Methatrexate with Abx

[Rockin Annie]

I haven't posted for a while but have been here reading the new posts.

Anyway I need so advice now and hope you can help.

My pain has increased very much and thought it had been different things I was doing, but it has gone to my feet, knees, neck.  I had a phone consultation with my Dr in Melbourne and she wants me to go on 5mg Mtx till I see her in November.  As you can guess I was devastated.

My question is my own GP asked me was I supposed to stay on the cocktail of abx while on the Mtx, silly me didn't ask, so when I rang back to find out, my Dr in Melbourne has gone on holidays for 3 weeks. So I don't know what to do now, can anyone help.

I am on Cilicaine and Rulide in the morning and mino in the afternoon on MWF.

Thanks Rockin Annie

 

Diagnosed with RA in 2004, after trying many conventional meds I changed to mino.
2015 changed to doxy 50mgs
2016 went off doxy, after getting double pneumonia and massive flare put myself on 250 mgs Zith & 50 mgs doxy, which I will increase slowly.
Supps, magnesium, NAC, vit c, krill oil, oregano oil, thisylin, turmeric, olive leaf extract, vit B, multi vit.

[lynnie_sydney]

Annie – my guess would be that Dr D intends for you to ADD that to your regime rather than replace it. However, another option would be for you to call LW's office and ask for LW to call you back with her take on this. She is very knowledgeable in her own right – plus works very closely with Dr D and would almost certainly have encountered this before. She will call you back after clinic hours. Lynnie

Be well! Lynnie

Palindromic RA 30 yrs (Chronic Lyme?)
Mino 2003-2008 100mg MWF - can no longer tolerate any tetracyclines
rotating abx protocol now. From Sep 2018 MWF - a.m. Augmentin Duo 440mg + 150mg Biaxsig (roxithromycin). p.m. Cefaclor (375mg) + Klacid 125mg + LDN 3mg + Annual Clindy IV's
Diet: no gluten, dairy, sulphites, low salicylates
Supps: 600mg N-AC BID, 1000mg Vit C, P5P 40mg, zinc picolinate 60mg, Lithium orotate 20mg, Magnesium Oil, Bio-identical hormones (DHEA + Prog + Estrog)

[Rockin Annie]

Thanks Lynnie, I never thought of that option, I will call her on Monday.

Thanks again…….Rockin Annie

Diagnosed with RA in 2004, after trying many conventional meds I changed to mino.
2015 changed to doxy 50mgs
2016 went off doxy, after getting double pneumonia and massive flare put myself on 250 mgs Zith & 50 mgs doxy, which I will increase slowly.
Supps, magnesium, NAC, vit c, krill oil, oregano oil, thisylin, turmeric, olive leaf extract, vit B, multi vit.

[Kim]

Hi Annie, nice to see you back, but sorry you're having a rough go. 🙁

Take care…..kim

[Rockin Annie]

Hi Kim,  I have always been here and do read what is going on, but just not posting.  I can cope with most things but when it starts to effect my feet and dancing, thats a little different.  Hopefully I won't be long on the hard stuff, fingers and feet crossed.

………..Annie

Diagnosed with RA in 2004, after trying many conventional meds I changed to mino.
2015 changed to doxy 50mgs
2016 went off doxy, after getting double pneumonia and massive flare put myself on 250 mgs Zith & 50 mgs doxy, which I will increase slowly.
Supps, magnesium, NAC, vit c, krill oil, oregano oil, thisylin, turmeric, olive leaf extract, vit B, multi vit.

[justsaynoemore]

Annie – if you do a drug search for tetracyclines and methotrexate, you will find the recommendation is to do a month's wash of the tetracycline, then add the MTX, then add back in the tetracycline.  I found this out the hard way, as supposedly MTX when taken while ON tetracyclines can double the toxicity of the MTX for some people, like it did for me, and I had a high liver enzyme crisis which hospitalized me.  Luckily no damage as it was caught early. 

