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Methotrexate is an FDA-approved medication for treating certain cancers, psoriasis, and rheumatoid arthritis. It operates by slowing cell growth, particularly cancer cells, and dampening the immune system to reduce inflammation. The drug comes in various forms and dosages, and it carries significant FDA black box warnings due to its potential for severe side effects. It’s crucial to adhere to the doctor’s instructions regarding dosage and monitor for interactions and side effects.

Product Overview

Methotrexate is an essential drug in the antimetabolites class. It is commonly prescribed for treating various forms of cancer, including leukemia and lymphoma, as well as autoimmune diseases like psoriasis and rheumatoid arthritis. It works by inhibiting cell growth, specifically targeting rapidly dividing cancer cells and suppressing the immune system to reduce inflammation and prevent the progression of autoimmune disorders. 

Available in oral tablets, solutions, and injectable forms, Methotrexate’s dosage is typically tailored to individual patient needs based on body size and the specific condition being treated. The FDA has issued severe warnings about this medication, including risks of liver damage, lung problems, and potential toxicity in pregnant women. 

Users must follow their healthcare provider’s guidelines carefully, especially regarding dosage and the management of missed doses or overdoses. Patients must also be aware of possible drug interactions and side effects, ensuring they consult their doctor with any concerns about other medications they are taking or any unusual symptoms they experience.

Uses of Methotrexate

It is commonly prescribed for:

  • Managing Psoriasis
  • Controlling Rheumatoid Arthritis
  • Treating specific types of cancer, including those that start in tissues surrounding a fertilized egg in the uterus, as well as lung, breast, head, and neck cancers, lymphomas, and leukemia.

Benefits of Methotrexate

  • Effective in treating various autoimmune diseases, such as rheumatoid arthritis, psoriasis, and Crohn’s disease.
  • Works by suppressing the overactive immune system, reducing inflammation and joint damage.
  • May slow the progression of rheumatoid arthritis and prevent permanent joint damage.
  • Improves symptoms like joint pain, swelling, and stiffness in rheumatoid arthritis.
  • Can lead to significant improvement in the severity and extent of psoriasis lesions.
  • Generally well-tolerated at low doses used for autoimmune diseases.
  • Can be administered orally or through injections.
  • May have a steroid-sparing effect, reducing the need for long-term corticosteroid use.
  • Can be used alone or in combination with other disease-modifying antirheumatic drugs (DMARDs).

Side Effects of Methotrexate

Common side effects of Methotrexate may include:

  • Fatigue
  • Nausea or vomiting
  • Dizziness
  • Reduced appetite
  • Hair loss
  • Diarrhea
  • Headache
  • Stomach pain

[Note: This list is not exhaustive, if you notice any other symptoms not mentioned above, consult your doctor immediately.]

Methotrexate Dosage

Forms & Strengths

Methotrexate comes in these following forms and strengths:

  • Oral Tablet: 2.5 mg, 5 mg, 7.5 mg, 10 mg, and 15 mg
  • Self-injectable Solution: 7.5 mg, 10 mg, 12.5 mg, 15 mg, 17.5 mg, 20 mg, 22.5 mg, and 25 mg
  • Oral Solution: 2.5 mg per 1 ml
  • Injectable IV Solution (can only be given by a doctor)

Recommended Dosages

For Oral Tablets
  • Acute Lymphoblastic Leukemia (ALL):
      • An adult’s dosage is based on body size, which your doctor determines.
      • Initially: 20 milligrams (mg) per square meter (m²) of body size once a week.
  • Mycosis Fungoides:
      • When used alone: 25 to 75 mg once a week.
      • When used with other medications: Your doctor will decide on a dosage based on your body size; typically, 10 mg per m² of body size twice a week.
  • Non-Hodgkin Lymphoma:
      • Adults: 2.5 mg, 2 to 4 times a week; not to exceed 10 mg per week.
  • Polyarticular Juvenile Arthritis (pJIA):
      • Children: Dosage is based on body size, which your doctor decides.
      • Initially: 10 mg per m² once a week.
  • Psoriasis:
      • Adults: Start with 10 to 25 mg once a week; not to exceed 30 mg per week.
  • Rheumatoid Arthritis:
    • Adults: Initially, 7.5 mg once a week.
For Oral Solution (Adults)
    • Acute Lymphoblastic Leukemia (ALL): Dosage is based on body size, determined by your doctor. Initially, 20 milligrams (mg) per square meter (m²) of body size once a week. Adjustments may be made as needed.
  • Mycosis Fungoides:
    • When used alone: 25 to 75 mg once a week.
    • When used with other medications: The dosage is based on body size, determined by your doctor; typically, it is 10 mg per m² of body size twice a week.
  • Non-Hodgkin Lymphoma: 2.5 mg, 2 to 4 times a week, with the total weekly dose not exceeding 10 mg.
  • Psoriasis: Initially, 10 to 25 mg once a week, not to exceed 30 mg per week.
  • Rheumatoid Arthritis: Start with 7.5 mg once a week.
For Oral Solution Form (Children)
  • Acute Lymphoblastic Leukemia (ALL) & Polyarticular Juvenile Idiopathic Arthritis (pJIA):
    • Dosage is tailored to the child’s body size and must be determined by a doctor.

Depending on how well the child tolerates the treatment in each given condition, the doctor may adjust the dosage as needed.

How to Take Methotrexate?

  • The dosage of Methotrexate varies for each person.
  • Always adhere to your doctor’s prescription or the guidelines on the medication label.
  • Do not change your dosage without your doctor’s approval.
  • Do not use Methotrexate more often or for a longer duration than prescribed.
  • This medication is not intended for daily treatment of conditions other than cancer.
  • Swallow the Methotrexate tablet whole; do not crush, break, or chew it.
  • If you cannot swallow the tablet, do not attempt to take it.
  • Doctors may recommend taking folic acid or folic acid supplements to reduce side effects for conditions like rheumatoid arthritis, psoriasis, and juvenile arthritis.

Missed Dose

If you forget to take a dose of Methotrexate, take it as soon as you remember. Do not take a double dose to make up for the missed one.

[Note: Do not take two doses of Methotrexate simultaneously to compensate for a missed dose. This can increase your risk of experiencing side effects.]


If you take more Methotrexate than your doctor has prescribed, contact your doctor immediately. 

[Note: If you notice you have taken too much medication, call your local emergency number immediately.]

How Does Methotrexate Work?

Methotrexate belongs to a group of drugs known as antimetabolites. It works by slowing down cell growth. In treating cancer, it specifically targets and decelerates the growth of cancer cells. For psoriasis, it reduces the rapid growth of skin cells, helping to prevent the formation of scaly patches. In the case of rheumatoid arthritis, Methotrexate suppresses the activity of the immune system, which helps to lessen joint inflammation and alleviate pain.

Important Safety Precautions

Methotrexate carries black box warnings issued by the FDA. The black box warnings include:

  • Liver problems 
  • Incorrect dosing
  • Lung problems
  • Pregnancy 
  • Using birth control pills
  • Lymphoma
  • Dizziness and tiredness
  • Skin reactions
  • Infections
  • Anesthesia
  • Harmful buildup of Methotrexate in the body
  • Tumor lysis syndrome
  • Some treatments and drugs that may increase the side effects include:
    • Radiation therapy
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Severe gastrointestinal tract issues


  • Store methotrexate tablets in their original container at room temperature.
  • Protect the medication from excess heat, direct sunlight, and moisture.
  • Do not freeze the medication.
  • Keep the medication out of the sight and reach of children.
  • Avoid flushing the medication unless specifically instructed. Consider using a medicine take-back program for disposal.

Methotrexate Interactions

Medications That Increase Your Risk of Side Effects

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Seizure drugs
  • Gout drugs
  • Antibiotics
  • Proton pump inhibitors
  • Post-transplant drugs
  • Anti-inflammatory drugs
  • Anesthesia

Medications That Can Make Your Drugs Less Effective

  • Antibiotics such as chloramphenicol, tetracycline, and others.

[Note: This list of interactions isn’t complete. Talk to your doctor if you notice any interaction with food, over-the-counter drugs, prescriptions, or supplements.]

Methotrexate Alternatives

  • Stelara (ustekinumab)
  • Cyclosporine (cyclosporine)
  • Leflunomide (leflunomide)
  • Skyrizi (risankizumab)
  • Corticosteroids

[Note: Your healthcare provider will choose which Methotrexate alternative is best for you. Taking or consuming them by yourself may cause serious side effects.] 

Frequently Asked Questions

Does Methotrexate cause weight gain?

It has been observed that DMARDs (disease-modifying antirheumatic drug), including Methotrexate, may lead to gradual and modest weight gain in some individuals with rheumatoid arthritis.

What foods should you avoid while taking Methotrexate?

When taking Methotrexate, avoiding unpasteurized milk and soft cheeses is advisable. Additionally, limit your caffeine intake, which is found in coffee, tea, cola, energy drinks, and chocolate.

Why is Methotrexate high-risk?

Methotrexate is considered high risk because it can increase the likelihood of developing issues with your liver or lungs, particularly at higher doses. To mitigate these risks, your doctor will closely monitor your health through regular check-ups, allowing for the early detection and management of potential problems.

Who should not take Methotrexate?

Individuals should not take Methotrexate with certain health conditions, including severe liver disease, thrombocytopenia (a low level of platelets in the blood), or a weakened immune system. 

Our Guarantee

At Arctic Meds, we guarantee that you will find the most competitive prices for purchasing Methotrexate through our platform. As the best Canadian online pharmacy, we are committed to delivering only the highest quality products. Each order is fulfilled through a reputable and licensed Canada pharmacy online. Our reliable service ships your medications directly from Canada right to your doorstep. For seamless access to buy Methotrexate online from Canada at a low price contact us.


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