Antibiotics and Dermatomyositis

Has your doctor suggested Ivermectin? I know this drug got a lot of flack during COVID, but, it does work for some people.

From what I am understanding, it has to be compounded as very few physicians will prescribe it. So, with that said, you would have to probably go to an Integrative Medicine doctor and get his/her take on it.

Praying for you to get better. Blessings & Happy New Year!

@livinglife1 I understand your nervousness about going to an urgent care. I have a AD that hardly anyone has heard about so going to an urgent care was scary for me, too. I have been several times over the past years so I’m used to going now. What I would recommend for you to do, is to go prepared. You can print pages from Mayo
Clinic and take them with you. You can give them to the doctor or nurse and say, “I have an unusual AD so here is information about it.” I have to explain to everyone what my AD is! The best entry to the internet is in the blue area at the bottom of this page. Below the logo for Mayo Clinic are the words Mayoclinic.org. Tap here to access all Mayo Clinic’s information. Learn what you can so you will be an informed patient. I know you can do this!

If the treatment requires an antibiotic you could request the pharmacy
filling your prescription to run a drug interaction screen on their software.
It helps if you use the same pharmacy regularly with your drug profile on file.
Their are several helpful drug interaction checker sites online that are easy to
plug in your meds but the results are best interpreted with your doctor or
pharmacist.

I am confident usually in my PCP. He knows my diagnosis of amyositis dermatomyositis. But I have an undiagnosable pharyngitis - negative strep, covid and flu, and he gave me doxycycline. I am starting MTRX today for 1st time. So I hope these drugs are compatible. I will check However I felt so bad last night I took Percocet for the pain. Highly unusual for me. Now I wonder if I should always call my Rheumatologist (who is an hour away) when I have an illness like this? Or is this antibiotic totally ok to try?
Thanks anyone who can help.

You might ask if you could hold off taking methotrexate until you finish antibiotic course. Have you been offered anything to gargle and spit for local
relief?

I did consult with PCP after I had taken the MTX He said just do 7 days of the doxycycline then get back to the weekly onboarding of MTX. Some sore throat sprays and gargling helps
I hope this works and we don’t go on the diagnostic merri-go- round. I never used to get sick with things like this. Its just frustrating to try to integrate medical advice and treatments when they do not have a simple means of inter communication.

You can not take an antibiotic with methotrexate. I also have dermatomyositis along with RA. I am on Rasuvo{ which is injectable methotrexate} along with Remicade infusions. My RA doc says I have to stop these meds if I got on antibiotics.

@elainebee there are antibiotics that are not compatible for those with CTD or on MTX. The quinolines are not great for those with any connective tissue issues, so I avoid cipro and any antibiotics in that family. Sulfa-based antibiotics and penicillin-class antibiotics are not ideal for anyone on Methotrexate as both the drugs and infections put stress on your organs, making it harder for your body to process medications safely. My GP had no idea about any of this. It was the pharmacist who bought it to my attention as I was standing there ready to pick up!!

As far as going to an urgent care - personally I hate going if they’re busy as my thought is always what if I go in with a really bad cold and come away with Covid?! I’m always terrified of picking up something worse than I came in with!.

Can you call your GP’s practice to see if you can get a call back and explain you’re immunocompromised. Maybe the call-back physician might have some suggestions to tide you over (ie which of the cold and flu meds would be most appropriate with the other drugs you’re on) and if you’re not better in a day or two you might not have a choice, and you’ll have to go in. Hope you’re feeling better quickly!

Same comment for you as for Elaine - there are antibiotics that are not compatible for those with CTD and/or on MTX. The quinolines are not great for those with any connective tissue disease, so I avoid cipro and any antibiotics in that family (I have dermatomyositis/RA overlap). Sulfa-based antibiotics and penicillin-class antibiotics are not ideal for anyone on Methotrexate as both the drugs and infections put stress on your organs, making it harder for your body to process the medications safely.

I skip MTX when I am on antibiotics as it further lowers your immunity anyway while you have an active infection and resume the following week once the antibiotic is done. Hope you’re feeling better fast 🙂

@pm56
Thank you. This is very helpful. Doxycycline is not a penicilin but rather a tetracycline. The plan is to shorten the antibiotic course by 3 days and then resume onboarding or building up the dose of MTX. Meanwhile this week only in order to get on with life i have been orescribed a prednisone burst. I wonder if that also makes healing from this infection more difficult? Thank you