Methotrexate and mino

[niteowl]

Is anyone here taking Minocycline whilst on Methotrexate? I am curious to know how you space them so as not to decrease the effectiveness of MTX.

Thanks in advance!

Diagnosed with RA in 2012
Fifth Disease in '03
Lyme? in 2000?
Had radioactive ablation of hyperactive thyroid in 1997
autoimmune thrombocytopenia resolved
Anemia resolved with treatment of RA with Minocycline
Blood type: B neg

Meds:
Minocycline 50mg once a week
Levothyroxine .88mg
Liothyronine 5mg
Methotrexate 20 mg once a week

Folic acid
B12
B6
Vit D
Biotin
Biosil
Cbd balm
Flexaril as needed
Aspirin
Benedryl
Ventolin inhaler
Lactibiane probiotic

[PhilC]

I noticed that you are taking a rather low dose of minocycline. Is there a good reason why you’re not taking a higher dose of mino? The reason I ask is because if you were taking minocycline every day you might not even need methotrexate.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[niteowl]

In order to understand why the lower dose I must give alittle back story; My recent xrays are showing arthritic changes and I have lost 40# of prednisone weight. However, I have also had alot of muscle wasting so I felt maybe I needed something more for awhile. My husband was afraid I was dying in front of him. Looking back, I have had symptoms since 1992-ish yet went undiagnosed until 2012. I was fortunate to find a Rheumy initially who agreed to try Mino. He had me on 100mg twice daily until I hit a wall about a month out. I did very well in the beginning I went to taking Mino 100mg every other day and that was great.
Then my Dr retired. I went to an AP Dr and then he retired from AP 2 years later. I then went to an AP dr about 2hours away and got terrible advice and treatment that made me go into a Lupus like condition: rashes, very bad asthma and pitting edema in my lower legs and hands. And the worst herxing. I think it sensitized me to Mino for a time. My Primary Dr put me on Prednisone which was great until it wasn’t!
I do feel the Mino helps protect the synovial lining as I have read in a few places. So I was hoping to incorporate Mino, again.
If I take a larger dose of mino than 50mg, I have worse asthma and herxing and GI issues. I started MTX three weeks ago and haven’t added the Mino, yet. And that’s where I am, now.

Diagnosed with RA in 2012
Fifth Disease in '03
Lyme? in 2000?
Had radioactive ablation of hyperactive thyroid in 1997
autoimmune thrombocytopenia resolved
Anemia resolved with treatment of RA with Minocycline
Blood type: B neg

Meds:
Minocycline 50mg once a week
Levothyroxine .88mg
Liothyronine 5mg
Methotrexate 20 mg once a week

Folic acid
B12
B6
Vit D
Biotin
Biosil
Cbd balm
Flexaril as needed
Aspirin
Benedryl
Ventolin inhaler
Lactibiane probiotic

[Maz]

Hi Niteowl,

I think you’re wise to consider changing things up. If I may ask, what was the terrible advice and treatment you received from your last AP doc? If you prefer, you can PM me with this info. It may be important to add this to the doc notes for others.

The description you gave re: mino sounds a bit like microbial hypersensitivity – too much die-off. Minocycline is prescribed to help asthma so I’m wondering if you started experiencing mino-induced pneumonitis? What sort of investigations did your doc do? Did he run any DILE labs or do a pulmonary scan? It would be good to get some confirmation on these things as you might want to discuss switching to a diff abx class altogether.

That said, some people do use mino and mtx together successfully. A lady in the new RBF FB page just shared she is in med-free remission after being on this combo for a year plus LDN and the autoimmune paleo diet. She’s in remission in both labs and symptoms!

If you look on drugs.com interactions checker, there is a moderate interaction with these two that just requires monitoring.

Minocycline/Methotrexate Interaction Checker

As for when to take them, it shouldn’t be an issue as oral methotrexate is usually taken once a week and you pulse low dose mino. Folic acid is a necessity when on methotrexate as it interferes with folic-acid producing microbes in the gut. Hopefully your doc mentioned this? Can you share what dose you’re taking?

Alternatively, have you discussed hydroxychloroquine with the rheumy? It might be less likely to cause blood count anomalies as you’ve had this issue before with the low platelets. I didn’t tolerate methotrexate well – was on it for 16 months (15mg) but felt bone-tired all the time, reflux, elevated alkaline phosphatase, very low lymphocytes and other reduced blood counts (it suppresses bone marrow), and worse swelling. I switched to hydroxychloroquine and it worked like a miracle in combo with tetracycline.

Hope you find some relief, Niteowl. It’s a journey to find what works for one’s self. Everyone is different and what works for one may not work for another…including which generic Minocycline may be more effective than another.

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