1. WHAT IS METHOTREXATE? Methotrexate is classified as a DMARD this stands for Disease-Modifying Anti-Rheumatic Drug. Brand names include Rheumatrex and Trexall. Methotrexate is classified as a DMARD because it decreases pain and swelling associated with arthritis, and also, methotrexate can lessen joint damage and lower the risk of long-term disability.
2. WHY IS IT USED? Methotrexate was approved by the U.S. Food and Drug Administration in 1988 for the treatment of rheumatoid arthritis. Methotrexate was prescribed for treatment of psoriasis and cancer before it was approved for treatment of rheumatoid arthritis. Methotrexate is also used to treat other rheumatic conditions including: psoriatic arthritis, lupus, ankylosing spondylitis (peripheral joint disease) vasculitis and juvenile arthritis.
3. HOW DOES IT WORK? Methotrexate interferes with immune system function. Methotrexate blocks the enzyme dihydrofolate reductase. By doing so, it will affect the production of a form of folic acid, which is needed for actively growing cells.
4. HOW IS IT TAKEN? Methotrexate is not taken daily like most medication. Methotrexate is usually taken one day a week. Methotrexate is available in 2.5 mg tablets. The starting dose for most adults is 7.5 to 10 mg (3 or 4 pills). These 3 or 4 pills are taken together once a week on the same day each week is optimal. The dose can be increased to 20 - 25 mg each week at a doctors instruction. Methotrexate is also available in an injectable form which most patients can self-inject.
5. HOW LONG DOES IT TAKE TO WORK? Improvement from Methotrexate may be seen at 6 weeks but it may take 12 weeks or even 6 months of treatment for full benefit to manifest.
6. HOW YOU ARE MONITORED: It's of the upmost importance to monitor the use of Methotrexate. Methotrexate can cause abnormal liver function. Users will typically have liver function blood tests every 2 to 12 weeks to observe any side effects.
7. KNOWN SIDE EFFECTS: Other than abnormalities with liver function, the most common side effects associated with Methotrexate are nausea and vomiting. Though they vary from person to person. Side effects are usually dose-dependent. So a doctor may suggest adjusting the dose in order to eliminate the problem. Possible side effects include: mouth sores, rash, diahorrea, blood count abnormalities, cirrhosis of liver (rare) persistent cough, unexplained shortness of breath, hair loss (gradual) and sun sensitivity. However other patients experience no significant side effects while taking Methotrexate.
8. USING OTHER MEDICATION WHILE TAKING METHOTREXATE: It's incredibly important to remind your doctor of all the medications you take including prescription and over the counter. Some medications and natural remedies may interact dangerously with Methotrexate. Drugs known to increase Methotrexate toxicity include the antibiotic Trimethoprim (Bactrim) and NSAIDs (nonsteroidal anti-inflammatory drugs) – including Ibuprofen.
9. METHOTREXATE AND FERTILITY: Methotrexate should NEVER be taken if you are pregnant or plan to become pregnant. Methotrexate can cause serious birth defects as well as pregnancy complications. It is important to use a form of contraception while taking Methotrexate and for 3 months after you stop taking Methotrexate.
10. CAN I DRINK ALCHOHOL? Studies have shown that Alcohol can increase the risk of liver damage in people taking Methotrexate. Ideally, you should not drink alcohol if you take Methotrexate. At most, and with doctor's permission, you should drink little and infrequently.
This information was gathered from: Eustice, C (2012) ‘Methotrexate - 10 Things You Should Know: Methotrexate Safety Decreases Unwanted Side Effect’ [WWW] Accessed 01/07/2013
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