neutropenia & methotrexate

lynnoot

I'm sure this subject has come up before, but I wonder if someone can inform me. I take 20m MTX weekly and for the last 4 months have had lowered neutrophil count. I started with and infection last Thursday, which is still not better. I went to the GP on Friday and she said not to worry at this stage, but also said to return if things didn't improve. I'm due to take MTX tomorrow, so don't know whether I should.

stickywicket

Neutrophils are, according to my little blue meth recordings book, 'a type of white blood cell that kills and digests germs'..I guess that's why we're tested regularly for them among so many other things.

Has it been suggested you have another blood test just to see how things progress?

As for taking to 'meth or not to meth' I omit mine readily if there's any problem or potential probem (eg when I had a tooth out). I find that some GPs will suggest this. others, often the older ones, are less aware of the connection.

It's probably best to ring your rheumatology helpline to see what they advise. They might prefer you to stick with it in case it's just a blip.

dreamdaisy

I routinely stop my meth and humira at the first sign of trouble (the trouble is the first sign doesn't arrive until somethings got a grip ) so that I allow my immune system to fire up and thus fight the bug. I was told to do so by my hospital and always have but it's best to chat things over with a rheumatology nurse: does your hospital have a helpline you can contact? DD

dibdab

Hi there,

I'm with DD and Sticky in leaving the meds alone when infection rears its head, on the advice of rheumatology. I have previously been told by the rheumatologist to miss doses of methotrexate when my neutrophils are lowered......so maybe the best course of action is to ring your rheumy for advice.

Hope the infection begins to clear soon.

Deb xxx

lynnoot

Thanks for the advice. I spoke to my rheumy nurse at the hospital and he suggested missing this week's dose of MTX. The infection knocked me for six, and am just starting to feel better.

dreamdaisy

The bug I had has only just cleared, I began it nearly three weeks ago and it floored me for at least a fortnight. I remember being told that because we don't have an active immune system when a bug moves in we don't produce symptoms until something has a good hold on us - this is why we have to be so vigilant about hand washing, using anti-bac wipes etc.

I resumed the injected meth an hour ago so I shall take it easy today, just to be on the safe side. I hope you are beginning to feel better and it might be worth getting official guidance from your rheumatology unit about stopping the meth etc. when unwell. Good luck! DD

stickywicket

Good I think that was the best way to deal with it as you've had no prior instructions on such things. I hope the break from the meth will allow your immune system to get on top of this but, if in doubt for the next dose, ask again. Have you been told to have any additional blood test?

Starburst

I've had the occasional episode of neutropaenia. I was always advised to take a short break from MTX and other strong immunosuppressant meds. I do this and the neuts. bounce back up again. An infection can knock you for six when you're on these meds. Take it easy.