Looking after yourself this flu season

Published: 26 Jan 2018

Getting an annual flu vaccine is recommended for people with RA, but if you do develop flu or live with someone who has it, the following advice issued to patients by Portsmouth Hospital’s Department of Rheumatology may be useful to you.

The following guidance is aimed at supporting those who may feel that they have developed flu or those who may be in close contact with a relative/ friend who has had confirmed flu (flu swab). 

Take Home Message for Patients and Healthcare Professionals

  • If a patient becomes unwell with symptoms of flu, they should usually temporarily stop* their immunosuppressant rheumatology medication and be given a 5 day course of anti-viral medication. Swabs to test for flu should be sent and if they are returned negative the anti-viral medication can be stopped.
  • If a patient has been in close residential contact with a person diagnosed with flu and if they themselves do not have any symptoms of flu, then they should be given a 10-day course of anti-viral medication as a preventive measure. They do not need to stop their rheumatology medication unless they develop flu symptoms. Oseltamivir may theoretically increase methotrexate levels but with weekly dosing of methotrexate, this is not significant and can be ignored.
  • If a person is in residential contact with someone who is on immunosuppressant rheumatological medication then there is a need to specifically test for flu, even if the person with flu themselves is not at higher risk of flu complications.

If you notice that you have flu like symptoms or been in close contact with some who has had confirmed flu (flu swab)- please contact your GP Practice for advice and guidance or 111 service. For patients who are on DMARDS/ Biologic Therapies you will need to start the anti-viral medication and have swab tests for flu.

  • If you swabs come back negative then you will be able to stop the anti-viral if advised to by your GP
  • If your swabs come back positive- you should complete the course of anti-viral course of treatment

*There will be a minority of patients who have had organ-threatening Rheumatological disease including some forms of vasculitis, SLE and connective tissue disease and in these individuals there may be particular concern over stopping immunosuppressant medication – even temporarily.  If you think you or your patient is one such individual then the rheumatology department should be contacted directly for individually tailored advice.