Methotrexate and codeine

I started methotrexate on 19th April and I have not experienced any side effects and my fortnightly blood test were stable so we went to monthly. My last fortnightly set was in June. Since then it looks like I have prolapsed a disc in my back and my GP prescribed codeine after checking for interactions. This is the 5th or 6th time I have done this disc in 10 years and have a history of spinal cord tumour so I am waiting for an MRI to check.

I started the codeine on 3rd July and my blood tests last week showed the ALT had shot up from 18-62 (it was 10 before I started methotrexate and had been consistently under the normal range when I was on sulfasalazine).I had a call with a rheumatology nurse this morning who told me I should try not to take the codeine which is really ot helpful considering the pain levels and was really unhelpful.


is it likely to be the codeine with the methotrexate that has raised the ALT? If so what other pain relief options are there?

I don’t want to stop taking the methotrexate as it has been the first time I have managed to cut down prednisolone with having a flare (it’s the 3rd attempt)

Comments

  • Hi @AlliO

    Thank you for your posting on the Online Community. I am sorry to hear that you a prolapsed disc and it is understandable that being told to try not to take your pain relief is unhelpful.

    Unfortunately we cannot say if the codeine did raise the ALT and you would need to check with your rheumatology department or pharmacist for confirmation on this as we are not medically trained and although there are many other alternative pain relief medications, you would need to ask your healthcare professional for advice on what is best for your own individual circumstances and I hope you are able to find an alternative that will help with your pain.  I have put a link below to our information on painkillers that you may find helpful when discussing with your healthcare team. I hope that this is helpful.

    Best Wishes

    Dawn, Helpline Advisor