Ocular Side Effects of Methotrexate

Methotrexate is used to halt cancer growth in the skin, head, neck, breast or lung. The drug is more commonly known by the brand names Rheumatrex Dose Pack and Trexall. Methotrexate is also used to fight rheumatoid arthritis and psoriasis.

But methotrexate is not without side effects, including those that can affect the ocular system, or eyes.


Methotrexate sodium is an FDA-approved active ingredient manufactured in tablet and injection forms. It belongs to the class of chemotherapy drugs called antimetabolites. When antimetabolites are added into the cellular metabolism, the cells are unable to divide, stopping the growth of cancer. Methotrexate is able to counteract folic acid in cancer cells, which causes them to die.

Ocular Side Effects

Numerous side effects can occur ranging from mild to severe. Possible ocular side effects include eye discomfort, ocular-related headache, blurred vision, dizziness, vision changes, confusion, yellowing of the eyes and vision loss. If blurred vision, vision changes or vision loss occurs while using this medication, see a medical professional or emergency physician immediately.

Delay in Side Effects

According to the Mayo Clinic, side effects from methotrexate medications can occur months or even years after their initial use, even if the medication has been ceased for that amount of time.

Drug Interaction Warning

Non-steroidal anti-inflammatory drugs such as Advil, Aleve, Ansaid, Dolobid, Indocin, Lodine, Mobic, Motrin, Ralafen and Voltaren can affect methotrexate. Penicillin antibiotics, diabetes medications, aspirin and others also can interact adversely. Check with your health care professional about any interaction concerns before treatment use of methotrexate. Pregnant patients should not use the drug, as it can cause birth defects.


Methotrexate has caused death in some individuals who did not follow the proper dosage amounts, according to the online website Drugs.com. These fatalities were due to overuse of the medication, which can happen if the drug is taken every day, rather than once a week. Confirm any questions about dosage with your doctor. Do not take any missed dose without consulting your doctor first.