Explanation of methotrexate

Question 1

How does methotrexate work?

Answer 1

• Type of medication called a ‘disease- modifying agent’
• it reduces inflammation + suppresses the immune system
• the earlier you start it the the better outcome + the more it improves your sx

Question 2

How often do you take methotrexate?

Answer 2

• once/ wk- make sure you take it on the same day of the week each time
• take folic once a week the day after the methotrexate
• will build the dose up slowly over time

Question 3

How do you take methotrexate?

Answer 3

• orally in tablet form - may have to take several tablets at once depending on the dose you are prescribed
• swallow tablets whole with a glass of water
• injection also available

Question 4

How long will I be on methotrexate for?

Answer 4

• it is a long term treatment

Question 5

How long will it take for me to see the effects of the drug?

Answer 5

• 4-6 months

Question 6

What tests are involved in taking methotrexate?

Answer 6

• Will need blood tests
• FBC, U&Es, LFTs
• before starting treatment
• every 2 wks until therapy stabilised
• every 2-3 mths

Question 7

What are the common side effects of methotrexate?

Answer 7

• alopecia
• headaches
• GI disturbance

Myelosuppression

• sx of infection –> go to A&E
• unexpected bleeding/ bruising/ purpura
• anaemia

Question 8

What are the complications of methotrexate?

Answer 8

• myelosuppression
• liver toxicity- monitor alcohol intake
• pulmonary toxicity- inform Dr if get SOB

Question 9

What are the CI for methotrexate?

Answer 9

• pregnancy- inclu. male if TTC
• hepatic impairment
• breast- feeding
• active infection
• immunodeficiency

Question 10

What are other recommended steps if taking methotrexate?

Answer 10

• no NSAIDs/ aspirin

- get annual flu jab

Question 11

Where can you get additional info on methotrexate?

Answer 11

• Arthritisresearch/org.uk

- NHS website