Methotrexate

Methotrexate calms the immune system. It is taken once a week for rheumatoid arthritis, psoriasis and Crohn's disease. Higher doses treat some cancers.

Type of medicine

Disease-modifying antirheumatic drug (DMARD) and chemotherapy

Also known as

Metoject, Nordimet, Maxtrex

Comes as

tablets, liquid, injection pens

How you get it

Started by a specialist, then sometimes prescribed by a GP

What it is used for

Rheumatoid arthritis and juvenile idiopathic arthritis
Severe psoriasis and psoriatic arthritis
Crohn's disease
Some cancers, at much higher doses

Read our guides:

Off-label uses

Doctors sometimes prescribe a medicine for a condition it is not officially licensed for. This is called off-label use. It is legal and common when there is good evidence it helps, and your doctor should explain why they are suggesting it.

Severe eczema, vasculitis, lupus and other inflammatory conditions
Ending an ectopic pregnancy

How it works

At low weekly doses, methotrexate reduces the activity of immune cells that cause inflammation. At high doses, it stops cancer cells from dividing.

Side effects

Like all medicines, Methotrexate can cause side effects, although not everyone gets them. Many are mild and ease after the first few weeks.

Common side effects

feeling sick
mouth ulcers
tiredness
hair thinning
headache
more infections

Tell your doctor or pharmacist if these bother you or do not go away.

Serious side effects

These are rare. Call 111 or contact your doctor straight away if you get:

a new dry cough or breathlessness
signs of infection, such as a high temperature or sore throat
unusual bruising or bleeding
yellowing of the skin or eyes

Call 999 if you have signs of a serious allergic reaction, such as swelling of your lips, mouth, throat or tongue, or trouble breathing.

You can report any side effect to the Yellow Card scheme, run by the medicines regulator.

Stopping and withdrawal

Important safety information

It is taken ONCE A WEEK, on the same day each week. Taking it daily by mistake can be fatal.
You will usually also take folic acid on a different day.
You need regular blood tests.
Avoid pregnancy. Both men and women should use contraception during treatment and for 6 months after.
Limit alcohol. Avoid trimethoprim and co-trimoxazole antibiotics.

Questions about your medicine?

A pharmacist can answer questions about your medicines for free, without an appointment. You can also ask your GP for a medication review. Check if you can get free prescriptions.