Hello, The particular statement of methotrexate-induced lung changes do apply for particular cases in which there is compromised immunity, drastic changes in CD4 counts and other parameters as well; it does not apply to every person on the therapy. Regular physician follows up with evaluation via pulmonary function test and x-ray will help to avoid any unusual circumstances in your case particularly. Guidelines at present - avoid exposure to noxious stimuli - deep breathing exercises - balanced nutritious diet to combat underlying immunity issues - fresh air walk - continuous medications with cough preparations with or without steroids as per the consultant advise and decision - avoid active or passive smoking to any extent. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon