Methotrexate Early Side Effects

Assoc. Professor Peter Youssef
Rheumatologist, Royal Prince Alfred Institute of Rheumatology and Orthopaedics, Sydney
Chair – Arthritis Australia Scientific Advisory Committee

Once treatment is started, it is important for patients to maintain close contact with their general practitioner and their rheumatologist. Patients should report any side effects to their general practitioner or their rheumatologist.

Dr. Marina Kang
General Practitioner

Because they’re such a specialised medication I just generally tend to get them to come back and if they have any side effects I tend to pick up on any unwanted side effects that they may have. But generally the patients come back and they tell me, or I get a letter back to say that they’ve been put on these medications and they’re generally very effective. So my role is, I feel, to just make sure that there’s no unwanted side effects, that they’re aware of what the side effects potentially could be and the step in when there’s a need for them.

Dr. Samuel Whittle
Rheumatologist, The Queen Elizabeth Hospital, Adelaide

Some people experience some minor side effects when they’re starting out on it. Things like some nausea or some gastric upset. Sometimes some tiredness or fatigue. Particularly on the day after they take the methotrexate but often for the rest of the week they have no symptoms at all and many people who have those early side effects with methotrexate find that those side effects improve over time. There’s also ways that the rheumatologist can help to offset some of these side effects and one of the best ways that we do this is by prescribing some folic acid, which is a vitamin which is often taken alongside the methotrexate to help prevent some of the side effects.

Dr. Irwin Lim
Rheumatologist

Over many decades, it’s proven to be a very effective agent. Yes, it does have a range of side effects for some people but the majority of people do seem to tolerate it quite well.