Up to you really. Take the stuff at 25mg per week. Last November-December had the flu for over three weeks. But I knew my flare-ups would be so bad, if I stopped the MTX, so I had to take antibiotics to get rid of the flu instead.

Thanks. I updated my post to include that I am on Orencia as well for those who might not know. I had the flu not once, but THREE TIMES!

Also debating not having flu shots anymore. THOUGHTS???

i kind of dislike like telling people what to do medically since each one of our cases of RA is so unique :) which I think you probably have noticed. you know best after concert with your doctor. You frequently state and re-state that mtx and bio go together. I have frequently stated in return that my MD spends much time talking to me about stand alone biologics (mostly when I have to go off mtx).

I was hospitalized in 2010 in ICU for pneumonia and after that particular infection I took a mtx hiatus at work and was on biologic alone. I managed to keep working. I have also come off mtx for the stupid dental implants and every other infection. I also had a time at work when I decided that the mtx brain fog was affecting my position and I went biologic alone. My rheum is the flex plan MD and so am I. so I am not going to offer advice - but I might offer not thinking in didactics and absolutes and shooting the hay with your rheumatologist.

also! before you forget these damn infections (in case for YOU they become a distant memory - ha ha - put a diary together of the dates and interruptions - I can't remember all the infections when the years and years go by and I find it tiresome to piece it together through researching my antibiotic fills and hospitalizations. the diary is easier.

sorry kiddo - you'll make your decision with your doctor (some are more sympathetic to consecutive infections than others I bet - so I should say your doctor will figure it out with YOU laughing)

also don't forget mtx cockiness - what's that? - oh that's when I think the hiatus will not be that bad and the half life thingeedoee is done and I really feel the difference negatively. that's my brand of selective pharmaceutical memory (smile).

hugs
depotblue

Thanks. I am keeping track. And like you have been off MTX for years at a time with no apparent detriment.

What I have shared with others is that -from what I have read - most biologics (except Zejanz) are RECOMENNDED to be used in combination with MTX. It's a balancing act - weighing the pros and con for each of us individually....and an option to consider if meds are not woking optimally.

I think you need to consult your rheumatologist. And see a lung specialist and/or allergist before you do it.

My rheumatologist is a big believer in not changing things, if they are working. I thought if I got off prednisone, he would let me go off Arava. He said 6 months off prednisone and see how I am feeling. I take Arava 2/3 days. So, I skipped the two dosing days, once. I woke up on the 5th day, with a major flare in my right shoulder, and feeling like I had been hit by a truck. (Don't tell my doctor I did this!)

So I am a bit of an experimenter! And I did learn my lesson, this time anyway! I'm so sorry you keep getting so sick.

With regards to the flu shot, I had it in the 1980's. I think I had it 84, 85, 86. This was before any auto-immune issues. The third year, I had the flu 7 times. The last time, it was so bad I had to be hospitalized, I had lost so much fluid. The doctor told me I should get the flu shot next year, but I told him I already had. After he heard about how many times I had the flu. He said "Don't ever get a flu shot, again!" Apparently there is some kind of paradoxical reaction. I never got the flu shot again, and although I have had colds from the grandkids, I have never had flu again, in all those years.

Ask your doctor if the flu shot is doing this to you. Maybe google it and see what you come up with. I was always eligible for the flu shot because of asthma and then RA. But I would never take a shot again! It might be necessary for you

I hope you figure this out. I'm in my 5th week of what is looking like chronic bronchitis. I'm so tired of coughing and coughing stuff up. But since I never got better from these infections before RA meds, I don't believe going off would help me. But it might make a world of difference for you!

Let us know what you decide, and if it helps or not!

Well, as a said, I survived WELL without MTX from 014 to 2016.

marlene - please explain why a pulmonologist or an allergist for recurring flu?? my lungs have been X-rayed and listened to multiple times and come up clear every time.

I'm not Marlene, but a pulmonologist will do more than an X-ray and listen to you (and an allergist as well). Perhaps there is some other underlying problem that is making you have these recurrent symptoms. If you are considering a big change in your RA meds, you may want to be sure everything is checked out.

Sorry, Doodlebug, I thought it was Marlene who said that..... But I really believe the one underlying issue is that MTX is an IMMUNSUPRESENT and it's making me vulnerable to the FLU.

