Sounds like 'meth-o-trex-ate'

Easy-to-read medicine information about methotrexate – what it is, how to take methotrexate safely and possible side effects.

Type of medicine Also called
  • Immunosuppressive medication (weakens the body's immune response)
  • Antimetabolite - folic acid analogue
  • Anti-cancer agent

  • Methoblastin®
  • Trexate®
  • Methotrexate (Hospira)®

What is methotrexate?

  • Methotrexate is an immunosuppressive medication, which means that it weakens the body's defense system or immune response. It is used to treat a number of auto-immune conditions related to an 'over-active' immune system such as rheumatoid arthritis, psoriasis, lupus
  • Methotrexate is also used as an anti-cancer agent. It works by stopping the growth of cancer cells.
  • Methotrexate will be prescribed for you by a specialist doctor who is experienced in treating your condition. 


  • The dose of methotrexate will be different for different people.
  • Your doctor will calculate your dose based on your condition, your weight and height, and your response.
  • 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 unwanted side effects. Take your folic acid on a different day from your methotrexate.

How to take methotrexate

  • Methotrexate is usually taken once a week (every 7 days) as it has a long-half life, meaning it lasts in your body for much longer than most medicines.
  • Take methotrexate on the same day each week.
  • Swallow the tablets with a drink of water.
  • You can take methotrexate before or after food.
  • Limit or avoid drinking alcohol while you are taking methotrexate. 
  • If you forget to take your 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 dose by more than 2 days, contact your doctor for advice about what to do. Never take two doses together to make up for a missed dose. 

Special instructions

  • Extra care is needed when taking methotrexate.
  • Double-check your prescription: is it the right strength, the right number of tablets and the right frequency (once a week)?
  • While you are taking methotrexate you will need to have regular blood tests to monitor for side effects and to determine if the treatment is effective. 
  • Methotrexate makes your skin more sensitive to the sun. Protect your skin when you are in the sun, especially between 10 am and 3 pm. If outdoors, wear protective clothing and use a high factor sunscreen (SPF 30+).
  • Make sure you tell anyone providing you with health, dental or medical care that you are on methotrexate
  • Do not get pregnant while either you or your partner are taking methotrexate and for 12 weeks afterwards. Speak to your doctor about suitable contraception.

Possible side effects

Like all medicines, methotrexate can cause unwanted side effects, although not everyone gets them. Often unwanted side effects improve as your body gets used to the new medicine.

Side effects What should I do?

  • Feeling sick (nausea) 
  • Vomiting
  • Diarrhoea

  • Take your methotrexate with food or in the evening.
  • Tell your doctor if troublesome

  • Tiredness
  • headache
  • Muscle and joint pains
  • These are quite common when you first start taking methotrexate and usually go away with time.
  • Tell your doctor if troublesome
  • Signs of problems with your lungs such as dry cough, short of breath, difficulty breathing, chest pain.
  • Tell you doctor immediately or ring Healthline on 0800 611 116
  • Signs of changes in your blood cells such as sore mouth, mouth ulcers, easy bruising, nosebleeds, bleeding gums, short of breath, fever, infection.
  • Tell you doctor immediately or ring Healthline on 0800 611 116
  • Signs of problems with your liver such as sudden pains in your stomach, loss of appetite, yellowing of the skin and eyes.
  • Tell you doctor immediately or ring Healthline on 0800 611 116


  • Methotrexate may interact with a number of important medications and herbal supplements so check with your doctor or pharmacist.
  • Also check with a pharmacist before taking over-the-counter anti-inflammatories such as diclofenac (e.g. Voltaren Rapid), ibuprofen (e.g. Nurofen), naproxen (e.g. Naprogesic). Taking these together with methotrexate may increase your risk of side effects.

Learn more

Medsafe Consumer Information Sheet


Arthritis Research UK


Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr Janine Bycroft, GP, Health Navigator NZ