Methotrexate and infections

Barbieg

Although I don't take methotrexate as I am on Sulfasalazine, my neighbour takes it . Have I understood correctly on the forum that if you have an infection it's best to stop the methotrexate ? I'm sure I've seen this on here, but my neighbour has never heard of it. Can someone tell me please? Barbara.

dreamdaisy

This is very much a matter of individual rheumatology practise, I was told to stop my meth etc. when dealing with an infection but others are told to continue regardless. The latter makes no sense to me but I am not a doc, just a 'practising' arthritic. I take a triple therapy (injected meth and humira plus tablet sulph) so happily stop the first two: it has to be very bad for me to stop the sulph. DD

jen9432

Methotrexate is an immune system suppressant. So if you have RA your immune system is ramped up already and this medication calms it down as well as calming down the inflammation that comes with it. If you have an infection in your body you need your immune system to be working to fight off the infection, but on methotrexate it is suppressed. So when the doctor tells you to go off it, that is to allow your immune system to fight off the infection. Once the infection is gone, you can continue back on the methotrexate. Hope this helps.

marrianne

I just hate it a cheap rotten drug that almost destroyed me Please guys dont be mad at me if it worked for you guess its horses for courses Marrianne xx

stickywicket

I've never been t old to stop mine by my rheumatologist but my GPs know I do (and are happy with that) for reasons the others have outlined. Your neighbour should check it out though before taking unilateral action.

Marrianne, I'm so sorry if you've had a bad reaction to meth. It's been great for me.

Barbieg

Thank you very much for your replies. He takes the pills not the injections and has never been told to stop them. Last year he had a very prolonged bout of infections that did not respond to antibiotics and he was talking about it today, so I mentioned what I had read on this forum. I will pass on your very helpful explanations and then it's up to him. Thank you.

Starburst

My GP never told me to stop MTX when I had infections but after a year or so, I noticed that other people on the forums were being advised to miss their dose. Rheum nurse said I only had to skip the dose if I was having trouble shaking an illness or on antibiotics. Now I'm on 2 DMARDs and an anti TNF, it is imperative that I stop MTX injection and anti TNF injections or it takes ages to shake off any sort of virus/infection.

dreamdaisy

If he didn't stop the meth tablets then no wonder he was repeatedly ill. The irony of the healthy telling us what we should or shouldn't do is not lost on me. ; they live with theories about arthritis and the meds - we have the reality of living with arthritis and the meds. Missing a couple of doses shouldn't be enough to trigger the arthritis into action and it can help one get better quicker. DD

Barbieg

Just wondered if it's the same for Sulfasalazine too. I have had a cold but am left with a chesty cough. Been to GP who says it's not a chest infection but has given me antibiotics to take if it gets worse. Other than that she said its a virus that will take it's time to go. Do I still take my Sulfasalazine ? What do others do?

dreamdaisy

I have to be very bad to stop the sulph so rarely do. It is a DMARD, however, so maybe you should contact your rheumatology unit and ask for advice, they are better placed to help you decide. I wish you well. DD

Barbieg

Thank you all who replied. I have learnt a lot on this forum and am grateful for that. My consultant who first diagnosed me 10 years ago retired from the NHS 3yrs ago and only does private which is no good to me , so after seeing 2 locums I have finally got a permanent consultant but don't feel as though we know one another yet (if you see what I mean) I've certainly learnt more from this forum than I ever have from my consultants , so thank you for that. Barbara.

dreamdaisy

We know our stuff and deal with the day-to-day realities, so we understand how confusing and unsettling this business can be. Never be afraid to ask questions when you see your consultant (I'm on my third) and does your unit have a telephone Helpline? Mine does, I ring, leave a message and someone gets back to me within two days (or quicker if it's an urgent enquiry). DD

Starburst

Barbieg, I don't take sulphasalazaine anymore but I do take a daily dose of leflunomide. I was told that medications like sulph and lef build up over time whereas MTX is one bolstering immunosuppressing dose, hence why we stop it. If you are really ill, you may be advised to stop the tablets but for a run of the mill infection, it shouldn't be an issue. That said, no one is qualified on here, so the best person to speak to if your GP or rheum.

Barbieg

Starburst, thanks that makes a lot of sense how you explained the difference between them.
Dreamdaisy, I had no idea about the help line till 2 months ago when I had to have a mouth biopsy and needed to ask about stopping my medication. My consultant had never mentioned it. I have since been diagnosed with oral lichen Planus which is another auto immune disease. I am so lucky ( I don't think!)