Examples
Methotrexate is a medicine taken orally once a week or in 3
divided doses taken at 12-hour intervals during a 24-hour period (for instance,
taken at 8 a.m., at 8 p.m., and then again at 8 a.m.).1
It may also be given as a shot once a
week.
How It Works
Methotrexate slows the rapid growth of
skin cells in
psoriasis.
Why It Is Used
Methotrexate is used to treat severe
psoriasis (more than 20% of the skin is affected) when creams, ointments, tar
products, and phototherapy have not worked or cannot be used. It is also used
to treat
psoriatic arthritis.
Methotrexate cannot
be used by women who are pregnant or trying to become pregnant or by
people:
- With blood disorders or severe
anemia.
- With stomach
ulcers.
- With liver or kidney diseases.
- With an
infectious disease, such as
tuberculosis.
- Who drink alcohol
frequently.
- Who cannot return to the doctor for tests to check for
side effects of the medicine.
How Well It Works
Methotrexate takes several weeks to
show benefits. If side effects can be tolerated, methotrexate can work very
well for some people. If you are taking methotrexate, your blood tests should
be monitored carefully. And it is very important that you do not drink
alcohol.
Side Effects
Common temporary side effects
include:
- Nausea, fatigue, loss of
appetite.
- Trouble sleeping.
- Low blood
counts.
Less common temporary side effects include:
- Sunburn if you are exposed to large doses of
sunlight or
ultraviolet (UV) light either before or after taking
the drug.
- Vomiting, diarrhea, and occasional blood in the
stools.
- Mouth sores.
- Easy bruising and
bleeding.
- Skin rash or
sores.
- Headaches.
- Chills and
fever.
- Lightheadedness.
- Birth defects (if taken by a
woman who is pregnant or who becomes pregnant while taking the
medicine).
Long-term side effects include liver damage. If it is not
severe, the damage reverses after you stop taking methotrexate. The risk of
liver damage is higher if you drink a lot of alcohol, have kidney or liver
problems or diabetes, or are overweight.
See Drug Reference for a
full list of side effects. (Drug Reference is not available in all
systems.)
What To Think About
Because it can cause serious side
effects, methotrexate is used only to treat severe psoriasis that cannot be
treated with other medicines, such as psoriasis associated with arthritis
(psoriatic arthritis).
People taking
methotrexate need to have their blood counts and liver function tested before
they start taking the drug and then regularly while they are taking it.
You may need to have a liver
biopsy to check on the health of your liver while you
are taking methotrexate.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
References
Citations
- Abel E, Lebwohl M (2008). Psoriasis. In EG Nabel, ed., ACP Medicine, section 2, chap. 3. Hamilton, ON: BC Decker.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Alexander H. Murray, MD, FRCPC - Dermatology |
|---|
| Last Revised | November 9, 2010 |
|---|
Abel E, Lebwohl M (2008). Psoriasis. In EG Nabel, ed., ACP Medicine, section 2, chap. 3. Hamilton, ON: BC Decker.
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