Methotrexate: what it is and who takes it

Methotrexate is a well-known medicine used for cancer and for inflammatory diseases like rheumatoid arthritis and psoriasis. It’s also used in certain pregnancy complications and some rare conditions. The idea here is simple: low doses calm an overactive immune system; high doses can block rapidly growing cancer cells.

People often worry about safety because methotrexate can be powerful. That’s fair — but with the right dosing, regular blood checks, and simple habits, most users get the benefits while keeping risks low.

How methotrexate works and what it treats

On a basic level, methotrexate blocks folate metabolism. That slows down DNA production in fast-dividing cells — which helps in cancer — and it calms immune cells that drive inflammation. For rheumatoid arthritis and psoriasis, doctors usually prescribe a weekly low dose. For cancer, dosing is higher and done in cycles under specialist care.

Common uses: rheumatoid arthritis, psoriatic arthritis, severe psoriasis, some cancers (like leukemia and lymphoma), ectopic pregnancy management, and certain autoimmune or inflammatory diseases when other treatments fail.

Practical tips, monitoring, and safety

Dosing schedules matter. For chronic inflammatory conditions, methotrexate is often once weekly, not daily. Taking it daily by mistake can cause serious harm — always double-check with your provider and pharmacist.

Folic acid is commonly given alongside methotrexate to reduce mouth sores, nausea, and liver strain. Don’t stop folic acid unless your doctor tells you to.

Watch for side effects: nausea, mouth ulcers, hair thinning, unusual bruising, infections, cough or shortness of breath, and yellowing of the skin. Serious problems include liver injury, low blood counts, and lung inflammation. If you get fever, severe sore throat, bleeding, sudden breathlessness, or yellow skin, contact medical care right away.

Routine monitoring keeps things safe: regular blood tests for liver enzymes, kidney function, and complete blood counts. Frequency depends on dose and how long you’ve been on the drug — often every 1–3 months at first, then spacing out if stable.

Important interactions: avoid high alcohol intake (extra liver risk), and tell your doctor about NSAIDs, some antibiotics, and supplements. Live vaccines are usually avoided while on methotrexate. Never take methotrexate if you’re pregnant or planning pregnancy without a specialist’s advice — it causes birth defects.

Final practical notes: keep a list of your meds, carry a card stating you’re on methotrexate, and ask your clinician before starting any new drug or vaccine. If you’re worried about side effects, a dose change or switch to a different treatment is often possible.

Methotrexate can be highly effective when used carefully. Talk openly with your healthcare team, follow monitoring advice, and report any worrying symptoms early.