- 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;
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.
Latest Skin News
Daily Health News
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
Rheumatoid Arthritis (RA) Symptoms & Treatment
What is rheumatoid arthritis (RA)? Learn about juvenile rheumatoid arthritis. Discover rheumatoid arthritis (RA) symptoms,...
Psoriasis Quiz: Test Your Medical IQ
Take the mystery out of psoriasis. Take the Psoriasis Quiz and see what you know about the types, symptoms, treatments and more....
Ankylosing Spondylitis Quiz: Symptoms & Treatment
What is ankylosing spondylitis? Take this quiz to learn the causes, symptoms, and treatments for this painful disorder....
Ulcerative Colitis Quiz: Diet, Symptoms & Treatment
What is ulcerative colitis and what risks are associated with suffering over the long term? Take this Ulcerative Colitis Quiz to...
Rheumatoid Arthritis Quiz: What is Rheumatoid Arthritis?
How is rheumatoid arthritis different from other forms of arthritis, such as osteoarthritis and gout? Take the Rheumatoid...
Picture of Systemic Lupus Erythematosus 1
A chronic inflammatory condition caused by an autoimmune disease. See a picture of Systemic Lupus Erythematosus (SLE) and learn...
Picture of Atopic Dermatitis
This condition is the most common of all pediatric dermatoses. See a picture of Atopic Dermatitis and learn more about the...
Picture of Systemic Lupus Erythematosus 2
Erythematous, edematous plaques appear in a "butterfly" distribution on the face. See a picture of Systemic Lupus Erythematosus...
Psoriasis Types, Images, Treatments
What is psoriasis? Explore psoriasis treatment options such as topical ointments, phototherapy, natural remedies and more. Learn...
Types of Psoriasis: Medical Pictures and Treatments
Learn about the common skin condition psoriasis. Explore about the different types of psoriasis such as vulgaris (plaque...
Psoriatic Arthritis Symptoms, Treatment, Images
What is psoriatic arthritis? Psoriatic arthritis is an arthritis type that comes with psoriasis (skin inflammation). Psoriatic...
Related Disease Conditions
Liver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high...
Psoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales....
Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints,...
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing...
Crohn's disease is a chronic inflammatory disease, primarily involving the small and large intestine, but which can affect...
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding....
IBS vs. IBD: Differences and Similarities
IBS (irritable bowel syndrome) and IBD (inflammatory bowel disease) are both problems with the digestive tract...
Lupus (Systemic Lupus Erythematosus or SLE)
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease....
Polymyalgia rheumatica (PMR) is a disorder of the muscles and joints that causes pain and stiffness in the arms, neck, shoulders,...
Sarcoidosis, a disease resulting from chronic inflammation, causes small lumps (granulomas) to develop in a great range of body...
Crohn's Disease vs. Ulcerative Colitis (UC)
Crohn's disease and ulcerative colitis are diseases that cause inflammation of part of or the entire digestive tract (GI)....
Pulmonary fibrosis is scarring throughout the lungs. Pulmonary fibrosis can be caused by many conditions including chronic...
Primary Biliary Cirrhosis (PBC)
Primary Biliary Cirrhosis (PBS) is a liver disease in which bile building up in the organ damages bile ducts. Ultimately, this...
Scleritis is inflammation of the white part of the eye. It may be caused by a serious underlying condition, such as an autoimmune...
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms and signs include painful, stiff, and swollen...
Vasculitis (Symptoms, Causes, Diagnosis, Treatment, Types)
Vasculitis (arteritis, angiitis) is a general term for a group of uncommon diseases which feature inflammation of the blood...
Myasthenia gravis, a chronic autoimmune neuromuscular disease. Varying degrees of weakness of the voluntary muscles of the body...
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in...
Still's disease (systemic-onset juvenile rheumatoid arthritis) is a disorder characterized by inflammation with high fever...
Optic neuritis is inflammation of the optic nerve, the structure that connects the eye to the brain. The precise cause of optic...
Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint...
Scalp Psoriasis (Psoriasis of the Scalp)
Scalp psoriasis causes red, raised, scaly patches that may extend from the scalp to the forehead and the back of the neck and...
Polymyositis is a disease of the muscle featuring inflammation of the muscle fibers. It results in weakness of the muscles which...
Primary Sclerosing Cholangitis (PSC)
Primary sclerosing cholangitis or PSC is a disease of the liver. The cause of PSC is not known. Symptoms may include itching,...
SAPHO syndrome is a chronic disorder that involves the skin, bone, and joints. SAPHO syndrome is an eponym for the combination of...
Bullous pemphigoid is a skin disease that causes blistering eruptions on the skin's surface and sometimes affects the inner...
Uveitis is inflammation of the eye. Symptoms include blurred vision, eye pain, eye redness, photophobia, and floaters. Treatment...
Relapsing polychondritis is an uncommon, chronic disorder of the cartilage that is characterized by recurrent episodes of...
Eosinophilic Fasciitis (Shulman's Syndrome)
Eosinophilic fasciitis is a skin disease that causes thickening and inflammation of the skin and fascia. Symptoms include...
Takayasu disease (also referred to as Takayasu arteritis) is a chronic inflammation of the aorta and its branch arteries....