Talk to your doc, for sure, but not everybody has Marlene's synergistic "magic." Didn't we just talk about this in another post?

As far as flu goes, here's my take, for what it's worth... flu shots use dead virus, but a) the whole reason for taking them is to build antibodies to combat the virus. You can have a reaction because your body.... guess what? ... reacts. b) there are any other viruses. I think people who don't have vaccinations are intentionally putting on blinders. c) your immune system is messed up.

I tried MTX for my first RA drug and I hated it. When I started rituximab, he said don't worry. A DMARD probably won't make a difference. I never get flu (I do get vaccinations), infections and rarely get colds.

I'm all for collaborative health care, which lets you make choices, BUT consult with your doctor. Doodlebug says pulmonologist or allergist. She's a physician, and it makes sense, although I've seen 2 snakes allergists and a disinterested pulmonologist, so I'd put my $$$ on a good internist and your RA doc, if it were me in your shoes.

Good luck. You've been dancing around this stuff for a while, and I know you realize you probably need some help with dx and tx moving forward. Best wishes.

joline you're funny. i like your take about a good internist. :) i'm with an allergist if you can believe. re-doing shots after having done them from age 10 to 14. this is the brilliant minds answers to some of my infections after immuno testing. i'm almost a half year in. I am also with a major teaching hospital's pulmonology department and on 3 different inhalers and inhalation machine. i don't doctor google and I don't consult with my friends about my treatment. I read more than I let on and I think all the individual silos are just that, medical silos.

i have had infections and colds since being born prematurely. i'm sero positive ra. the rheumatologist has me on a 1/2 dose of enbrel - the 25mg for toddlers (laughing) and I cycle in and out of mtx depends on my infections. I don't think my allergist or pulmonologist are particularly all that but after 5 decades I aint switching, again. and I follow the regimens that they both have me on - because less infections are better than more infections. you don't always move on Joline, sometimes you just deal, which I have found.

depot

BIG THANKS TO EVERYONE for all the input - even contradictory, which is natural!! Each of us is unique. Each of us has unique experiences and each reacts differently.

All I know is this: I am 72 and have had RA for 40 some odd years. I raised 3 kids. Went on their class trips and school parties and was their asst. scout leader - so around lots of kids and never, ever had a cold or flu!! My kids had strep and ear infections. I never got anything. BUT... those were the years BEFORE DMRADS and biologicals! So my RA kept me safe. We used to joke back then in support groups (in person) that the "gift" of RA was never having a cold or the flu.

I have been on biologics about 11 years (Enbrel, Humira and now Orenica for 7 years). Most of that time I was either on a very low dose - .3 ml. MTX, or none. And now I am on Rasuvo, 15mg. And not around anyone who is coughing or sniffling. I have NO IDEA where I keep catching these bugs! But my body is telling me that this drug (MTX) is too much for me and destroying my aging immune system (which does get weaker with age even without RA and these drugs). And the older I get the more serious flu is.

As for flu shots, my former rheumatologist always left everything up to me. He told me the pros and the cons of taking it. The past few years I have - on the advice of internist and rheumy - taken the shot which is supposed to be safe because it is not live vaccine. "They" say if you take the shot and get the flu anyhow, one of a couple of things occurred: 1. You didn't get it soon enough; 2. you got a different train; 3. you will get a milder flu. Who knows!

All I know is that these bouts of Flu are knocking me out! I feel like I barely get my head above water and I am getting knocked down by another wave. And I also feel like a whining cry-baby because i know many of you have suffered with pneumonia and far worse infections than this. I myself had C-Dif last year which was worse.

I think we collect data and input from others, doctors, reading and in the end it is our body and our decision. My body is telling that it is the MTX that is wrecking havoc on my immune system and causing this. And, I KNOW I am ok without it! So, for me it seems a no-brainer.

THANK YOU all again! Your input is invaluable! I truly believe that in many ways those of us who live with RA are far better "experts" than any doctors who read about it!

UPDATE: I messaged my rheumy via his patient portal and he basically agreed!! I told him what was going on and what I wanted to do re stopping the MTX and he replied: "I understand."

I have been on orencia for over 5 years and have not been taking methayrexate. During those years. Initially my dr was against the idea but he agreed to see how I did without it for 6 mos. No flare ups in all this time. I am pleased to be off of the methatrexate as I also agree it reduced my ability to fight off infections.