Methotrexate a cause for UTI??

[cakenomore]

I had symptoms of a UTI back in July. Usual procedure followed. Stop Mxt take antibiotics, but it didn't clear up. My GP said that a rare side effect of Mxt is inflammation of the bladder and as urine test didn't show infection it could be my meds. At first rheumatology would have none of it and told GP to refer me to Urology, I have a phone appt in November. In the mean time I'm in a lot of pain with my bladder and now have a massive flare. I spoke to Rhmy nurse yesterday about increasing Mxt because symptoms and pain not being controlled. She was very adamant that under no circumstances would they put my Mxt dose up because it can cause issues with the bladder!! I'm confused. My GP has stepped in and given me a steroid injection to calm the flare and weirdly it has helped the bladder pain too. He did say that it would be an experiment to see if that would happen,as it would suggest that it is bladder inflammation not infection. Previous to this experience I hadn't heard of methotrexate causing bladder issues and wondered if anyone else had .

[oldtimer]

There is a paper here collecting accounts of people with bladder pain who are on methotrexate.

ehealthme.com/ds/methotrexa... looks as if there may be rarely an association between the two?

Methotrexate is inexpensive and works well for lots of people, but not everyone. I'd suggest you look at alternative treatments (look at the NRAS website)and ask your rheumatology team to explore other treatments.

[cakenomore in reply to oldtimer]

Thank you for your reply I shall take a look at the paper. It's so frustrating because methotrexate, at the higher dose, had really helped bring the arthritis under control.

[Hallwood]

As I understand it, immune suppressant medicine like methotrexate can/does increase the risk of infection like a UTI. Should you pursue a more targeted antibiotic from your GP rather than a wide spectrum approach that may have been offered to you?

[cakenomore in reply to Hallwood]

Thank you for your reply. The doctor's surgery did a dip stick test which came back negative, but I have all the symptoms of an inflamed bladder. The steroid injection I had for my RA flare has definitely helped the bladder pain. I will be interested to see what urology makes of that.

[Sharon56]

I haven't heard about bladder problems with Methotrexate. I'm not surprised though.

[Deege]

I had exactly the same issue as you.I came off of Methotrexate for other reasons and it all settled down.

[cakenomore in reply to Deege]

Thamk you for replying . Well that is interesting. My Rhmy nurse has lowered my dose but not stopped it completely. It's all a bit of a balancing act with these meds. I'm so glad your symptoms settled down. I was finding it very difficult to cope with.

[Doughnut61]

I could not tolerate MTX made me really feel unwell. Now on my notes not to take it!

[Sohmui]

I've been on MTX on and off for 10 years and not had a problem with UTI. It does however make sense that any drug that weakens the immune system might have that effect. You do seem to have an efficient and caring GP and that is something to be thankful for. I hope the problem settles by itself and you don't have to come off MTX because otherwise it has been effective for the arthritis.

[cakenomore in reply to Sohmui]

Thank you for your reply. You are right MTX in all other respects has been a great med for me. Even helped my hair stop falling out when I had alopicia. If it wasn't for my GP I'd be crawling up the walls by now. I am very thankful for all the staff there.

[Jollyjill]

Hi - I've never heard of MTX causing bladder problems and have no personal experience of this. My layperson's suggestion is to treat the UTI and get your Dr. (not Rheum) to do a battery of tests to determine the actual cause. Because the infection occurred while you were on MTX does not necessarily establish an association. MXT works superbly for me but we're all different in how we react to these meds. I also suggest that you talk to a Urologist who might be able to shed some more light on the issue. Hope you"ll feel better soon!