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Suggest treatment for sore throat - Online Doctor Chats

Date : 18-Apr-2014
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2548 Questions
User:Hello. My name is XXXXXXX & I am on methotrexate for an auto immune problem. I have had a sore throat (sides) for 3 1/2weeks now. I have seen my local GP who advised that it is viral, but it won't go away. I stopped my methotrexate last Thursday hoping to boost my immune, tired gargling with salt water, betadine throat gargle but it is still bothering me. Any ideas what else to do. Also I was thinking of not taking the methotrexate again this Thursday, but don't know if that is the right decision. Any advice would be appreciated.
Doctor:Hi
User:Thank you wondering if you can help with the above problem
Doctor:You have rather difficult situation
Doctor:I will try and give you my opinion
Doctor:but you will have to talk to your doctor who put you on Methotrexate before acting on my advice
User:Is that all you can offer at this stage?
Doctor:I think you have good knowledge about how methotrexate acts, so I presume that you understand methotrexate acts by decreasing your immunity
Doctor:So basically methotrexate makes you prone to infections, these infections can be bacterial, or viral or fungal in nature
Doctor:apart from decreasing your immunity, methotrexate is also a cytotoxic drug
Doctor:that is it kills cells
Doctor:so the inflammation in the throat could be due to cytotoxic effects as well as due to infection
Doctor:The best thing to do in treating such inflammations/infections is to get a throat swab culture and sensitivity done
Doctor:based on which appropriate antibiotics may be selected
Doctor:and since your immunity is compromised due to methotrexate, you will have to take the antibiotics for a much longer time
Doctor:probably 2 weeks instead of one week
Doctor:and meanwhile you should also stop methotrexate till the infection is clear
User:Ok thank you. I will also speak to my specialist.
Doctor:I have more
Doctor:You should continue with betadine gargles
Doctor:and salt water gargles
Doctor:both will be of help
Doctor:You can do steam inhalation with vicks, this will reduce the itching and irritation
Doctor:Do not take any medicines that may contain steroids
User:Thank you I will continue with these & try the Vicks as well
Doctor:You may take benadryl if the cough is severe
User:I don't have a cough just sore throats
Doctor:Okay
Doctor:In that case you do need antibiotics
Doctor:please see your doctor for a prescription
User:Thank you I will
Doctor:Do you have anything else to ask me?
Doctor:I guess that was it
Doctor:I wish you speedy recovery
Doctor:thanks for using the service, have a good day ahead
Doctor:good bye
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