Methotrexate & getting sick or an infection

I was hoping that I could get some help with a question that has been on my mind for months now. I have been taking methotrexate for 10 months now, ever since I was diagnosed with PsA. I hear that when taking methotrexate we need to avoid people with viruses and I hear that we are at higher risk for infections. I do not quite understand. When you are on methotrexate does it increase your chances of getting sick?? Am I at higher risk of getting sick and if so is it more often? And if so, when you do get sick, say with a virus, do we suffer worse because of our weakened immune systems than if we did not have a weakened immune system? And if we get infections, are they worse than they would be w/o the weakened immune system?? Luckily I haven't been sick once since starting on the mtx. last April, but have recently had my doseage increased from taking 12.5mg to 20mg and fear that with an increased dose of mtx. I am at higher risk for worse side effects. Is that correct? Do our risks for side effects increase with our doseage increases? I would really appreciate some feedback on this subject as I am just clueless.
Thank you all,
Kathy

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One more thing ~ I have read that if I get fever, chills, sore throat, or other symptoms of a cold or flu that I am to call my health care provider and not to treat these symptoms myself. Is that really true that we call our doctor if and when we get one or more of those things? Do we call our rheumatologist or our regular MD? These particular questions have been burning inside of me for months now and now that I've found this site I'm hoping to get some help figuring it out.
Thanks again,
Kathy

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Hi Kathy,

Methotraxate has the side effect of suppressing your immune system. I have been on 20 mg of MTX for several months as well as Humira. I have had one sinus infection and I haven't had one of those in years. I do have dogs and wash my hand frequently. I haven't tried to avoid sick people and even spent 3 days in the hospital for surgery. The only thing I have done is to get a flu vaccination and also got a pneumonia vaccination. If you are really concerned, discuss it with your rheumatologist.

Marta

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Like mrawlin said, MTX surpresses the immune system making you more vulnerable to infections and viruses. Take more MTX (20mgs instead of 12.5mgs) would further surpress the immune system but probably not a great deal more. I wouldn't live in fear of getting a virus if I was you. Just sanitize, wash your hands, and of course do your best to avoid being around sick people. But must people try to do that anyways.

As for calling your doctor when you have symptoms of fever, chills, or sore throats, I believe this is referring more to possible side effects of MTX rather then a cold virus. A sudden on-set of fever, chills, and sore throat would be unusual for the common cold. If fever and chills are present in the common cold they are usually mild and self limiting. Colds are usually more of a stuffy, runny nose, tired, scratchy throat kinda thing. On-set of high fever, chills, could indicate something more serious such as the flu or an adverse reaction to the MTX. In these cases, your doctor should be contacted immediately.

One thing you should establish with your doctor is whether or not you should continue to take your MTX if you do get sick. This question can only be answered by your doctor because opinions vary. Some say you should stop taking your MTX until your symptoms subside, other doctors (like mine) says it's safe to continue with MTX while sick.

I wouldn't over worry about this. I usually get 1-2 colds a year. When I took MTX for a year, I didn't get one single cold. If you maintain a healthy diet, excersise, and try your best to avoid ill people, you should be just fine.

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I have been on 10 pills each week (25mg) for what seems like forever now. More like months though. The side affects almost completely went away for me.

My daughter is not in school until this upcomming September. I am pretty much house bound until spring. I have gotten sick, but not as bad as I was last year. But I have been avoid everyone.

It's harder to heal, easier to get sick or an infection. Not treating something or putting it off is not good with a lowered system. But I have not overly freaked out yet about it. I am not that active.

I will worry more when my daughter starts school though. We'll have to see. My advise is to just pay attention to your body and be blunt to the doctors when you know something is 'off.'

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I had a horrible sinus/bronchial infection in October, it took 1 1/2 months to get over it and 2 rounds of antibiotics. My Rheum and my PCP both say no MTX while on antibiotics and for 1 week after finishing treatment. So I had no MTX for 1 month! Not fun, had a very bad flare up of the PSA and the P which was 100% cleared came back on my elbows only and remains till this day!

Personally I just try to avoid sick people and I am very vigilant about washing my hands. You can't live in a bubble just use common sense and don't worry. As for side effects I started out initially on 10mg per week, then up to 12.5 mg per week, I have been on MTX for just over 1 year now, my side effects went away after a couple of months. I think your body just needs to adjust to it. Even if you do experience some side effects give it time to work itself out because the med does really work to help PSA and IMHO the benefits outweigh the risks/side effects. Good luck to you.

Deanna

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I really appreciate you all taking the time and going to the trouble to respond to me. Your responses mean a lot to me and I am taking it all in :D
A sincere Thank You!!!!!

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I am also on methotrexate..My rheaumatologist also told me to TRY to keep a safe distance when someone is sick/feverish etc..It does weaken the immune system but I dont feel like I get even a common cold as often as everyone else I know.lol..I try to avoid it but ,like my doc said,Live your life.....

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The thought of having to go off my mtx. if I get sick just makes me sick....lol. It takes so darn long for it to build up in your system to begin with. I was so miserable before I started on the mtx and hate the thought of what I would feel like if I had to be off of it for any length of time like realtor910. I am real good about washing my hands and sanitizing. But as of Sunday night I've had a sick husband in the house (virus) so it really made me start to wonder what I might be facing.

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Hi....I have been on MTX since October 10...been on 17.5 mg weekly for two weeks when a horrible severe bronchitis hit (i've never had this infection before). Am now on second 14 day antibiotic, inhalers, and a med to sort of "numb" my lungs to reduce the cough. No one else in my house (i have three kids at home and hubby) have had this so it wasn't viral. My rheumy says NO MTX while on antibiotics or with symptoms.........I had already had to miss one week the month before due to sinus infection that cleared quickly....I am now at the end of week 2 no MTX--today would be dose day so starting the third week without treatment and know for sure I have at least one more, probably two to go.

