Methotrexate

Methotrexate 2.5 mg / 7.5 mg Tablets

Methotrexate is a critical medication used in many inflammatory conditions involving an overactive immune system. It is categorized as an antimetabolite and also a Disease-Modifying Antirheumatic Drug (DMARD). Specifically, it inhibits the production of rapidly dividing cells responsible for inflammation and tissue damage in chronic autoimmune conditions.

Common Uses

Arthritis: Relieves joint pain, stiffness, and swelling while preventing long-term joint damage.

Psoriasis and Psoriatic Arthritis: Reduces skin inflammation and immune-mediated symptoms.

Crohn’s Disease: Helps maintain remission and reduces bowel inflammation.

Oncology: At higher doses, Methotrexate is used in treating various cancers including breast, lung, blood, and bone cancers.

Administration of Methotrexate

Vital Information: Methotrexate is usually taken ONCE A WEEK, not daily. Daily use can lead to severe, life-threatening toxicity.

Methotrexate Day: Choose a fixed day each week (e.g., “Methotrexate Monday”) and stick to it consistently.

Folic Acid Helper: Doctors often prescribe Folic Acid (Vitamin B9) on non-methotrexate days to reduce side effects like mouth ulcers and skin reactions.

Hydration: Drink plenty of water on the day of your dose to support kidney function and drug elimination.

No Alcohol: Avoid alcohol completely, as it significantly increases liver toxicity.

Essential Precautions

Follow-up: Regular monitoring of liver function, kidney function, and blood counts is essential.

Infection Risk: As an immunosuppressant, it increases susceptibility to infections. Avoid close contact with sick individuals.

Sun Sensitivity: Skin becomes more sensitive to sunlight. Use sunscreen and protective clothing.

Pregnancy Warning: Contraindicated in pregnancy. Both men and women should use effective contraception and plan conception only after medical advice (typically 6 months after stopping).

Common Side Effects

Most side effects are manageable, especially with folic acid supplementation:

Nausea or “methotrexate fog”

Temporary hair thinning

Tiredness or dizziness (especially after the weekly dose)

Mouth sores or ulcers

Frequently Asked Questions (FAQs)

Q: Why is Methotrexate taken only once a week?

A: Methotrexate is a potent medication. Taking it daily instead of weekly can cause serious toxicity, affecting blood cells and vital organs. Always double-check your dosing schedule.

Q: Can I take painkillers like Ibuprofen with Methotrexate?

A: Use caution. NSAIDs (like Ibuprofen) may reduce the elimination of Methotrexate via the kidneys. Always consult your doctor. Paracetamol may be a safer alternative in some cases.

Q: When will I start feeling better?

A: This is a slow-acting medication. Benefits are usually seen after 6–12 weeks of consistent use.

Q: What should I do if I miss my weekly dose?

A: If remembered within 1–2 days, consult your doctor and take the dose. If more than 2–3 days have passed, skip the dose and resume on your next scheduled Methotrexate Day. Never take a double dose.

Q: Does Methotrexate cause permanent hair loss?

A: Hair thinning may occur, but permanent hair loss is rare. Increasing folic acid intake often helps manage this side effect.