Methotrexate is used to treat some autoimmune conditions such as rheumatoid arthritis and psoriasis. Find out how to take it safely and possible side effects.
|Type of medicine||Also called|
What is methotrexate?
Methotrexate is an immunosuppressive medicine, which means it weakens your body's defence (immune) response. It is used to treat some autoimmune conditions related to an ‘overactive’ immune system, such as rheumatoid arthritis and psoriasis.
Methotrexate is also used as an anti-cancer agent. It works by stopping the growth of cancer cells. Methotrexate is prescribed by a specialist doctor who is experienced in treating your condition.
In New Zealand methotrexate is available as tablets (2.5 mg and 10 mg).
Watch a video about methotrexate for inflammatory disease such as arthritis.
- The dose of methotrexate will be different for different people.
- Your doctor will calculate your dose based on your condition, your blood test results and your response.
- If methotrexate is being used for arthritis or psoriasis, it is usually taken once a week (every 7 days) as it lasts in your body much longer than most other medicines.
- Take methotrexate on the same day each week.
- If methotrexate is being used to treat cancers such as leukaemia or lymphoma, or for some people with psoriasis, the dosing may be daily, or a few days per week.
- Always take your methotrexate exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much methotrexate to take, how often to take it and any special instructions.
- You may be asked to take folic acid tablets while you are on methotrexate. This is to help reduce side effects. Take your folic acid on a different day from your methotrexate.
|Choose the option that applies to you
I am taking methotrexate for:□ arthritis
□ a skin condition
|My dose||Take methotrexate ONCE a week.
______ tablets to be taken on _____________ (day of the week).
How to take methotrexate
- Timing: If methotrexate is being used for arthritis or psoriasis, it is usually taken once a week (every 7 days). Take your dose on the same day each week. You can take methotrexate before or after food.
- Swallow your tablets with a drink of water. Do not crush or chew them.
- Limit or avoid alcohol. Heavy drinking can increase your risk of side effects, such as problems with your liver.
- Missed dose:
- If you forget to take your weekly methotrexate dose, and it is within 2 days of when you should have taken it, take it as soon as you remember.
- If you have missed your weekly dose by more than 2 days, contact your doctor for advice about what to do. Never take 2 doses together to make up for a missed dose.
Extra care is needed when taking methotrexate
Make sure you take the right dose
When you collect your methotrexate prescription, check that your tablets are the right strength, the right frequency (once a week) and that you have the right number of tablets. Methotrexate tablets come in 2 strengths: 2.5 mg and 10 mg. If your tablets look different to your last supply, get advice from your doctor or pharmacist.
While you are taking methotrexate you will need to have regular blood tests to monitor for side effects and to work out whether the treatment is effective.
Some vaccines should not be taken if you are taking methotrexate. Always check with your doctor or pharmacist first. It is safe for you to have the annual flu vaccine.
Methotrexate makes your skin more sensitive to the sun. Protect your skin when you are in the sun, especially between 10am and 3pm. If outdoors, wear protective clothing and use a high factor sunscreen (SPF 30+).
Pregnant or planning a pregnancy
Methotrexate should not be taken if you are pregnant. If either you or your partner are taking methotrexate talk to your doctor about contraception. If you or your partner wish to become pregnant, ask your doctor about stopping methotrexate. It should not be taken for at least 12 weeks before pregnancy.
Tell your healthcare providers
Make sure you tell anyone providing you with health, dental or medical care that you are taking methotrexate
Precautions - before taking methotrexate
- Are you pregnant or planning to have children in the future?
- Are you breastfeeding?
- Do you have stomach problems including a stomach ulcer?
- Do problems with your liver or kidney?
- Have you recently had or been in contact with people with chickenpox or shingles?
- Are you taking any other medicines? This includes any medicines you buy without a prescription, such as herbal and complementary medicines and medicines for pain relief.
If so, it’s important that you tell your doctor or pharmacist before you start methotrexate. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.
Like all medicines, methotrexate can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.
|Side effects||What should I do?|
- Methotrexate may interact with a number of medicines and herbal supplements, so check with your doctor or pharmacist before starting methotrexate and before starting any new medicines.
- Also check with a pharmacist before taking over-the-counter anti-inflammatories such as diclofenac (eg, Voltaren Rapid), ibuprofen (eg, Nurofen), naproxen (eg, Naprogesic). Taking these together with methotrexate may increase your risk of side effects.
The following links have more information on methotrexate. Be aware that websites from other countries may contain information that differs from New Zealand recommendations: