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Have COPD with asthma, on oxygen and RA. Taking amoxicillin. What antibiotic to take while on Methotrexate?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
What antibiotic can I take for upper respiratory infection while on Methotrexate? Currently taking AMOX/K CLAV 500mg. Saw that Metho & current antibiotic has problems being taken at the same time. I have COPD with asthma, on oxygen and RA. What would happen if I stop Metho for 7-day AMOX/K CLAV med? Can't reach my Rheumatologist today & Metho dose due today. Will call primary doctor AND rheumatologist tomorrow.
Posted Sat, 1 Jun 2013 in General Health
Follow-up: Have COPD with asthma, on oxygen and RA. Taking amoxicillin. What antibiotic to take while on Methotrexate? 10 minutes later
No reports currently available. Waiting for chest x-ray report from 2 days ago. All vitals okay, oxy range from 94 to 97.
Answered by Dr. Hema Yadav 1 hour later
Yes,Medications like amoxicillin, especially when given at high dosages for serious infections, can sometimes increase the blood levels and effects of methotrexate. You may have increased side effects such as nausea, vomiting, mouth ulcers, and low blood cell counts, which can make you more likely to develop anemia, bleeding problems, and infections.Similarly other antibiotics like trimethoprim are contraindicated along with methotrexate while clarithromycin , cloxacillin etc can also show drug interactions with methotrexate .Hence many a times doctors advise to stop methotrexate while you are on an antibiotics course.
The risk in continuing methotrexate is worsening or persistence of infection as well as methotrexate toxicity.
The risk in stopping methotrexate is worsening of the arthritis or primary condition for which it was started.
Only the treating doctor can weigh the risk benefit ratio in such a situation and accordingly ask to continue or withhold methotrexate .
So please don't worry as it won't be XXXXXXX to stop or adjust the methotrexate dose while on antibiotics . But as you rightly decided its mandatory to inform and consult your doctor for advice before taking such a decision.
Hope that answers your query.
I'll be available for any follow up queries .
Wishing you good health.
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