How poorly before you skip methotrexate in children

[tshirthunter]

Dd had first dose of methotrexate last week and has now come down with a cough and cold. We all have it so not a side effect.

The rheumatology nurse said not to take if ill with a fever or on antibiotics. Normally I'd just let her recover naturally as it feels viral.

But is it only if those two things are there or should we skip tonight's ?

Trying to get hold of a rheumatology nurse and will speak to a pharmacist and try gp if able to but thought I'd try people with experience of taking this.

as an adult who takes it for arthritis I would definitely still take it- you don’t want to miss it unless you’re told to- however I would call your rheumy nurse.

GPs usually defer to what rheumatology say ime

My doc told me it takes a while to get going so I needed to take it every week and the same time and wouldn't really feel the full benefits for several weeks.

Similarly once you're on it and it's working it takes a while to stop so even if you're ill missing a dose isn't going to immediately put your immune system back to what it was.

So I'd definitely take it.

Stop at the antibiotics point, carry on until
then in our experience.

High fever or antibiotics was what I was told were the stopping thresholds. I add in how unwell. If floored, lethargic etc then take the week off but if still active just with a runny nose and cough then take it

Theres a really prolonged cough virus going round (not whooping cough) - it didn’t really become much as an illness but it lasts ages so stopping for a cough might mean ages off the meds.

My son has had to miss his methotrexate and adalimumab twice this year. Once due to fever of 39.8 which ended up with a trip to a&e as it wouldn't come down and when he had hand, foot and mouth so rheumatology told us to skip it. Both times he's ended up with flaring joints so I wouldn't miss a dose unless really poorly and/or a fever.

Thanks all she's been running around like crazy so we went with it as she's clearly not that ill. It's all new to us so I'm sure I will end up with lots of other questions x