On the other hand, when I was first diagnosed I went on MTX as recommended for 14 months and my liver enzymes were slowly rising past normal and the rheumy was just about ready to pull me from MTX.  I thhen discovered minocin and started it with my primary, which of course infuriated the rheumy.  I then went sero-positive again and he retaliated with doubling my MTX with my liver enzymes past normal.  I immediately stopped the MTX and next blood draw I was sero-negative again and have been so for over three years on minocin alone.  I never went back after that appointment so he thinks he got me sero-negative again with doubling the MTX, fine, but it was the STOPPING of the MTX and the starting of the minocin which normalized my liver functions and going sero-negative again. 

So, I would do some research and SHOW your doctor about this reaction between tetracyclines and MTX, as there is alot about this on the web.  My rheumatologist, pharmacist, and primary were all unaware of this reaction.  I can never take MTX again because of all of this, which is fine with me, especially as alot of biologics are recommended to be taken with MTX.  I am sticking to tetracyclines as they work for me. 

Good luck ~~ Cathy

[Rockin Annie]

Hi Cathy, 

Thanks for your reply.  I did a drug interaction like you advised, and all my drugs interact with both the Augmentin Due Forte and the Mtx.  Thank goodness for you as I was just going to take all together, now I think I will give the Mtx a miss, as I was having second thoughts anyway.   

Thanks for the push to check………..Annie

Diagnosed with RA in 2004, after trying many conventional meds I changed to mino.
2015 changed to doxy 50mgs
2016 went off doxy, after getting double pneumonia and massive flare put myself on 250 mgs Zith & 50 mgs doxy, which I will increase slowly.
Supps, magnesium, NAC, vit c, krill oil, oregano oil, thisylin, turmeric, olive leaf extract, vit B, multi vit.

[Maz]

[user=807]Rockin Annie[/user] wrote:

My question is my own GP asked me was I supposed to stay on the cocktail of abx while on the Mtx, silly me didn't ask, so when I rang back to find out, my Dr in Melbourne has gone on holidays for 3 weeks. So I don't know what to do now, can anyone help.

I am on Cilicaine and Rulide in the morning and mino in the afternoon on MWF.

Hi Annie,

I don't know if this will help or not, but I wondered about this a while back in relation to my MIL in UK who was considering, at the time, adding minocycline to her mtx (as she's 79 now, she decided she just wanted palliation and the thought of herxing, while living alone was too much for her to consider).

The member, Texas T, kindly posted and shared info her doc had received from O'Dell who had done research on RAers using both methotrexate and doxycycline. This may be relevant as you're on minocycline and contemplating adding methotrexate:

The first link is my post and ensuing insights from Texas T with the letter her doc received from O'Dell. In the second link, O'Dell's study, it was his finding that the doxy improved the action of mtx. This is the 2nd link below:

http://rbfbb.org/view_topic.php?id=1910&forum

http://www.ncbi.nlm.nih.gov/pubmed/16447240

O'Dell also conducted longterm research on RAers using minocycline over a 4 year period that demonstrated the efficacy of longterm AP, but it's not clear if he believes in infectious causes or not…not that it really matters. Certainly, the addition of methotrexate would likely diminish the anti-bacterial props of the tetracyclines, as they are bacterostatic and require some amount of normal immune functioning in order to kill pathogens.

I'm afraid I haven't come across any info on the combination of methotrexate and the other abx you're taking, though – Cilicaine and Rulide. These interactions would need to be checked.

And, aside from the O'Dell studies, here is an interesting 'take' on the methotrexate and minocycline combo that was posted on an informational page at: 

http://www.rheumatic.org/mtx.htm

So, while we all realize that methotrexate and the tetracyclines taken together are working against one another (if one believes in infectious causes, of course), in the smaller doses taken for RA (and not in the higher doses as a cancer patient would take), the two can be safely taken together, according to O'Dell. Ideally, however…and this is just my take….this would be for a short term period with the goal of gradually weaning off the methotrexate asap, when some stability is reached, as the two in the longer term would like add incrementally increasing pressure to the liver.

