Methotrexate: Once a week dose information

New start oral methotrexate discharge education

 

You will be discharged on methotrexate.  This information is for low dose methotrexate taken once a week.

Once a week dosing is used to treat arthritis, psoriasis, multiple sclerosis, lupus, inflammatory muscle diseases, and other conditions.

How do I take methotrexate? 

  • Take methotrexate exactly as prescribed.

  • Pick the day of the week and take it on that day only.

  • Never take an extra dose.

  • If you miss a dose, please call your provider for instructions.

 

You should start to feel better 3 to 6 weeks after you start the medication.

You should continue to improve during the first 12 weeks of taking methotrexate.

Does methotrexate interact with any food, medications, or procedures? 

  • You can take methotrexate with or without food.

  • Do not take methotrexate with milk-rich drinks or foods (examples: cheese, milk, yogurt)

  • Avoid alcohol while taking this medication.

  • Avoid certain over-the-counter (OTC) medications:

    • Anti-inflammatory pain medications (naproxen, ibuprofen, Aleve®, Advil®, Motrin®)

    • Vitamins containing folate and echinacea

 

Talk with your provider or pharmacist before starting any new OTC or prescription medications, vitamins, herbal products or supplements. 

Tell all your healthcare providers that you take methotrexate. Check with all providers before any procedure to see if it is safe to continue methotrexate. 

Side effects I should be aware of? 

  • Nausea and/or vomiting

  • Drowsiness

  • Skin can be more sensitive to the sun.  Wear sunscreen and protective eyewear and clothing.

 

Your doctor may prescribe folic acid to help minimize some of these side effects.

Do not take methotrexate if you are pregnant or breastfeeding. Avoid pregnancy for at least 3 months following treatment. Men who take methotrexate should protect women from pregnancy up until 3 months after taking their last dose.

When should I seek immediate medical attention?

Call your provider or go to the emergency department if you:

  • Have trouble breathing, swollen face, swollen tongue, or rapid heartbeat

  • Have a skin rash, red or peeling skin

  • Notice mouth or tongue sores

  • Have diarrhea or black stools

  • Notice changes in how often you urinate

  • Have unusual bleeding or bruising

  • Have persistent stomach or back pain

  • Feel excessively dizzy, tired, weak, or confused

  • Have fever, chills, or dry cough