Methotrexate - Uses - Dosages - Side Effects - Precautions

Methotrexate: Frequently Asked Questions Answered

What is methotrexate?

Methotrexate belongs to a category of medicines called immunosuppressants. It also belongs to a class of drugs known as antimetabolites, which interfere with enzymes or their reactions.

Only a medical professional can prescribe methotrexate. It is used to reduce inflammation as well as slow down the body’s immune system to prevent it from damaging healthy tissues. Methotrexate is useful in treating inflammatory conditions such as Crohn’s disease, rheumatoid arthritis, and psoriasis.

What are the uses of methotrexate?

One of methotrexate’s primary uses is reducing uncontrolled inflammation. It can treat psoriasis, which causes scaly, red, and itchy patches on the skin. It also helps control rheumatoid arthritis and Crohn’s disease, an inflammatory bowel disease.

Methotrexate is also an immunosuppressant. Hence, it can treat autoimmune conditions like sarcoidosis. It can also hinder cancer cell growth. Therefore, doctors prescribe it for treating specific cancers like breast and lung cancer, leukemia, and certain kinds of lymphoma. Children with lupus, uveitis, vasculitis, juvenile idiopathic arthritis, and localized scleroderma can also use methotrexate.

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What are the side effects of methotrexate?

Methotrexate is usually prescribed for severe conditions that other medications have failed to control.

It can have significant side effects like dizziness, drowsiness, fatigue, dullness, decreased appetite, headache, hair loss, and swollen gums. Vomiting and nausea are also two other common side effects, affecting up to 65 percent of those with rheumatoid arthritis taking methotrexate. Around 30 percent develop mouth ulcers.

Consult a doctor if any of these symptoms persist. Do not hesitate to contact our team at Yashoda Hospitals for advice regarding side effects, precautions, etc.


Frequently Asked Questions about Methotrexate

1. Is methotrexate a steroid?

Methotrexate belongs to a category of drugs called immunosuppressants. These are steroid-sparing drugs, i.e., while not directly steroidal, they enhance the action of steroids. Since the 1980s, it has been used as a corticosteroid-sparing agent to treat bronchial asthma. Since its action benefits steroids, it is available only with a valid prescription.

2. How long does methotrexate stay in your system?

Methotrexate is mostly cleared from the body of a non-pregnant adult within one week after the last dose has been taken. More specifically, to eliminate methotrexate taken in low doses, it can take between 16 to 55 hours. For high-dose methotrexate, the time increases, to between 44 and 83 hours.

3. Does methotrexate cause weight gain?

Methotrexate is an immunosuppressant with proven anti-inflammatory properties. Therefore, it can treat the joint inflammation seen in rheumatoid arthritis. A side effect, in this case, is weight gain. Studies have proved that methotrexate can cause a small amount of weight gain in people with rheumatoid arthritis, especially if they have lost weight due to the ailment.

4. How bad is methotrexate for you?

Methotrexate can have severe, risky side effects. It may cause lung damage, increase the risk of developing lymphoma, or life-threatening skin reactions. If you experience any fever, rash, diarrhea, shortness of breath, or dry cough, call your doctor. Inform your doctor beforehand if you’ve ever had stomach ulcers or lung or kidney disease.

5. How to take methotrexate?

Methotrexate is usually taken once a week orally. You must take extreme precautions to take only the dosage prescribed. You can take it with or without food. However, most people prefer splitting the dose – half in the morning and another half 12 hours later with food – to prevent gastrointestinal side effects.

6. Is methotrexate chemo?

Yes. Methotrexate is a chemotherapy drug. Acute lymphoblastic leukemia (ALL) and breast cancer are two cancer conditions it can treat. It prevents cancerous cells from using folic acid to make DNA and RNA, thereby killing them and slowing their growth. Methotrexate, when used for inflammatory arthritis, is not considered chemotherapy.

7. What should you avoid while taking methotrexate?

Avoid receiving a ‘live’ vaccine while on methotrexate, as it can cause a serious infection. Abstain from alcohol, as it might increase the risk of liver damage. Doctors recommend avoiding foods rich in folic acid as they may decrease the effectiveness of the therapy. Also, avoid NSAIDs like aspirin, ibuprofen, etc., as they may accelerate side effects.

8. Is methotrexate a biologic?

Biologics are genetically engineered proteins. They target specific areas in the immune system that fuel inflammation. Methotrexate is an immunosuppressant, but it is a non-biologic drug. Rather, it is a DMARD (Disease Modifying Anti-Rheumatic Drug). However, studies show biologics added with methotrexate are more effective in improving symptoms than when using methotrexate alone.

9. When to take methotrexate: morning or night?

Methotrexate is usually taken orally. Splitting the dosage, which is taking half the pills in the morning and the other 12 hours later with food, can help alleviate gastrointestinal side effects. As some of the side effects of methotrexate include fatigue and nausea, doctors suggest taking the full dose at night to minimize inconvenience.

10. Can methotrexate cause cancer?

Methotrexate is often the first course of treatment for rheumatoid arthritis and other such inflammatory conditions. It is also used to treat certain cancers. However, it is suggested that unregulated use of methotrexate may increase the risk of developing cancers such as lymphoma, skin or lung cancer, non-Hodgkin’s lymphoma, and even melanoma.

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