About Methotrexate

1. Methotrexate is the most commonly prescribed disease-modifying anti- rheumatic drug (DMARD) in the treatment of patients with rheumatoid arthritis (RA).

2. Highly efficacious and has an excellent safety profile. It has been used in since the 1950s.

3. It usually takes a couple of months to demonstrate response, and it takes about 4 - 6 weeks to flare after it is stopped. Although there is wide individual variation.

4. Typically taken orally but can also be subcutaneous

5. Usual dose is 20 mg once a week followed by Folic acid 5mg for the next 2 days

   1. Folic acid administration can reduce some of the side effects of methotrexate.

6. While its exact mechanism of action is unknown, it can impact the function of almost every cell associated with inflammation in the body.

7. Its efficacy and safety has been well established in rheumatoid arthritis through various trials

8. Side effects

   1. Most common side effects are gastrointestinal (Anorexia, nausea, vomiting and diarrhoea). Most of these occur shortly after methotrexate is started and most are mild.

   2. It can rarely reduce the white cell count

   3. Liver toxicity is a well known side effect of methotrexate and close monitoring of the blood tests is required

   4. Methotrexate is a known teratogen and needs to be stopped for 3 months prior to attempting conception.

9. For patient information sheet, please visit: https://arthritisaustralia.com.au/wordpress/wp-content/uploads/2017/09/Methotrexate-1.pdf

#methotrexate #rheumatoidarthritis #patientinformation

ref: Hochberg, Marc C. Rheumatology. Edinburgh: Mosby, 2018.