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Methotrexate (MTX)

Methotrexate (MTX) is a commonly used drug in dermatology and other medical fields. It affects the immune system in ways to help fight against inflammation in the body. In high doses, it can be used for chemotherapy, but it is used in very low doses for various types of arthritis, psoriasis, urticarial (hives), Grover’s disease and other itchy dermatoses/rashes.

MTX can be given orally or by injection. Side effects are uncommon but include nausea, fatigue and hair loss. Everyone taking MTX should take Folic Acid (a vitamin) daily to protect the GI tract. MTX is always taken ONCE WEEKLY and NEVER daily.

If you are given the pill form, take the dose on the same day each week. Some patients take half in the AM and half in the PM while some take the entire
dose at one time. Regardless of how you do it, always take MTX WITH FOOD.

If you are given the suspension/liquid form to be taken by mouth, inject the prescribed amount from the vial into a small amount of Orange Juice and take it
that way. Again, take it WITH FOOD.

If you are given the suspension/liquid form to be used as an injection into the fat (abdomen or thighs), you will also take the dose ONCE WEEKLY.

Your provider will have you get a blood test 7-10 days after your first dose of MTX. This is VERY important since rare side effects sometimes occur and can
be discovered with that blood test. Periodically, you will have blood tests otherwise while on MTX for the same reasons.

Here are some other important things to remember while taking MTX:

  • Minimize alcohol intake since both MTX and alcohol are metabolized by the liver
  • Avoid pregnancy
  • Avoid taking the antibiotic Septra (Bactrim, Sulfamethoxazole-Trimethoprim)
  • Minimize high doses of ibuprofen, aspirin, Aleve or other NSAIDS (baby aspirin (81mg) is fine)

Click here to to download this Methtrexate information in PDF format.

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