Body fluids caution on low dose MTX?

Hi All!

Hoping someone can shed some light. I started on MTX about a month ago (10mg every Saturday night). I was informed of the possible side effects and am unlucky enough to have suffered from all of them to some extent! Folic acid dose changes have helped somewhat.

One question I had and forgot to ask my rheumatologist at my review last week, was whether I have to be cautious of contact with my body fluids after taking the MTX. Both for my safety and the safety of others. Without getting too personal, do I have to avoid others coming in contact with all body fluids including faeces, urine, saliva and vaginal fluids? And if so, for how long after taking the dose? My rheumo did not mention this at all.

Australian info sheets do not raise this as an issue, but I have seen some mention on information available from US sites. I wonder if this is for higher doses (like cancer treatment) or even for low doses like mine?

Thanks so much everyone!

With a dose of 1 mg/kg one should wait a week or so before having intercourse. This has nothing to do with toxicity, but it is at this point where it works as an abortive drug (ectopic pregnancy) and can cause some thinning of the vaginal tissue leading to painful intercourse.

The reason its not raised as an issue, is because it isn't, even at the 50 mg/kg used as chemo. Taken orally much of the dose is partly metabolised by the intestinal flora to 2,4-diamino-N10-methylpteroic acid, a pharmacologically inactive metabolite. The rest is totally absorbed by the tissues within 30 minutes to a couple of hours. If you are going to have side effects from the MTX itself it will start during this period. Injection will eliminate many of them as the absorption is much quicker and more complete that way. If you have any additional side effects its from depleted folate (which can be replaced) or reading to much on the internet. Any that is removed by the body incidentally is done so by the kidneys.

Surprised. Most doctors require some sort of verbal agreement talking about these issues before subscribing MTX. I had to agree to either no sex or use of a condom. Guess that’s not the case anymore.

Birth control is an different issue. I believe that is is still a part of the protocol. But again those issues are not related to the MTX but rather the depletion of folic acid. All women receive folic acid supplementation during pregnancy these days not only to prevent miscarriage but a number of specific birth defects.

You just aren't going to poison a sexual partner.

Thanks for the replies so far. Of course my doctor discussed the issues of birth control on MTX and I am well aware of the issues with conceiving on MTX or a number of other DMARDs etc. That area is taken care of. I am also happily managing any side effects and not getting caught up in the endless Googling that can lead to paralysis by analysis :) Education is important for making medical choices, but some of the sites Google throws at you are not the ideal places for that!

I was more concerned with contact with body fluids and the potential for toxicity in and of itself. It may sound naïve, but is passionate kissing a problem, and to make it perfectly clear (cringe) oral sex??

Sorry, don't want to get graphic, but I figure we are all here to support each other!

NOPE none at all.

Without being too graphic invest in some very good lube, as inflammation decreases dryness can become a problem.

paralysis by analysis - I LOVE IT

Taking low dose methotrexate won’t turn you or your body fluids poisonous to your nearest and dearest! Relax … and yes, we are here to support eachother.