methotrexate, Rheumatrex, Trexall

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Get a Grip on Rheumatoid Arthritis

SIDE EFFECTS: Methotrexate can cause severe toxicity which usually is related to the dose taken. The most frequent reactions include:

  • mouth sores,
  • stomach upset;
  • low white blood counts;
  • severe toxicity of the liver, kidneys and bone marrow, which require regular monitoring with blood tests;
  • headache
  • drowsiness

Methotrexate can cause itching, skin rash, dizziness, and hair loss. A dry, non-productive cough can be a result of rare lung toxicity.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Injectable: 25 mg/ml. Powder for injection: 1 g. Tablet: 2.5, 5, 7.5, 10 and 15 mg

STORAGE: Methotrexate should be stored at room temperature 15 C to 30 C (59 F to 86 F), avoiding light.

DOSING: Methotrexate may be taken with or without food. For rheumatoid arthritis and psoriasis, the dose of methotrexate is given weekly, by injection or orally. The oral dose is 7.5 to 20 mg once weekly. For psoriasis, the starting oral dose is a single 7.5 mg dose weekly or 2.5 mg every 12 hours for three doses, once weekly. The final dose ranges between 10 and 25 mg weekly orally or by injection.

DRUG INTERACTIONS: Using nonsteroidal anti-inflammatory drugs (NSAIDs) before or during methotrexate treatment may result in serious adverse events because NSAIDS may increase the blood concentrations of methotrexate. Combining methotrexate with drugs that adversely affect the liver or kidneys may result in additional liver or kidney toxicity.

Medically Reviewed by a Doctor on 9/11/2015

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