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39 years
I've been on methotrexate for 3 years. I take 4 pills per week. My WBC dropped from 7 to 6, 5.2 and now 4.4. What are the causes of this drop?
Aug 31, 2014

Dr. Zakia Dimassi Pediatrics
Methotrexate is known as a disease-modifying anti-rheumatic drug (DMARD), because it decreases the pain and swelling of arthritis in addition to its ability to decrease damage to joints and long-term disability. Till this day, it remains one of the most effective and commonly used medicines in the treatment of several forms of arthritis and other rheumatic conditions.
The following side effects are common (occurring in greater than 30%) for patients taking methotrexate:
• Low blood counts: white and red blood cells and platelets may temporarily decrease. This can put the patient at increased risk for infection, anemia and/or bleeding.
Nadir (lowest cell count): Meaning low point, nadir is the point in time between therapy cycles in which you experience low blood counts.
Onset: 7 days
Nadir: 10 days
Recovery: 21 days
Just make sure that, during this period, you avoid eating outside, eating raw (uncooked) foods or at least cleanse them very well (soak vegetables in Presept for 10 min then wash with fresh water), avoid undercooked meat/poultry, avoid sick contacts (people with signs of illness), and injuries (as they may easily be complicated with a difficult-to-treat infection).