What is Methotrexate?

Methotrexate is an anti-inflammatory agent used to treat rheumatoid arthritis and other inflammatory conditions. It works by suppressing the blood cells that cause inflammation. It is a chemotherapy agent used to treat cancer, but in 1988, the FDA approved it to be used by rheumatoid arthritis patients (in much lower doses). Nearly 60% of all rheumatoid arthritis patients are currently on or have been on methotrexate.

How do I take it?

Methotrexate is taken ONCE A WEEK. The pills are 2.5mg. each and the usual dose is 3 to 10 pills. The pills are taken together as a single dose on the same day each week (for example-every Friday). Follow your doctor’s directions. Do not take more or less medicine than ordered. This medicine can be taken with food. You should also take 1 mg. of folate (folic acid) each day. This will help prevent side effects.

What else should I know?

Methotrexate has caused mouth ulcers in a few patients, in the beginning of treatment. This should go away with time. Another possible side effect is nausea and vomiting. Your doctor should be informed if any of the side effects are bothersome. Methotrexate can cause mild liver irritation. Please tell you doctor if you have a history of any alcohol abuse, hepatitis, yellow jaundice, or liver disease. While on methotrexate you must limit yourself to 2 alcoholic beverages per week. Blood work will be done every 4-8 weeks to check your liver function. This blood work will also include a complete blood count (CBC) since methotrexate can also cause a decrease in blood counts.

Although methotrexate does not cause increased susceptibility to infections, your doctor may want to stop methotrexate if you develop a serious infection. Notify your doctor if you have signs or symptoms of an infection.

Methotrexate may cause birth defects in the children of both men and women taking this drug. If you are pregnant or considering having a child, discuss this with your doctor before beginning this medication. Use of an effective form of birth control is critical throughout the course of this treatment and for months after it is stopped.

What about other medications?

When you are taking methotrexate, it is very important that your doctors know if you are taking any other medicine. This includes prescription and non-prescription medicines as well as birth control pills, vitamins, and herbal supplements.

Methotrexate can be taken with other medications – NSAIDS (Celebrex®, Vioxx®, ibuprofen, naproxen), prednisone, Enbrel, plaquenil. You should not take methotrexate while taking any medicine containing trimethoprim-sulfa (Bactrim®, Sulfatrim®, etc…).

Updated: April 25, 2012

Victoria Ruffing, RN

About Victoria Ruffing, RN

Ms. Ruffing has been a member of the Arthritis Center since 2000, currently serving as the Nurse Manager. She is a critical member of our patient care team.