3. Methotrexate

Methotrexate

  • Methotrexate is used to treat various conditions.
  • Two strengths of methotrexate tablets are available - 2.5 mg and 10 mg. It is important each time you collect a prescription that you check to make sure you get the SAME STRENGTH of tablets you have had before.
  • Methotrexate doses are usually once EACH WEEK.
  • You will need regular blood tests while you are taking methotrexate.
Type of medicine Cytotoxic antimetabolite
Used for Rheumatoid arthritis
Psoriasis
Cancer of various types
Also called Maxtrex®
Metoject®
Available as Tablets
Injection

Methotrexate is used to treat conditions where some kind of over-activity in the body is causing problems. Methotrexate prevents this over-activity.

Cancers form when cells in the body multiply in a way that is abnormal and out of control. These cells then spread and destroy nearby tissues. Methotrexate works by stopping the cancer cells from dividing and multiplying.

It is thought that rheumatoid arthritis is caused by excessive activity of the immune system; methotrexate may work by suppressing this excessive activity and so reducing inflammation.

In psoriasis, methotrexate prevents the excessive division and multiplication of skin cells that causes skin scaling and raised plaques.

Before taking methotrexate make sure your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you are suffering from diarrhoea.
  • If you are suffering from an infection.
  • If you have a stomach or duodenal ulcer.
  • If you have liver or kidney problems.
  • If you have a blood disorder.
  • If you have ever suffered from a mental health problem.
  • If you suffer from porphyria (a rare blood disorder).
  • If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
  • If you have ever had an allergic reaction to this or to any other medicine.
  • Before beginning treatment, read the manufacturer's printed information leaflet.
  • Take methotrexate exactly as directed by your doctor.
  • It is important for you to know why methotrexate has been prescribed for you, and how you take it. If you are unsure why you are taking it, what dose to take, or which day of the week to take it, ask your doctor.
  • Usually doses of methotrexate are taken once a week. Make sure that you take each dose on the correct day of the week and at the correct time. Methotrexate is only occasionally taken more frequently, usually when the patient is in hospital. Do not take methotrexate every day, unless you are sure your doctor has instructed you to do so.
  • Methotrexate tablets are available in two strengths: 2.5 mg and 10 mg. You will only be given one strength of tablet. If your tablets look different to your last prescription speak with your doctor or pharmacist for advice.
  • The amount of methotrexate you take will have been carefully calculated for your particular condition and to suit your individual requirements. Make sure you take the correct number of tablets each time you take a dose.
  • Handle the tablets as little as possible.
  • You may be asked to take folic acid tablets while you are being treated with methotrexate. This is to help reduce unwanted side-effects. You will be told which day (or days) to take it.
  • Keep your regular appointments with your doctor so that your progress can be monitored. You will need to have regular blood tests while you are taking methotrexate.
  • Do not take medicines containing aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) or vitamin preparations containing folic acid, without first consulting your doctor. Some medicines that can be bought over the counter may contain these. Check with your pharmacist if you are unsure about the contents of any medicine.
  • It is important that you do not become pregnant or father a child while you are taking methotrexate, and for at least 3 months afterwards. Ask your doctor for contraceptive advice.
  • Any unwanted tablets or any waste from injections must be disposed of in a special way. If you need to dispose of methotrexate, ask your local pharmacy for advice.
  • While you are taking methotrexate, and for a while after you stop treatment, do not have any immunisations (vaccinations) without talking to your doctor first. Methotrexate lowers the body's resistance and there is a chance that you may get an infection from some vaccines.
  • If you are having any treatment like an operation or dental treatment tell the person carrying out the treatment which medicines you are taking.

Your doctor will have discussed with you the possibility of unwanted side-effects of treatment with methotrexate. Let your doctor know if you experience any of the following:

Common side-effects - these affect less than 1 in 10 people who take this medicine What can I do if I experience this
Increased chance of infection Try avoiding people with infections and let your doctor know straight away if you think you are getting a sore throat or if you have a high temperature
Feeling or being sick, diarrhoea Eat little and often. Stick to simple foods and drink plenty of water to replace any lost fluids
Sore mouth Brush your teeth with a soft toothbrush 2-3 times daily and use a mouth rinse frequently
Headache Ask your pharmacist or doctor to recommend a suitable painkiller
Dizziness, tiredness, rash, loss of hair If any of these become troublesome, speak with your doctor

Important: If you develop any of the following, let your doctor know straight away:

  • Sore throat, unusual bruising, mouth ulcers
  • Sickness, abdominal pain, dark urine
  • Shortness of breath, cough

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

  • Never take more than the prescribed dose. If you suspect that you or someone else has taken an overdose of this medicine go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
  • This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
  • Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.
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Further reading & references

  • British National Formulary; 59th Edition (March 2010) British Medical Association and Royal Pharmaceutical Society of Great Britain, London.
  • Manufacturer's PIL, Maxtrex® Tablets 2.5 mg; Manufacturer's PIL, Maxtrex® Tablets 2.5 mg, Pharmacia Limited, electronic Medicines Compendium. Dated October 2009.
Original Author: Helen Allen Current Version:
Last Checked: 21/10/2010 Document ID: 1079  Version: 23 © EMIS

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.