- Rheumatoid Arthritis Slideshow Pictures
- Take the RA Quiz
- Joint-Friendly Exercises to Reduce RA Pain Slideshow
- What is methotrexate, and how does it work (mechanism of action)?
- What brand names are available for methotrexate?
- Is methotrexate available as a generic drug?
- Do I need a prescription for methotrexate?
- What are the side effects of methotrexate?
- What is the dosage for methotrexate?
- Is methotrexate safe to take if I'm pregnant or breastfeeding?
- What else should I know about methotrexate?
What is methotrexate, and how does it work (mechanism of action)?
Methotrexate is classified as an antimetabolite drug which means it is capable of blocking the metabolism of cells. (Metabolism consists of the production and destruction of important components of the cell as well as the production of energy for use by the cell.) As a result of this effect, it has been found helpful in treating certain diseases associated with abnormally rapid cell growth, such as cancer of the breast and psoriasis. Recently, methotrexate has been shown to be effective in inducing miscarriage, for example in patients with ectopic pregnancy. This effect of methotrexate is attributed to its action of killing rapidly growing cells such as those of the placenta. It also has been found very helpful in treating rheumatoid arthritis, although its mechanism of action in this illness is not known. It seems to work, in part, by altering immunity which may play a role in causing rheumatoid arthritis. The FDA approved methotrexate in December 1953.
What are the side effects of methotrexate?
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;
Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment
What is the dosage for methotrexate?
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.
Is methotrexate safe to take if I'm pregnant or breastfeeding?
Methotrexate should not be used in pregnancy, as it can be toxic to the embryo and can cause fetal defects and spontaneous abortion (miscarriage). It should be discontinued prior to conception if used in either partner. Male patients should stop taking methotrexate at least 3 months prior to a planned conception in order to avoid the theoretical risk of methotrexate-induced abnormal sperm. Women should discontinue use for at least one ovulatory cycle before conception to reduce exposure of a developing ovarian follicle to methotrexate.
Methotrexate is excreted in breast milk and should not be used by nursing mothers.
What else should I know about methotrexate?
What preparations of methotrexate are available?
Injectable: 25 mg/ml. Powder for injection: 1 g. Tablet: 2.5, 5, 7.5, 10 and 15 mg
How should I keep methotrexate stored?
Methotrexate should be stored at room temperature 15 C to 30 C (59 F to 86 F), avoiding light.
Methotrexate (Rheumatrex, Trexall) is a drug prescribed to treat cancer, psoriasis, inflammatory diseases of the skin, arthritis (rheumatoid arthritis in adults and children), psoriatic arthritis, polymyositis, lupus, and to induce miscarriage in women with ectopic pregnancies. Side effects drug interactions, dosage, and pregnancy safety information should be reviewed prior to taking this drug.
Multimedia: Slideshows, Images & Quizzes
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Treatment & Diagnosis
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Top methotrexate Related Articles
Ankylosing SpondylitisAnkylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited. Treatment incorporates medications, physical therapy, and exercise.
Ankylosing SpondylitisWhat is ankylosing spondylitis? Take this quiz to learn the causes, symptoms, and treatments for this painful disorder.
Atopic Dermatitis PictureThis condition is the most common of all pediatric dermatoses. See a picture of Atopic Dermatitis and learn more about the health topic.
Crohn's DiseaseCrohn's disease is a chronic inflammatory disease, primarily involving the small and large intestine, but which can affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are common symptoms.
Liver DiseaseLiver disease can be cause by a variety of things including infection (hepatitis), diseases such as:
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- toxins (medications and chemicals).
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Polymyalgia RheumaticaPolymyalgia rheumatica (PMR) is a disorder of the muscles and joints that causes pain and stiffness in the arms, neck, shoulders, and buttocks. Treatment for polymyalgia rheumatica aims to reduce inflammation with aspirin, ibuprofen, and low doses of cortisone medications.
PsoriasisPsoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales. There are several types of psoriasis, including psoriasis vulgaris, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Symptoms vary depending on the type of psoriasis the patient has. Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy. There is no cure for psoriasis.
Severe Psoriasis PicturesLearn about the common skin condition psoriasis. Explore about the different types of psoriasis such as vulgaris (plaque psoriasis), guttate psoriasis, and scalp psoriasis. Discover different psoriasis treatment options.
Psoriasis SlideshowWhat is psoriasis? Explore psoriasis treatment options such as topical ointments, phototherapy, natural remedies and more. Learn about psoriasis symptoms, causes and treatment. View psoriasis pictures of different types of nail, plaque, and scalp psoriasis.
Psoriatic Arthritis SlidesWhat is psoriatic arthritis? Psoriatic arthritis is an arthritis type that comes with psoriasis (skin inflammation). Psoriatic arthritis symptoms often affect hands and fingers. Learn more symptoms of psoriatic arthritis here.
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
RA SlideshowWhat is rheumatoid arthritis (RA)? Learn about juvenile rheumatoid arthritis. Discover rheumatoid arthritis (RA) symptoms, diagnosis, and treatment.
Take the RA QuizHow is rheumatoid arthritis different from other forms of arthritis, such as osteoarthritis and gout? Take the Rheumatoid Arthritis (RA) Quiz to rest your RA IQ.
Sarcoidosis, a disease resulting from chronic inflammation, causes small lumps (granulomas) to develop in a great range of body tissues and can appear in almost any body organ. However, sarcoidosis most often starts in the lungs or lymph nodes.
Systemic LupusSystemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous system. When only the skin is involved, the condition is called discoid lupus. When internal organs are involved, the condition is called systemic lupus erythematosus (SLE).
Ulcerative ColitisUlcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Ulcerative Colitis QuizWhat is ulcerative colitis and what risks are associated with suffering over the long term? Take this Ulcerative Colitis Quiz to learn causes, symptoms, and treatments for this painful digestive disorder.
VasculitisVasculitis (arteritis, angiitis) is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.