Side effects of methotrexate

The most commonly observed adverse events (AEs) of low-dose methotrexate therapy are associated with the gastrointestinal tract, including:

  • Nausea
  • Anorexia
  • and less often stomatitis or diarrhea.

More serious AEs include

  • Hepatotoxicity
  • bone marrow suppression
  • 43 and rarely hyper-sensitivity pneumonitis
  • opportunistic infections

Due to these potentially severe side effects, a specific evaluation is recommended for patients before the start of methotrexate. Methotrexate is a known teratogen and is contraindicated in pregnancy.

Patients should get x rays done to rule out lung injury, CBC, CMP and pregnancy test.

The dose is 12.5 mg methotrexate orally once a week with 1 mg folic acid.

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