Methotrexate in the Hospital

The young woman who’d so cheerfully introduced herself as my nurse when I was admitted to the hospital returned to my room about ten minutes later.  Now looking afraid, she stopped hesitantly only a few steps into the room and explained that there would be a different nurse assigned to me since she was expecting a baby and I was taking methotrexate.

Methotrexate, unlike tons of other prescription medications, comes with a black box warning.  Patients are told to be careful to avoid infections because one could be deadly, and are given a host of other instructions.  There are apparently some things they never tell us about this medication, though.

More than once I heard people talking at my door stop as they were about to enter, then one would tell the other, “Uh-oh.  Someone else will have to take this room.”  Apparently people taking methotrexate are worse than lepers.

Later I discovered that my hospital room had this sign on the door:

Part of me thought, “This is ridiculous.  It’s not like I’m exuding the stuff through my skin.”  Another part of me wondered why they were so concerned about methotrexate, but not about Cimzia.

It turns out that although methotrexate doesn’t ooze out the pores, it can be found in bodily fluids for 72 hours after a dose is given.  Since medical people deal with blood, vomit, urine, and the like, they really do have to be careful when patients are taking methotrexate.

Had I known that, I might have been able to alert people from the very beginning:  “I’m taking mtx; please make sure my caregivers are people who aren’t trying to have a baby.”

Women expecting a baby try to do everything possible to have a healthy baby.  Seeing the look on that poor nurse’s face, I imagine she was beside herself.  She looked to be about eight months along, and spending the next month worrying what she might have done to her baby couldn’t be good for either of them.  It wasn’t until a few days later that I learned what the concern with mtx is, and I asked my nurse if she could track the other nurse down and let her know that my last injection was beyond the 72 hours, so she and her baby were in the clear.

That should never have happened.  Had I known that it was an issue, I would have told them from the start.  Wouldn’t we all do that?  Shouldn’t we all do that?

A stranger’s baby shouldn’t suffer birth defects due to the medicines I’m taking.

I’m adding a note to my cell phone (where I keep my meds list):  Cytotoxic agents.  If there’s ever a next time, that information will be among the first provided.

7 thoughts on “Methotrexate in the Hospital

  1. Wow… just… wow.
    I guess there are a lot of things we don’t know about what we are and who we are.
    Now… now I have to figure out who to warn and who to avoid if I can. Sometimes trying to get better is kind of scary.

    • I think we just need to avoid bleeding, peeing, or vomitting on people who are pregnant or lactating. That’s probably not too hard in the course of our everyday affairs, so not a big deal outside the hospital setting. As an inpatient, it’s a whole different story.

  2. So glad to see your home. Hope you are feeling better each day. I wear an id when I do outdoor activities that I may be injured doing (riding a bike, hiking etc.) It says that I take mtx and Enbrel and lists my RA and another medical condition I have. I origianaly did this so they would know I was immune suppressed. Glad to know it will also help any first responders who should not be exposed to mtx.

  3. Good to know. I was on Mxt for many years and was in and out of the hospital and no one ever told me. I never had a sign on my door. Interesting… I also wear a medic alert necklace just in case. Another thing I don’t have to worry about in an emergency!

  4. Warmsocks, So glad to see you are home, hope that the healing process is very quick for you. It is too hard to have healing in the health care environment, at least for me I always feel better once I am home. You have been in my prayers and thoughts.

  5. This actually is all fairly new. There was a study released sometime this year about the hazardous chemical nature of some IV medications that RNs handle on a regular basis. Between OSHA, the Joint Commission and lawyers hospitals were quick to alert nurses concerning the hazard. It has been procedure for cancer chemotherapy drugs but I think this study put the fear of God in everyone.

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