What Is Methotrexate Used For?

A drug with many uses, methotrexate is licensed to treat severe psoriasis, certain types of cancer, and other serious medical conditions. The medicine is very strong -- typically, its use is recommended only when other, less-toxic treatments have been tried first. Methotrexate is approved for cancer and juvenile arthritis (but not psoriasis) treatment in children.

An Overview of Methotrexate Uses

Methotrexate (Rheumatrex®, Trexall®) is a prescription medication used to treat a few different serious medical conditions. In particular, it is approved to treat the following conditions:
Because methotrexate can cause serious side effects, it is important to make sure that other, less toxic medications have been tried first, if appropriate. Your healthcare provider will need to monitor you carefully, with frequent blood tests to check your kidney function, liver function, and blood cell counts. Chest x-rays may also be recommended to check for side effects that involve the lungs.
When used to treat cancer, high doses of methotrexate are often used, followed by "leucovorin rescue." Leucovorin is a form of folic acid that is given to help healthy cells -- especially bone marrow and gastrointestinal cells -- recover from the toxic effects of methotrexate.

How Does It Work?

Methotrexate works by inhibiting an enzyme known as dihydrofolic acid reductase (also known as dihydrofolate reductase). This enzyme is important for transforming an inactive form of folic acid into the active form, which is necessary to make some of the building blocks needed for DNA production. By inhibiting this enzyme, methotrexate interferes with a cell's ability to repair and replicate (copy) itself.
Although this drug can damage healthy cells as well as unhealthy cells, it tends to target rapidly replicating cells, such as cancer cells and bone marrow cells.
It is not entirely clear how methotrexate works to treat rheumatoid arthritis, although it is thought to work by affecting the immune system.
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Methotrexate Drug Information

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