What is methotrexate?
Methotrexate is prescribed for a number of patients with rheumatic diseases. Patients with rheumatoid arthritis, psoriatic arthritis, even children with juvenile arthritis cause it’s the best treatment. Methotrexate is used to control the disease, so the disease does not cause deformity and disability to a patient.
How does methotrexate work best?
So, methotrexate works best if you started early in the disease and we would hope that you would see some response by 4 or 8 weeks.
How long will I need to take methotrexate?
So some people who take low dose once weekly methotrexate will need to take it for a period of time, the disease goes into remission and may be able to wean off it. Other people are going to need to take low dose once weekly methotrexate for the rest of their life.
Patients on low dose once weekly methotrexate do need regular monitoring. The blood test might be once a month for the first few months until the dose is stable and then it could be every 2 or 3 months depending on other factors.
What about side effects?
When I’m trying to encourage someone to take methotrexate I will say that there are some annoying side effects and then some potential nasty side effects. But most people don’t get a side effect, most people just get benefit.
In terms of annoying side effects there is mouth ulcers, feeling sick, hair can get a bit thin but most of those can be managed with low dose folic acid.
The nasty side effects, so there can be problems with bone marrow, there can be problems with liver tests and lungs, but if you take your tablets properly or your injections properly and you have your appropriate screening, then your prescribing rheumatologist or doctor will ensure that any problems are picked up early and managed.