Posted by Larry Hoover on September 15, 2004, at 14:18:45
In reply to Methotrexate questions, posted by greenwillow on September 12, 2004, at 23:32:30
> In my 5th week of taking methotrexate pxd for undifferentiated spondyloarthropathy. I am having good success, but have a few questions I hope someone can answer: since it is an immuno-suppressant, I am wondering if my chances of catching something like a cold or flu are greater in the days right after I take it?
I had to look this up, so it's not something I already had a sense of, but it doesn't look like that's the case. Methotrexate blocks a key conversion of dihydrofolic acid to tetrahydrofolate, and thus impedes a number of cell replication processes, not just the immune system. The latter is considered to be a minor effect. I suppose it wouldn't hurt to be careful about hand-washing, and get a flu shot, that sort of thing.
> Also, my pain doctor has mentioned he might like to inject Botox into a messed up part of my back; will there be any problems with botox and methotrexate? thanks
Botulinum toxin causes nerves to lose the ability to conduct a signal. It's effect is very localized, because the dose is so small it gets "used up" by the nerves immediately surrounding the injection site. If those are pain conducting nerves, they just stop signalling pain. I can't think of a possible interaction, but your doctor (rheumatologist, probably?) would have a clear understanding.
Methotrexate isn't considered to be "first line" therapy any more. I'm glad it's working for you. TNF inhibitors seem to be first-line these days, but they have some side effects, and are very expensive. COX-2 inhibitors seem to be quite useful for symptomatic relief.
I'm sorry you're faced with this challenge. Good luck.
Lar
poster:Larry Hoover
thread:390162
URL: http://www.dr-bob.org/babble/health/20040729/msgs/391136.html