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Methotrexate: What It Is and How It Works

Ever wonder why doctors keep prescribing a single pill for arthritis, psoriasis, and some cancers? That’s methotrexate. It’s a medication that slows down cell growth, which helps reduce inflammation and control abnormal cell proliferation.

Think of it like a traffic cop for cells: it tells fast‑growing cells to back off, which eases joint pain, clears skin patches, and can shrink tumors. It’s taken once a week, not daily, and comes in a pill or injection form. The weekly schedule is key—taking it daily can be dangerous.

Common Uses & Dosage Guidelines

Doctors most often use methotrexate for three reasons:

  • Rheumatoid arthritis (RA) – to lower joint swelling and pain.
  • Psoriasis – especially the severe plaque type.
  • Cancer – in low doses for some leukemias and high doses for other cancers.

For RA and psoriasis, adults usually start at 7.5 mg to 15 mg once a week. The dose may go up gradually, but most people stay below 25 mg weekly. Cancer treatments use much higher numbers and are managed by oncology teams.

Take the pill with a full glass of water, preferably in the evening. Some doctors suggest a small snack to avoid stomach upset, but avoid alcohol because it can increase liver risk.

Side Effects, Precautions & When to Call Your Doctor

Like any medicine, methotrexate has side effects. The most common ones are nausea, mouth sores, and feeling tired. You might also notice mild hair thinning or a temporary drop in blood counts.

Serious side effects need fast action. Watch for yellow skin or eyes (a sign of liver trouble), severe nausea that won’t go away, or unusual bruising and bleeding. If you get any of these, call your doctor right away.

Because methotrexate can affect the liver, doctors usually order blood tests every few weeks at first, then every couple of months. Keep those appointments—missing them can hide problems.

Pregnancy is a big no‑no while on methotrexate. It can cause birth defects, so both women and men need to use reliable birth control during treatment and for a short period after stopping.

Before you start, tell your doctor about any other meds, especially antibiotics, anti‑inflammatories, or supplements like folic acid. Folic acid is often prescribed alongside methotrexate to lower side‑effect risk, but you should take it on a different day than the methotrexate dose.

Bottom line: methotrexate can be a game‑changer for chronic inflammation and certain cancers, but it needs careful handling. Stick to the weekly schedule, attend your lab tests, and call your doctor if anything feels off. With the right monitoring, many people find big relief without major issues."

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