Thing is, while none of us wants a rheumatic disease and no one likes taking any drugs, sometimes needs-must, so no one here should feel bad if they need extra DMARD or biologic help in order to function.

Hope something here helps, Annie, as you do your researches on all this.

Peace, Maz 

PS If you check the first link above where I pasted the bit about drug interactions of doxy and mtx, the piece says:

“Concomitant use of tetracyclines should be avoided in patients on high-dose methotrexate regimens.”

This would definitely be the case in patients using methotrexate for cancer.

[Rockin Annie]

Hi Maz,

Thankyou for all that information for me. I have checked out the links you posted and everything I have read only confirms what I had read yesterday.  I was on a web site which when I look back at it now, the principal investigator was James O'Dell, and the study was from 2001-2006 and stated everything that you wrote.

I have been on the internet since Thursday looking up different sites, my mind in a turmoil, whether I should or whether I shouldn't.  Anyway after looking up the interactions on Cathy's suggestion, I decided to forget the Mtx and maybe just go back onto Mino., 50mg am & pm MWF and forget the other Abx.  then when I saw the O'Dell's site, I changed my mind again.  Well I have decided to take only 5mgs Mtx till I fly to Melbourne to see Dr K.

Maz I want to thankyou for posting, something in your words are very comforting to me and your words have put my mind at rest at least for the time been.  I know that I had to do something about stopping any further bone damage, but I didn't expect my AP Doc to suggest going back onto Mtx.

……………..Annie

Diagnosed with RA in 2004, after trying many conventional meds I changed to mino.
2015 changed to doxy 50mgs
2016 went off doxy, after getting double pneumonia and massive flare put myself on 250 mgs Zith & 50 mgs doxy, which I will increase slowly.
Supps, magnesium, NAC, vit c, krill oil, oregano oil, thisylin, turmeric, olive leaf extract, vit B, multi vit.

[heatherbell]

Hi Annie,

I believe we see the same doc in Melbourne.  I started MTX two weeks ago (10mg a week) on the advice of our doc.  I have been on AP therapy since February and things have gotten worse.  Our doc suggested to start MTX to get the inflammation down (I have aggressive RA) to avoid any further damage to my joints (maybe too late, but that was my choice).  Anyhow, on the doc's advice I am continuing taking the abx.  Just make sure that you do not take them on the same day as the MTX which is taken only once a week.  I go back to see the rheumy in three months when she will up the dosage of MTX to 20mg.  I'm hoping that both the MTX and abx will work together so that I don't have to add on another DMARD.  However, I'm at the stage now where I want quality in my life.

[Rockin Annie]

Hi Heatherbell,

I have just lost the long reply to you, this computer is really giving me the he,be's.

Anyway I will start again.  Thankyou for your reply, I have just started taking the Mtx last night, it was so hard swallowing those pills (5mg).  Even though I am sorry you are on Mtx, I feel a sense of relief that someone is going down the same road as me.

Are you living in Melbourne! and how long have you had RA.  I also am hoping for the Abx & Mtx to work together to stop the damage, as my wrists have a lot more bone damage which stops me from doing most things.

I will remember to take the Abx on differents.  Can I ask how many days of Abx and which ones are you on?

………….Annie

Diagnosed with RA in 2004, after trying many conventional meds I changed to mino.
2015 changed to doxy 50mgs
2016 went off doxy, after getting double pneumonia and massive flare put myself on 250 mgs Zith & 50 mgs doxy, which I will increase slowly.
Supps, magnesium, NAC, vit c, krill oil, oregano oil, thisylin, turmeric, olive leaf extract, vit B, multi vit.

[maz.aust]

Hi Annabel,

Good to talk to you last week, must call you this weekend as well, (we have changed telephone providers & I can call landlines anywhere in the world for 8cents unlimited time).

