Methotrexate and covid

[GoldFrankensteinAndGrrr]

I was diagnosed with RA ten years ago but all the meds I was given gave me terrible side effects. I was due to start new ones last March but covid happened and my appointment was cancelled. Finally saw my consultant yesterday and I'm starting subcut methotrexate next week.

As is always the case my head completely emptied of all the questions I should've asked while I was there, including what the guidelines are re mtx and Covid. I'm not too concerned with the immediate future as I had Covid last month and am unlikely to catch it again so soon, but going forward, how much more at risk am I likely to be? My consultant did say it was one of the less immunosuppressant RA treatments and I will be on a low starting dose for a while (10mg pw).

I know that you're at far higher risk of catching covid if you're in a flare (I was mid flare when I caught it, though happily I was asymptomatic - I had a migraine and sneezed a bit but I get migraines and have allergies so it was likely unconnected). So I'm hoping that being on mtx and avoiding flares will counteract any effects of the drug, iyswim.

Also, does being on methotrexate mean I'll need a covid jab booster? I was group six when I was on no meds (I presume because of my RA), will I still be?

Thanks in advance!

Can you not ask your consultant? Do they not have a specialist nurse who deals with queries (we do for teems)

I would imagine you would need a booster as (as far as has been revealed) it's likely groups 1-9 will need them anyway.

Some people on immunosuppressants will get a "third dose" of vaccine before the booster, again, this might not apply to you, but you could check with your consultant's team.

Taking a list of questions in with you is a good idea (you can then complete them at leisure in advance )

My partner and daughter are on methotrexate for severe eczema. Dh on 30mg per week and daughter 20mg per week. Dh was advised last year at the start of the pandemic tgat he's classed as cev and needed to shield. But curiously daughter did not and her consultant said it's quite a low effect immune suppressant and she didn't need to shield. She's 12 and has been called for her Covid jab as she's classed as cev now this week. So confusing!!

I have lupus and until very recently was on methotrexate 25mg injections weekly. I was told that the idea with the methotrexate is that it reduces your over active immune system to the same level as someone who doesn’t have your issues, so essentially it should actually suppress your immune system to a point where you’re more prone to infections ie Covid- this is why when you take it they do regular blood tests (they’re checking to make sure your liver function is okay and that your immune system isn’t pushed too far the other way). So it should be okay. I was told that if I did get Covid or an infection that I should stop my methotrexate during that time just to give my immune system a chance to kick it out.

Unfortunately I had to stop taking it because it gave me horrible side effects - upset stomach, sickness etc but I do have a lot of other conditions which may have interacted with it all.