I understand the fear of going off MTX....I wasnt' completely clear how much it WAS helping me til I had to miss a dose...I am certainly in the middle of a flare up..worse than original diagnosis pain in my left foot, left hand, and right hip. My P on my scalp, elbow, and leg is also very red, scaly, and bleeding and was almost clear. Tonight my left foot was so swollen I could barely walk...<sigh>..........hang in there!

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I am so sorry to hear about your bronchitis and I hope you make a quick recovery and are able to get back on the mtx very soon. I never have liked taking this stuff and now I chuckle at myself for fearing the idea of ever having to stop taking it.....even if only temporary. Thank you for taking the time to respond. I really do appreciate all the feedback I can get on this subject.
Sincerely,
Kathy

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Dear Kathy, As far as i know drugs such as Methotrexate and later Ciclosporin were first used to suppress the immune system in patients receiving organ transplants to prevent transplanted organ rejection. The story goes that a male patient undergoing a kidney transplant, who also had psoriasis was observed by physicians to have had vast improvement in his psoriasis whilst having methotrexate for the transplant related condition, so began the use of methotrexate in the treatment of psoriasis which is an immune system T Cell related disorder. It is clear to anyone that any drug that suppresses the human immune system that this will expose the recipient to a far greater risk of infections that may prove to be fatal. the full facts of the situation are not in the hands of the general public, but in the hands of the dermatology profession and the pharmacetuical industry, However i can give you information from the UK Medicines and Healthcare Regulatory Agency (MHRA) on Reported Adverse Drug Events. Up to 2006 out of 1,145 reports there were 175 fatalities associated with methotrexate, (15.4%) up to September 2008 out of 1,620 reports there were 230 fatalities associated with methotrexate, (14.2%). It is to be noted that without a full public enquiry into these multiple deaths that the truth of historical events which may include hidden facts from the public by the Pharmacetuical Industry and the Dermatology profession that the reality of the facts will never be known. Yours Faithfully Terry Cunningham. E mail : tc494949@gmail.com

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I've been taking MTX 10mg/week for psoriasis, not psoriatic or rhuematoid arthritis, for about 8 months. I have been pretty healthy from colds or the flu. But my ALT blood level has gone up from 30 to 50 and for that reason my derm is suggesting that I switch to a biological.

In the meantime I am going to need a hip replacement and my surgeon has suggested that I stop all immune suppressors before the surgery and while healing. I am not afraid of the surgery - actually welcome it as I am tired of limping so badly - nor am I worried much about the recovery and rehab, but I do have a worry about MRSA. Is MRSA easier to get when you've taken MTX? My surgeon suggests that quiting MTX a month in advance is generally good. Anybody else have some extra knowledge about MRSA and MTX?

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Thank You So Much everyone for you much appreciated responses!!!
Kathy

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That is some bad stuff your taking. Everyone i ask including pharmacists say to stay away from it period. You must remember that the doctors dont usually care about what they give out to the patient because there not living it.

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psoriosisnomore ~

I do agree that this is some heavy duty stuff that SO many of us are taking, but I don't feel I have a lot of choices. I do not want to be crippled. I know their are significant risks, and it could even shorten my life span, but considering all the suffering I was doing before I got on it I had to make a decision......quality of life or quantity of life. I hope to live a long life and grow old with my husband and be here with my sons to see what direction their lives take them. I pray to have grandchildren someday. But I won't be able to enjoy any of that if I am crippled. For all I know something else, like cancer, will come and get me long before the methotrexate does me in. It is scary taking it, but I cannot live my life in fear of it.
I really do appreciate your concern and I hope you find something that works well for you. Take care my friend!!!!
Sincerely,
Kathy

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Since I started mtx and enbrel in Oct 2010 I have had pneumonia 2x.. Yes i've had the vaccine. Apparently it doesn't cover all pneumonia. And one sinus infection. I was told to stop both meds until I was better with antibiotics. I try to avoid sick people but I have an 11yr old son. Can't hide from him. When he's sick he just wants his momma.

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That's certainly not fair, to get vaccinated for pneumonia and then get it not just once but twice. It seems like I have heard a lot of people say that they have gotten sinus infections while on mtx. I really hate the idea of getting sick and having to stop taking my mtx. It funny, it's a love/hate relationship. I hate taking the stuff with a passion, yet I can't stand the thought of having to stop taking it. I read about people having bad flares while they're off it. Then I would guess that it would take weeks to build back up in your system again??? But being a mama definitely comes first. I stopped volunteering at my local elementary school because what worse place is there to pick up viruses and bugs. I hope you stay well :) and thanks for the response.
Take care my friend,
Kathy

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When I had to stop my Psoriasis and the pain from PA was definitely coming back. I hated having to stop just when I was seeing a bit of a difference.

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Kathy23, all the responses I've read are on the money. MTX is serious medication only take it if nothing else works. Cyclosporine is a less toxic drug that worked best for my skin issues. I seriously almost died from and overdose of MTX, caused by taking anti-biotics while on MTX. No doctor told me not to do this. I was on two rounds back to back. Anti-biotic's increase the potency of MTX by removing bactirea or flora which helps to break up the MTX before it meets your liver and kidneys. I was extremely sick, severely swollen and hand fulls of my hair fell out! it was very scary... please take this medicine very seriously. Any medication that list toxic fatality as a possible side effect, needs to be used only as a last resort.

Best of luck to you!

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OK, I am censored again.

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