Methotrexate and flu/covid jab

[Ann1A]

Please can anyone advise me.... I have my covid/flu jab tomorrow morning, and Sunday is the day I normally take my weekly Methotrexate 25mg injection, should I take the Methotrexate as usual or leave it for a week ?Thanks in advance, Ann

[DorsetLady PMRGCAuk volunteer]

Usual advice is to stop MTX for 2 weeks following vaccines..

Now you have asked you can see related posts advising same.

[Ann1A in reply to DorsetLady]

Thanks so much.

[maisied in reply to DorsetLady]

Do you know whether stopping immunosuppresants after the vaccines applies to all immunosuppresants or just Methotrexate

[PMRpro Ambassador in reply to maisied]

According to this, for any we are likely to be on - no.

bccdc.ca/resource-gallery/D...

[Nagswoman in reply to PMRpro]

It will not let me look at that.

[PMRpro Ambassador in reply to Nagswoman]

Working for me - are you getting the inbetween notice that tells you that you are leaving the HU site? You just click on it and it takes you to the new site.

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Works for me as well…

[DorsetLady PMRGCAuk volunteer in reply to maisied]

PMRpro has replied

[PMRpro Ambassador]

The medical advice is omit 2 doses after the vaccination.

[Ann1A in reply to PMRpro]

Thankyou !

[autumnlass in reply to PMRpro]

Do opinions on MTX and vaccine shots very Pro? My Rheumy told me to halt it today and next week …a weeks gap on either side of the shot?I suppose it adds up to the same?!

[DorsetLady PMRGCAuk volunteer in reply to autumnlass]

PMRpro will reply, but my understanding is that ceasing it after vaccine [there seems to be some discussion on whether that’s for one week or two] increases the response to the vaccine in people with autoimmune inflammatory diseases.

[PMRpro Ambassador in reply to autumnlass]

As far as I know, it is the stopping after the shot that has been shown to have the best effect. It takes up to 10 days or so for the immune response to build so that is the important period. I can't see how the stopping before the jab helps - and then starting just as the immune response is developing seems daft!

thelancet.com/journals/lanr...

PS - when you google it you get some searches that suggest it ISN'T a good idea but they are AI generated searches that are taking a sentence out of context. SO beware what you believe!!

[autumnlass in reply to PMRpro]

I understand .. I would normally be taking it tonight. So I dont, also next week but take it in 14 days time. Should I defer the flu jab next Wednesday? So much to consider! 🙄

[PMRpro Ambassador in reply to autumnlass]

I don't know - according to the studies, you would take it tonight, have the jabs tomorrow and not take the next 2. Crackers really isn't it because if the jab was today and the MTX tomorrow you'd miss this one. Did the rheumy know the relative days of vaccine and MTX?

[autumnlass in reply to PMRpro]

It’s all a bit daft yes! Yes I explained it all to him at length. I remember not liking Moderna last time as I had quite a bit of fatigue from it afterwards, but I asked a pharmacist from an independent pharmacy who just said carry in as normal. The Boots team weren’t available unfortunately as they are super bright and nice here. Lots of folk here apparently want the Pfizer as Moderna has more side effects, but it’s £95!!

[PMRpro Ambassador in reply to autumnlass]

I just accept what they offer me here in Italy!! It can be either on previous experience, depending on which nurse you land up with!!!

[autumnlass in reply to PMRpro]

Well yes too I go with the flo and take on what’s on offer!

[autumnlass in reply to PMRpro]

I’ve just looked on my NHS app - it was the Pfizer one - great!!!

[Golf-1 in reply to autumnlass]

I had previously been advised to not take MTX the week before and the week after the Covid Booster.

This time round the advice changed to have the MTX before the Booster and leave 10 - 14 days after before starting MTX again.

I had my Booster yesterday, I normally take MTX on Wednesdays so will miss this week and resume the Wednesday after.

Just a thought and I am prepared to be shot down on this !!! having had a 2 week break from MTX , is there any reason to stick to the same day as previously? Can we not start MTX on any day that suits us and then weekly after that ?

[autumnlass in reply to Golf-1]

I was given the first lot of advice to you this time by my Rheumy! So missed it yesterday and next week too! I will have not taken it in all for 14 days but will resume in 21 days. What a milarkey!

I did change my days of taking MTX but that was having a break from it for a while as I was in hospital. Best Wishes 💐

[DorsetLady PMRGCAuk volunteer in reply to Golf-1]

Doubt there's an issue in changing days after a break...

[PMRCanada in reply to Golf-1]

I have changed the day of the week I take my MTX injections over the years due to starting and stopping it because of various infections (diverticulitis, chest infection that required antibiotics), then weekly again after that.

I’ve also experimented with 10 days between injections (after discussion with my rheumy), as I was on a higher MTX dose back then and seemed to be getting ill with everything going. It was thought this was due to being on two immunosuppressive medications (pred and MTX).

[PMRpro Ambassador in reply to Golf-1]

Yup - ideal opportunity to adjust the day of the week to another if you want to.