About Methotrexate Side Effects

Written by peggy deland
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Methotrexate is an antimetabolite drug used to treat a variety of conditions. It is most commonly prescribed in the treatment of rheumatoid arthritis, although it is also used to treat psoriasis, psoriatic arthritis, ankylosing spondylitis and certain types of cancer. Single doses of methotrexate are sometimes used to induce abortion and to end early ectopic pregnancies.

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Methotrexate's mechanism of action is not well-understood, particularly in the treatment of autoimmune disorders such as rheumatoid arthritis and psoriasis. The drug appears to interfere with the function of the immune system, which is the source of some side effects associated with the medication. It also interferes with the body's absorption and production of folic acid, an important B vitamin.


Several side effects are associated with the use of methotrexate. The most common side effects are nausea, vomiting, sores in the mouth, fatigue, bruising and bleeding more easily, fever, chills, dizziness and headache. Some people who take methotrexate, especially in high dosages, may experience temporary hair loss. The hair loss caused by methotrexate is usually not extensive.


Methotrexate can cause damage to the liver, especially in people who have a history of excessive alcohol consumption. For this reason, regular liver function tests are performed on people who use this medication. Some doctors may also recommend a liver biopsy after the drug has been taken for a period of time, usually about 2 years. People who take methotrexate have a mildly impaired immune system and should take extra care to avoid being exposed to pathogens. Frequent hand-washing and careful preparation of food can prevent most infections associated with the use of methotrexate.


Some side effects caused by methotrexate can be prevented. For example, liver damage is unlikely to occur if the person taking the medication does not drink alcohol. The chance of liver damage is greatly increased if methotrexate is used with alcohol. For this reason, most doctors recommend that anyone taking methotrexate limit their drinking to no more than 2 drinks per month. Folic acid deficiency induced by methotrexate can be prevented by taking daily folic acid supplements. This is especially useful in preventing sores from forming in the mouth.


Methotrexate is a very effective drug, especially when used to treat autoimmune disorders. Unlike many drugs used for these conditions, methotrexate usually works within a few weeks and can prevent damage caused by rheumatoid arthritis and similar conditions. However, methotrexate is associated with serious side effects and is not always appropriate. People who have or have had liver disease, cannot limit their drinking, have abnormal kidney function or have diabetes should usually not use this medication. Methotrexate has been shown to cause serious harm to a foetus if taken during pregnancy; it should never be taken by pregnant women, and women who take this medication must use reliable birth control.

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