Methotrexate is a medication that is primarily used to treat various forms of cancer. It’s commonly used to treat neck, head, breast, blood, lungs, lymph nodes, bone, and uterus cancers. It may also treat severe psoriasis, rheumatoid arthritis, multiple sclerosis, lupus, polyarticular juvenile idiopathic arthritis, or PJIA. When it’s used to treat PJIA, it’s generally because the child has tried other types of treatments that didn’t work very well.

This medication may be used orally with other medicines to treat relapsed or refractory non-Hodgkins’s lymphoma and acute lymphoblastic leukemia. It can also be used alone or with other medicines to treat mycosis fungi.

This medication is a part of a group of drugs classified as antineoplastics, which are cancer medications. Methotrexate blocks a specific enzyme that cells need to live. This keeps cancer cells from growing or slows that growth, and the body eventually destroys these cells. When used to treat severe psoriasis, it slows down skin cell growth so that the scales present in this condition are kept from growing. It works to treat rheumatoid arthritis by causing less activity in the body’s immune system so that the body doesn’t attack its joints.  It’s a prescription medication only.

Methotrexate Precautions and Warnings

It’s essential not to use this medication during pregnancy to treat psoriasis or arthritis. In some cases, it may be necessary to use it during pregnancy to treat cancer.  This medication can cause death or injury to a baby during a pregnancy. If you plan on getting pregnant, it’s best not to start this medication. It can be dangerous for either the mother or the father to take this medication during conception.

For women, it’s essential to take a pregnancy with a negative result before you start this medication. While using it, use birth control. Keep using birth control for at least six months after you stop using it. For men, use birth control when your partner can become pregnant. Continue using effective birth control (such as Angeliq) for a minimum of three months after you stop taking methotrexate. If a pregnancy does occur, tell the doctor right away.

This medication can also affect the fertility of men and women who take it. Don’t breastfeed while you’re taking methotrexate. Please wait at least a week after you stop taking it to breastfeed. This medication shouldn’t be given to children unless it’s specifically prescribed for them.

If you have a weak immune system, low blood cell counts, chronic liver disease, or alcoholism, don’t use this medication to treat rheumatoid arthritis or psoriasis. It may need to be taken for cancer treatment; make sure the doctor knows about your condition.

It’s essential to take the correct dose of this medication for the condition you’re treating. In many cases, the medication doesn’t have to be taken every day. There have been deaths from people taking it every day when they didn’t need to.

Don’t take this medication if you’re allergic to it. Be sure your doctor knows about your health history if you’ve ever had any fluid in your stomach or other liver problems, lung problems like fluid in the lungs, kidney disease, ulcerative colitis, or a stomach ulcer. It may not be safe for you to take methotrexate if you’ve had one of these conditions.

This medication can cause your bone marrow to make fewer blood cells. It can also cause patients to get liver damage. The chance of this is higher if you have to take this medication for a long time. If you have a history of heavy alcohol use, even if you no longer use it heavily, you may not be a good candidate for this medication. This increases the risk of developing liver damage. The risk of this happening is also higher if you’re obese, you have diabetes, or you’re elderly.

Methotrexate can also make it more likely that you’ll develop a type of cancer that starts in the immune system cells called lymphoma. If this happens, the condition could disappear after you stop taking this medication. Or, you may need to get chemotherapy to treat it.

Side Effects of Methotrexate

There are severe side effects possible with methotrexate that can be life-threatening. This medication should only be taken to treat an extremely severe condition. It should be used when other drugs can’t be used to treat the condition. If you have questions about your risks while taking this medication, talk to your doctor about the risks versus the potential benefits of using it.

If you have side effects that signify low blood cells, you may have a fever, chills, a sore throat, unusual bleeding or bruising, pale skin, extreme fatigue, or shortness of breath. If you have any of these side effects, inform your doctor immediately. This medication can also cause damage to the lungs. If you get a fever, dry cough, or shortness of breath, you may have lung damage. Please be sure to tell your doctor about these symptoms immediately, or you can go ahead and seek emergency medical care.

This medication can also cause damage to the intestines, stomach, or the mouth’s lining. If you have any of these symptoms, you may need to stop the medication right away and tell your doctor about them:

  • Diarrhea
  • Mouth sores
  • Tarry stools
  • Black stools
  • Bloody stools
  • Bloody vomit
  • Vomit that looks similar to coffee grounds


Methotrexate can also cause severe skin reactions. This could cause side effects, including peeling skin, rash, fever, or blisters. Tell your doctor if you develop these.

Other side effects that this medication may cause include:

  • Muscle weakness
  • Mouth sores
  • Pain in the upper stomach
  • Tingling or numbness
  • Dark urine
  • Cough
  • Seizures
  • Rash
  • Skin peeling and blistering

Drug Interactions of Methotrexate

Many medications can interact poorly with methotrexate. These include many antibiotics, sulfa drugs, theophylline, and mercaptopurine. Medications for reducing stomach acids are often contraindicated. These include: omeprazole, esomeprazole, Nexium, pantoprazole, Protonix, Prilosec, and Nexium. Other medicines that can interact with methotrexate include NSAIDS, which are non-steroidal anti-inflammatory drugs. These include celecoxib, aspirin, Aleve, Motrin, Advil, diclofenac, meloxicam, and indomethacin.

Other drugs that can interact with this medication include Acetane, acitretin, azathioprine, sulfasalazine, and tretinoin (such as Vesanoid). Ensure your doctor knows all medications you take, including anything over the counter.

Methotrexate Strengths and Dosages

This medication comes in a tablet with strengths of 2.5 mg, 5 mg, 7.5 mg, 10 mg, and 15 mg. It also comes in an injection form. These are available in 7.5 mg, 10 mg, 12.5 mg, 15 mg, 17.5 mg, 20 mg, 22.5 mg, and 25 mg. There is also an oral pediatric solution available. This comes in a 2.5 mg strength. The dosage that you’re prescribed will depend on your body weight as well as the reason that you’re taking it.

Tablets:2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg
Injections:7.5 mg, 10 mg, 12.5 mg, 15 mg, 17.5 mg, 20 mg, 22.5 mg, 25 mg
Pediatric oral solution:2.5 mg per mL


Questions and Answers of Methotrexate

Can I drink alcohol while using this medication?

No, it shouldn’t be used with alcohol. One of the potential side effects is liver damage, and alcohol use can make that more likely. If you have a history of alcoholism, it may mean you aren’t able to take this medication.

Will this medication treat psoriasis?

Yes, but only if you have a severe case of it. This medication has several risks, so it isn’t used if the psoriasis problem is mild to moderate.

Is this a cancer drug?

Yes, this medication is commonly used to treat several cancer types.

Can you take methotrexate while pregnant?

No, it should never be taken by someone pregnant. It also shouldn’t be taken by a man who may get someone pregnant. It carries a severe risk of the death of the unborn.

Are there any severe side effects of this medication?

Yes, there is a wide range of severe side effects possible. For this reason, this medication isn’t prescribed unless it is essential. Some of the side effects can include gastrointestinal problems, heart conditions, liver damage, and more.

Can you take OTC pain relievers with methotrexate?

You can’t take non-steroidal anti-inflammatory drugs (NSAIDs), including common medications like aspirin, Aleve, Advil, and Motrin.

Can people be allergic to this drug?

Yes, some people suffer from mild to severe allergic reactions to this medication. The reactions can be severe and require emergency medical treatment.

Can children take this medication?

There is a liquid suspension that is for children who have a type of severe arthritis called polyarticular juvenile idiopathic arthritis.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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