An informed arthritis patient is always an intelligent arthritis patient. Conquer rather than cope with your arthritis.


What is Methotrexate?
Methotrexate is a drug used for treating Rheumatoid arthritis. It is also used to treat certain types of cancer. However the dose used for the same is much higher than that for rheumatoid arthritis.
How long will it take to work?
Methotrexate usually takes 4 to 6 weeks to start working in Rheumatoid arthritis. Evidence suggests that there is significant improvement in the number of swollen, tender joints in rheumatoid arthritis patients with Methotrexate *.
What dose of Methotrexate will I have to take ?
Methotrexate is taken either once or twice a week. The weekly dose varies depending on the severity of your arthritis. Take the dose as prescribed by your Rheumatologist.
What should I discuss with my Rheumatologist before
starting Methotrexate?
Before starting Methotrexate, tell your Rheumatologist if you have any of the following --
  • Any liver problem you have.
  • Amount of alcohol you consume in a week.
  • Any ongoing infections.
  • Any hematological problems you have
  • If pregnant or planning to conceive.
Can Methotrexate be taken in pregnancy?
No. Methotrexate can harm your unborn baby. Please talk to your rheumatologist if you are pregnant/ planning pregnancy. Methotrexate needs to be stopped 3–4 months prior to planning pregnancy **. Even though methotrexate cannot be taken during pregnancy, it does not decrease the women’s chance of becoming pregnant in the future. Men should stop methotrexate at least 1 month prior to planning pregnancy.
Can Methotrexate be taken while breast feeding?
Can I take alcohol when I am on methotreaxte?
No. You should not drink alcohol whilst on methotrexate.
What are the side effects of Methotrexate?
The most common side effects of Methotrexate are mouth sores or ulcers. One can also have nausea on the day of methotrexate. Other side effects include neutropenia (decrease in the white cells in the body), increase in the liver enzyme levels.
Will I require blood tests while on Methotrexate?
Yes. Your Rheumatologist would like to follow up your response to methotrexate closely. You will be asked to do blood counts and liver enzymes (SGPT, SGOT) regularly.
Why do I have to take folic acid while on Methotrexate *** ?
Folic acid has been shown to decrease the side effects of Methotrexate ***.
Can one continue Methotrexate if a surgery is planned?
No. Speak to your Rheumatologist & Surgeon if you are on methotrexate & planning to undergo any surgical procedure.

* Suarez-Almazor ME, Belseck E, Shea B, et al. Methotrexate for rheumatoid arthritis. In: The Cochrane Library, Issue 3, 2000.
** Antirheumatic drugs in pregnancy & lactation. Semin Arthritis Rheum. 2005; 35(2):112-21
*** Effect of folic or folinic acid supplementation on the toxicity and efficacy of methotrexate in rheumatoid arthritis: A forty-eight-week, multicenter, randomized, double-blind, placebo-controlled study Arthritis. Rheumatism. 44:1515, 2001

*** How to overcome nausea related to methotrexate?
How to manage hair loss related to methotrexate?
Unusual post dosing reactions with methotrexate?
       How to self inject methotrexate?
       Why is folic acid taken along with methotrexate?
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Created on: April 2007
Last updated on: Feb 2015
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