By Dr Irwin Lim, Rheumatologist
I had to take a call from a patient I had just commenced on Methotrexate (at a low dose of 10mg once a week).
She was worried by what a well-meaning friend and a well-intentioned pharmacist told her.
She was told that she needed to avoid contact with pregnant women! You can imagine how this made her feel. What a horrible drug Dr Lim was putting her on.
In addition, she could no longer take her Celebrex, the anti-inflammatory medication she was using to get some relief. How was she going to cope? Especially as Dr Lim had told her that Methotrexate would take upwards of 4 weeks to have effect. Cruel.
She wasn't actually told to stop the drug but she was warned strongly of potential problems with using the Celebrex while on Methotrexate. By the way, this combination is a common one and the combination of Methotrexate with pain relief medications and with anti-inflammatory medications is used widely and is generally safe.
Methotrexate, at the doses used in rheumatology is NOT chemotherapy (read that explanation here) but it suffers a stigma.
I'm glad she called so that I could discuss and correct the "information" she'd been given. I'm glad she didn't just decide never to take Methotrexate.
Over the years, my patients have reported a number of disturbing things told to them about Methotrexate:
- You need to use a different toilet from other members of your family
- You need to use gloves to handle the tablets . Worse still, one patient who was hospitalised told me that the nurse gowned up and wore gloves to hand her the Methotrexate tablet! With another, the staff at the local pharmacy refused to load her Methotrexate into the pill box citing occupational health & safety issues.
- You have to avoid crowded, public places to avoid catching an infective disease
- Fearmongering: It will kill you! It's poison! etc etc
Of course, Methotrexate has possible side effects. It's a serious drug and is treated as such. Doctors typically prescribe it when the potential benefits outweigh the risks (as should be the case with all medications).
But, misinformation abounds.
What ridiculous things have you been told about Methotrexate?Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.