Methotrexate

What is Methotrexate used for?

Methotrexate is a strong medicine used to fight cancer and some serious immune system problems. Doctors use it in combination with other drugs to treat childhood leukemia (ALL) and a type of adult lymphoma. It also helps adults with rheumatoid arthritis (painful, swollen joints) and severe psoriasis (skin condition), and children with a specific type of arthritis (pJIA).

How does Methotrexate work?

Methotrexate inhibits dihydrofolate reductase, disrupting DNA synthesis, repair, and replication in rapidly dividing cells. This mechanism underpins its effects in cancer and autoimmune diseases.

Is Methotrexate effective?

Clinical trials have demonstrated Methotrexate’s effectiveness in treating autoimmune diseases and certain cancers. Its efficacy is attributed to its ability to target rapidly dividing cells and modulate immune activity.

How does one know if Methotrexate is working?

For autoimmune conditions, improvement in symptoms (e.g., reduced joint swelling or skin lesions) indicates efficacy. For cancers, monitoring involves imaging, lab tests, and symptom changes.

What is the usual dose of Methotrexate?

Methotrexate is a medicine used to treat several diseases. The amount given depends on the illness and the patient's age. 

Adults:

Acute Lymphoblastic Leukemia (ALL): 20 mg/m² orally once weekly.

Rheumatoid Arthritis: Start at 7.5 mg orally once weekly, escalating as needed. Maximum: 20 mg per week.

Psoriasis: 10–25 mg orally once weekly, with a maximum of 30 mg per week.

Children:

Polyarticular Juvenile Idiopathic Arthritis: 10 mg/m² orally once weekly, up to a maximum of 30 mg/m² per week. 

How do I take Methotrexate?

Take Methotrexate exactly as prescribed, typically once a week. It may be taken with or without food. Patients should avoid alcohol and consult their healthcare provider regarding any food restrictions. Folic acid supplementation is often recommended to minimize side effects.

For how long do I take Methotrexate?

The duration depends on the condition being treated and response to therapy. For autoimmune diseases, treatment is usually long-term, but dose adjustments or discontinuation may occur based on clinical response or side effects.

How long does it take for Methotrexate to start working?

For autoimmune conditions, responses are usually observed within 3 to 6 weeks, though it may take up to 12 weeks for full effect. For cancer, the response depends on the specific regimen and cancer type.

How should I store Methotrexate?

Keep the medicine Methotrexate at room temperature (between 68°F and 77°F). Once opened, use it within 3 months. Keep the bottle closed tight. Throw away the medicine, bottle, and any used syringes properly—don't put them in the trash or toilet. 

Who should avoid taking Methotrexate?

Methotrexate Contraindications include:

Pregnancy (for non-cancer indications).

Severe hypersensitivity to Methotrexate.

Severe liver or kidney impairment.

Active infections or immunodeficiency.

Can I take Methotrexate with other prescription drugs?

Certain drugs, like NSAIDs, penicillins, and proton pump inhibitors, can increase Methotrexate’s toxicity. Inform your healthcare provider about all medications to avoid harmful interactions.

Can I take Methotrexate with vitamins or supplements?

Tell your doctor about all the medicines, vitamins, and herbal things you take, even if they're not prescribed. This is important if you're taking Methotrexate. This helps your doctor make sure there are no problems when you take Methotrexate with other things. 

Can Methotrexate be taken safely while pregnant?

No, Methotrexate is contraindicated during pregnancy for non-cancer indications due to high risks of fetal harm, including birth defects and fetal death. Effective contraception is required during treatment and for six months after stopping Methotrexate.

Can Methotrexate be taken safely while breastfeeding?

If you're taking Methotrexate , don't breastfeed during treatment and for a week after you finish. The medicine in Methotrexate can get into breast milk and harm your baby. 

Is Methotrexate safe for the elderly?

Elderly patients may be at higher risk of adverse effects due to age-related kidney function decline. Close monitoring and dose adjustments are advised.

Is it safe to exercise while taking Methotrexate?

Yes, unless fatigue or other side effects limit your ability. Discuss with your doctor if you have concerns.

Is it safe to drink alcohol while taking Methotrexate?

If you're taking the medicine Methotrexate, tell your doctor how much alcohol you drink, and if that amount changes. This is important for your safety and to make sure the medicine works correctly.