Methotrexate
Methotrexate is an immunomodulator used weekly (not daily) for rheumatoid arthritis, some other autoimmune diseases, and psoriasis when prescribed. It is also used in much higher cancer doses — those schedules are completely different from rheumatology dosing.
This medicine is part of the Blood pressure, cholesterol & related category.
Generic name: methotrexate
Quick answers
Short replies to searches people often run before speaking to a clinician. For the overview of what the medicine is used for, see the short summary under the page title above.
What is it for?
Methotrexate is an immunomodulator used weekly (not daily) for rheumatoid arthritis, some other autoimmune diseases, and psoriasis when prescribed.
How long does it take to work?
Onset varies by condition and dose. Your GP or pharmacist can explain what to expect and when to review.
What are common side effects?
Nausea, mouth ulcers, fatigue, or temporary hair thinning.
Can you take paracetamol or ibuprofen with it?
Trimethoprim and many NSAIDs increase toxicity risk.
More about what Methotrexate is used for
Methotrexate is an immunomodulator used weekly (not daily) for rheumatoid arthritis, some other autoimmune diseases, and psoriasis when prescribed.
It is also used in much higher cancer doses — those schedules are completely different from rheumatology dosing.
How does Methotrexate work, and how long does it take to work?
Low weekly doses reduce immune overactivity and inflammation in joints and skin.
Folic acid supplementation on a set schedule often accompanies treatment to reduce side effects.
How and when should you take Methotrexate?
Take only on your prescribed weekday — never daily by mistake. Swallow tablets with water after food if nausea occurs.
Alcohol limits are usually advised — follow your rheumatology team’s guidance.
What are the common side effects of Methotrexate?
Nausea, mouth ulcers, fatigue, or temporary hair thinning.
Blood count suppression can occur — attend monitoring tests.
Serious side effects of Methotrexate — when to get urgent help
Seek urgent help for fever, sore throat, unexplained bruising, shortness of breath, or severe mouth ulcers — these can signal low blood counts or pneumonitis.
What if you miss a dose of Methotrexate?
If you miss a weekly dose, contact your rheumatology nurse for when to take the next — do not double up next week without instruction.
Who should not take Methotrexate?
Pregnancy and conception planning must avoid methotrexate; men and women need contraception as advised. Severe liver disease, immunodeficiency, and active serious infection need review.
Can you take paracetamol or ibuprofen with Methotrexate? — other interactions
Trimethoprim and many NSAIDs increase toxicity risk. Live vaccines are usually avoided — check before travel vaccines.
Methotrexate in pregnancy and breastfeeding
Contraindicated in pregnancy; discuss washout periods before trying to conceive.
Blood tests and monitoring on Methotrexate
FBC, liver tests, and sometimes chest monitoring are scheduled — attend every blood test.
What might your GP prescribe instead of Methotrexate?
Sulfasalazine, leflunomide, or biologic injections may be alternatives depending on disease.
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Reviewed by UK registered pharmacists for accuracy and clarity. Content is informational only.
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Frequently asked questions about Methotrexate
People also ask — common Google searches
- What is Methotrexate used for?
- Methotrexate is an immunomodulator used weekly (not daily) for rheumatoid arthritis, some other autoimmune diseases, and psoriasis when prescribed. It is also used in much higher cancer doses — those schedules are completely different from rheumatology dosing.
- How long does Methotrexate take to work?
- Onset varies by condition and dose. Your GP or pharmacist can explain what to expect and when to review. Always follow your prescriber’s follow-up plan.
- Can you take Methotrexate with paracetamol or ibuprofen?
- Trimethoprim and many NSAIDs increase toxicity risk.
- What are the side effects of Methotrexate?
- Nausea, mouth ulcers, fatigue, or temporary hair thinning. Blood count suppression can occur — attend monitoring tests. See the sections below for more detail, including serious side effects and when to seek urgent help.
- Why weekly methotrexate but daily folic acid?
- Folic acid is usually taken on different days from methotrexate to reduce side effects while keeping treatment effective — use only the schedule your team printed.
- Can I drink alcohol on methotrexate?
- Many units advise strict limits or abstinence because of liver risk — follow your prescriber’s rule, not general population guidance.
Need personalised advice?
Your local pharmacist or GP surgery can help with questions about your medicines, side effects, and alternatives that may be suitable for you.
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Often used with
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