An Introduction to the Side Effects of Methotrexate
As with any medicine, side effects are possible with
methotrexate (
Rheumatrex®,
Trexall®). Methotrexate is a powerful medication that can cause significant and sometimes serious side effects. For this reason, the drug is usually reserved for treating severe diseases in cases where other treatments have failed or are not appropriate.
(This article covers many, but not all, of the possible methotrexate side effects. Your healthcare provider can discuss a more complete list with you.)
Potentially Serious Methotrexate Side Effects
Some side effects with methotrexate can be quite serious -- even life-threatening -- and should be reported to your healthcare provider.
These include but are not limited to:
- Severe vomiting, diarrhea, or mouth sores -- all of which may contribute to dehydration
- Signs of low white blood cells, such as frequent infections
- Signs of low blood platelets or anemia, such as easy bruising or bleeding
- Signs of liver fibrosis or cirrhosis (two types of liver damage), such as high liver enzymes or abnormal results from a liver biopsy
- A dry, nonproductive cough, which may be a sign of lung damage
- Signs of liver damage, such as abnormal kidney function test results
- Signs of an allergic reaction, such as:
- An unexplained rash
- Hives
- Itching
- Wheezing
- Swelling of the mouth or throat
- Difficulty breathing.
Most of these potentially serious side effects are related to the expected toxicity of methotrexate. This medication interferes more with cells that are multiplying rapidly, such as bone marrow cells that produce blood cells and platelets, or cells that line the digestive tract.
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