a mole hill.

Thanks for any advice.

Annette

[HeronNS]

As far as I know the reason to stop Actemra while you have an active infection and taking antibiotics is because Actemra suppresses the immune system so much and this is to help your body fight the infection. I believe you stop Actemra until the infection has cleared up, which perhaps doesn't always exactly match up with duration of antibiotic treatment? Your doctor is the best one to ask what you should do to avoid a flare. It seems to me a slight increase in pred makes sense, although of course that suppresses the immune system as well, although not as severely.

Get well soon!

[ILbbHpmr in reply to HeronNS]

I will bite the bullet and take 10 days worth and stop the Actemra. Thank you for the get well wishes!

[PMRpro Ambassador]

Your medical team should have told you what procedure to follow if on antibiotics - have you any way of contacting them?

versusarthritis.org/about-a...

says you should cancel the injection and speak to your rheumatology team.

[ILbbHpmr in reply to PMRpro]

Yes, I just heard back and he says to stop the Actemra until the infection has cleared up (I assume that means until I take all 10 days worth). I understand the concept but still don't understand that if I had taken the injection yesterday, I'd still be put on the antibiotic today! However, I will do as I'm told and I'll cross my fingers and hope I don't have a flare. I've been doing well and I hate to rock the boat, so to speak. Thank you for your help.

[PMRpro Ambassador in reply to ILbbHpmr]

You can only do the best adjustment you can - and you need the abx now, not in a week's time! But if the infection hasn't cleared after the 10 days, ask the medics again. You may need more abx.

Get well soon!

[ILbbHpmr in reply to PMRpro]

Thank you! Just another little bump in the road and it could be a lot worse! I'm so grateful for all that I have learned from all of you. 😀

[Bramble2000]

Hi, this is just my opinion, I have taken around five different “mab” jabs over the years. Delaying the jab for a couple of weeks probably won’t have much affect - probably. I guess what you don’t want is for this infection to take even longer to go away leading to delaying your jab even further. You’re right though, you could’ve taken your jab yesterday. All the best.

[PMRpro Ambassador in reply to Bramble2000]

"man" - or "mab"?

[Bramble2000 in reply to PMRpro]

Sorry, “mab” Adalimumab, Certolizumab, Infliximab etc.

[ILbbHpmr in reply to Bramble2000]

Thank you! Started taking it yesterday as prescribed and hoping all will be well.