Granulomatosis with Polyangiitis
Granulomatosis with polyangiitis is a condition that usually affects young or middle-aged adults, is an inflammation of the...
Male Breast Cancer
Male breast cancer accounts for 1% of all breast cancers, and most cases are found in men between the ages of 60 and 70. A man's...
Juvenile Idiopathic Arthritis (Juvenile Rheumatoid Arthritis)
Juvenile idiopathic arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are six...
Felty's syndrome is a complication of long-term rheumatoid arthritis. Felty's syndrome is defined by the presence of three...
Primary Biliary Cirrhosis Treatment (PBC)
Primary biliary sclerosis (PBC) is thought to be an autoimmune disorder that involves the deterioration of the liver's small bile...
Cleft Palate and Cleft Lip
Cleft palate and cleft lip are facial and oral defects that occur early in pregnancy. A cleft lip is a split of the two sides of...
Treatment & Diagnosis
- Rheumatoid Arthritis (RA)
- Crohn's Disease
- Systemic Lupus Erythematosus (SLE)
- Psoriatic Arthritis
- Lung Cancer
- Bladder Cancer
- Ulcerative Colitis
- Inflammatory Bowel Disease
- Ankylosing Spondylitis (Bechterew's Disease)
- Doctor: Checklist to Take To Your Doctor's Appointment
- Pulmonary Fibrosis
- Juvenile Idiopathic Arthritis
- Rheumatoid Arthritis FAQs
- Psoriasis FAQs
- Ulcerative Colitis FAQs
- Ankylosing Spondylitis FAQs
- Rheumatoid Arthritis (RA): 17 Warning Signs of Serious Complications
- Patient Story: Rheumatoid Arthritis and Pregnancy
- Medication Disposal
- Dangers of Mixing Medications
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Arava Approved For Rheumatoid Arthritis
- Does Methotrexate Cause Liver Damage?
- Patient Story: Rheumatoid Arthritis Treatment
- Psoriasis PUVA Therapy Can Increase Melanoma Risk
- Herbs: Toxicities and Drug Interactions
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
Prevention & Wellness
- New Version of RA Drug Enbrel: FAQ
- FDA Approves New Biological Drug for Rheumatoid Arthritis
- Nerve Zap Eased Rheumatoid Arthritis in Small Study
- Girls Given Risky Meds Don't Get Contraceptive Advice
- Weight Could Influence Rheumatoid Arthritis Relief
- Lower Doses of Rheumatoid Arthritis Drugs May Work for Some
- Popular Crohn's, Colitis Drugs Not Linked to Short-Term Cancer Risk: Study
- Drug Shows Promise Against Arthritis Common in People with Psoriasis
- Childhood Arthritis: Aggressive Treatment Better?
- RA Strategy: Treat Early, but With What Medicines?
- Treatment Options Expand for Psoriasis Patients
- Expensive or Not, Rheumatoid Arthritis Drugs Have Similar Effect: Study
- Rheumatoid Arthritis Drugs Have Same Impact on Time Lost at Work: Study
- Rheumatoid Arthritis Treatment May Not Work As Well for Heavier Patients
- Standard Rheumatoid Arthritis Therapy as Good as Costlier Newcomer: Study
- Ectopic Pregnancy Treatments Have Similar Effects on Fertility
- 5 Rheumatology Procedures You Might Not Need
- Newer Rheumatoid Arthritis Drugs Don't Seem to Increase Risk of Shingles
- Hoping to Ease Shortage, FDA Fast-Tracks Generic Form of Cancer Drug
- New Arthritis Drug Xeljanz Gets FDA Approval
- Lupus May Be Linked to Serious Pregnancy Complication
- Some Psoriasis Therapies May Cut Heart Attack Risk
- Pill Instead of a Needle May Soon Be Option for RA
- HIV Drug May Prevent Bone Marrow Transplant Complication
- Newer Drugs Help RA Patients Live Longer
- Study: Actemra Tops Rival in Rheumatoid Arthritis
- 'Uncertainty' Remains Over Supply of Key Cancer Drugs
- For Juvenile Arthritis, Pill May Work as Well as Needle
- Arthritis in Children Linked to Infections
- New Psoriasis Drugs Not Much Better Than Standard Therapy, Study Finds
- 'Chemo Brain' May Linger 20 Years After Breast Cancer Treatment
- FDA Moves to Head Off Shortages of 2 Cancer Drugs
- Lupus, Rheumatoid Arthritis Affect Birth Rates
- Health Highlights: Feb. 14, 2012
- FDA Thinks Shortage of Cancer Drug for Kids Can Be Averted
- Health Highlights: Feb. 13, 2012
- Chemo May Not Harm Unborn Baby
- Voraxaze Approved to Treat High Levels of Chemo Drug
- Pill for RA Works as Well as Shot
- Experimental Drug May Help Treat Psoriasis
- New Oral RA Drug Works in Unique Way
- Psoriasis Guidelines Call for Tailored Treatment
- Smoking May Interfere With RA Treatment
- Chemo During Pregnancy OK
- RA Drug Methotrexate Is Recalled
- Treating Psoriasis If Enbrel Fails
Health Solutions From Our Sponsors
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.
FDA Prescribing Information