Does methotrexate increase the risk of bacterial infections?
Methotrexate can affect the immune system and is commonly associated with an increased risk of infections in general, including bacterial infections, especially in people who take higher doses or also use other immune-suppressing medicines. [1]
Who is most at risk for bacterial infections while on methotrexate?
Risk is higher when methotrexate is combined with other immune-suppressants (such as corticosteroids or biologic therapies) and in people with factors that lower immune defenses, including significant kidney disease, older age, or poor nutritional status. [1]
What kinds of bacterial infections are people more likely to get?
Reports and clinical experience tend to include common bacterial infections (such as respiratory and skin infections) as part of the broader “infection” risk seen with immune suppression. The exact mix depends on the person’s other conditions and concomitant drugs. [1]
What symptoms should patients watch for?
Contact a clinician promptly if there are signs that could fit a bacterial infection, such as fever, chills, worsening cough, shortness of breath, burning or pain with urination, redness or swelling of the skin, or worsening wounds. [1]
When should methotrexate be held?
Because infection risk varies by severity and the person’s treatment plan, the decision to hold methotrexate is individualized. In practice, clinicians typically pause immunosuppressive therapy during significant infections and reassess when the infection is controlled, but patients should follow their prescriber’s instructions. [1]
Can vaccinations lower the risk?
Staying up to date on recommended vaccines can reduce risk of preventable infections while on immunosuppressive therapy. Whether a vaccine is live or inactivated matters, so patients should check with their clinician before getting vaccines. [1]
Sources
- https://www.drugs.com/methotrexate.html