Methotrexate (Oral)

Methotrexate is a medicine used to treat psoriasis.

In Psoriasis, your skin cells grow and mature too rapidly, resulting in elevated, red plaques covered by dry silvery scales. Methotrexate acts by slowing down this excess cell reproduction, so that the skin is restored to a normal appearance.

​This medicine is also used for other conditions, including the management of skin conditions, as determined by your doctor.

​​Methotrexate comes in the form of tablets. Take this medicine only as directed by your doctor. This medication should be taken only ONCE a week.

​​If you miss a dose, do not take the missed dose at all and do not double the next one. Resume your regular dosing schedule and check with your doctor.

​​Certain side effects of this medicine are not unusual and may even disappear during treatment. If any of the following effects persist or are severe, consult your doctor:-

• Nausea and vomiting. To reduce these effects take this medicine with some food or take it in divided doses, at 12 hourly intervals.
• Hair loss. This is only temporary. Normal hair growth should return when treatment has ended.
• The side effects of methotrexate include suppression of the bone marrow and liver toxicity. Your doctor will perform regular blood monitoring (full blood count and liver function test) to watch out for complications.

​​Consult your doctor as soon as possible if any of these additional effects occur, as they may indicate more serious side effects:

• Increased sensitivity of the skin to sunlight
• High fever or chills
• Bloody, black stools or severe stomach ache
• Sores in the mouth or lips
• Sores in the skin
• Unusual bleeding or bruising
• Yellow eyes or skin, with dark coloured urine
• Unusual tiredness or weakness
• Rash

• Inform your doctor if you have liver disease or a history of liver problems; kidney disease; an immune system disorder; blood or bone marrow problems; an infection; a stomach ulcer; any chronic lung disease; any allergies.
• For women: Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Methotrexate is not recommended during pregnancy. It is known to cause birth defects in an unborn baby. Avoid conception while on methotrexate and for at least a further 3 months after stopping methotrexate. Methotrexate may be harmful to a nursing infant. Breastfeeding is not recommended during treatment with methotrexate
• For men: Avoid conception while on methotrexate and for at least a further 3 months after stopping methotrexate.
• Avoid taking alcohol while on methotrexate. Alcohol can increase the risk of liver problems.
• Inform your doctor if you are taking any other medications, in particular, acitretin, phenytoin, probenecid, penicillins and sulpha-based medicine (e.g. co-trimoxazole). Do not take aspirin or other anti-inflammatory painkillers e.g. indomethacin, ketoprofen, mefenamic acid etc., without first checking with your doctor. These medicines may increase the effects of methotrexate, which could be harmful.
• Some patients who take methotrexate may become more sensitive to sunlight than they are normally. When you first begin taking methotrexate, avoid excessive exposure to sunlight. In case of a severe burn, check with your doctor.
• As mentioned above, this medicine can increase your risk of developing an infection. Inform your doctor at the first sign of a possible infection (fever, persistent sore throat). If you seek treatment from a family doctor, please inform them that you are taking this drug. Be careful also when cleaning your gums or teeth.
• Do not get any immunizations (vaccinations) without your doctor's approval while you are being treated with methotrexate and after you stop treatment with it. For some immunizations, there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have recently taken oral polio vaccine.
• Keep to your appointments regularly so that your doctor can monitor your response and adjust your treatment accordingly.
• Do not allow anyone else to take this medication.

• Keep this medicine away from heat and direct sunlight in a cool, dry place, out of reach of children.
• ​Do not keep this medicine with other medications in the same container. Keep each medicine separately in labelled containers.