I agree with Lynnie — if Dr D is off on hols contact LynnW, I just saw her myself this morning & Dr D comes back this Sun starting work Monday .. I also agree with Heather (lives in NT by the way), we all have to do what we need to do to get it under control then we can breath & make a new decision as to how long we are going to do something, but having said all that you know I need to be OK with whatever treatment I am offered, if I am not OK I tend to put it off … this time it is entirely up to you whether you wait 'til you come down to Melb in Nov or whether you need to do something & take the mtx now.  I am sure you will do whatever you feel is best.

The beauty of a website like the Roadback is that there is always somebody who is either going down or has been down the same road that can hold our hands on the journey.

Hugs
Maz (aust)

 

 

Dec07: Diagnosed PRA, (CTD; Fibromyalgia; suspected Lyme):
Mar08: Diet to heal gut/bolster immune system (no gluten, dairy, sulphites or sugar)

Jan 2018: ABX Mon/Wed/Fri (started AP 2008)
1/2 x 150mg Roxithromycin(Biasig), 1/2 x 150mg Clarithromycin (Klacid),
1/2 x Fungillin, 1 x 250mg Cephalexin (Keflex)

All off days Probiotics

[heatherbell]

Hi Annie,

Sorry for delay in replying.  I cannot get access to this website on home computer only work and I have been off work for the past week.  I live in Katherine, NT.  I have had RA since July 14 2009.  I take Biaxig & Keflex a.m., Klacid midday, and Doxycycline p.m. every Monday and Thursday.  I started MTX on 17/Sep.  Yes, it was hard to swallow that little harmless looking yellow pill the first time.  I waited to see what it was going to do to me for the first week!  Luckily, so far all is good except extreme fatigue in the middle of the week (I take the MTX on Saturday).  I'm glad you started taking it as it sounds as though damage has already occurred in your wrists.  I read in one of your latest posts about your toes are going off in all different directions!!  Well rest assurred I'm in the same boat.  I haven't been able to wear shoes, only thongs, for the past three months.  This must be a real worry for you as a dancer.  Anyhow, just keep positive about it all.  Good luck.

[lynnie_sydney]

[user=1734]heatherbell[/user] wrote:

Hi Annie,

Sorry for delay in replying.  I cannot get access to this website on home computer only work and I have been off work for the past week. 

Hi Heather – hopefully you have seen the announcement posts about lots of people having trouble accessing the Forum since 23rd Sept. Lynnie

Be well! Lynnie

Palindromic RA 30 yrs (Chronic Lyme?)
Mino 2003-2008 100mg MWF - can no longer tolerate any tetracyclines
rotating abx protocol now. From Sep 2018 MWF - a.m. Augmentin Duo 440mg + 150mg Biaxsig (roxithromycin). p.m. Cefaclor (375mg) + Klacid 125mg + LDN 3mg + Annual Clindy IV's
Diet: no gluten, dairy, sulphites, low salicylates
Supps: 600mg N-AC BID, 1000mg Vit C, P5P 40mg, zinc picolinate 60mg, Lithium orotate 20mg, Magnesium Oil, Bio-identical hormones (DHEA + Prog + Estrog)

[Rockin Annie]

Hi Heather,

Gee I thought I was doing it tuff, you sound far worse than me.  I must say the dance part really gets to me though.  I remember a while back I would put on my gorgeous dance shoes and struggle for a few hours because I hated wearing my old faithful tango shoes, but now I am even lucky to get them on lol, I should be grateful and enjoy what I can.

Good luck with yours too and thanks for your reply……………Annie

Diagnosed with RA in 2004, after trying many conventional meds I changed to mino.
2015 changed to doxy 50mgs
2016 went off doxy, after getting double pneumonia and massive flare put myself on 250 mgs Zith & 50 mgs doxy, which I will increase slowly.
Supps, magnesium, NAC, vit c, krill oil, oregano oil, thisylin, turmeric, olive leaf extract, vit B, multi vit.

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