Methotrexate (also sold under the brand names Rheumatrex and Rasuvo) is an immunosuppressant drug often prescribed for people with inflammatory types of arthritis. It is especially commonly used in patients with rheumatoid arthritis. The medication is taken once a week (sometimes taken as two doses 12 hours apart once a week).
Many patients on methotrexate have few or no side effects. Among those who do have problems, most side effects resolve by lowering the dose or, if needed, discontinuing the drug. But your dose should never be lowered or discontinued without guidance from your physician. Sudden discontinuation of the drug may put you at risk for a flare of your disease, so your doctor will want to monitor you appropriately.
However, it is important for you to be aware of any symptoms of possible side effects so that you can report them to your doctor promptly − and appropriate action can be taken if necessary.
Some serious side effects can occur without causing any symptoms you would immediately notice. That's why your physician will want to monitor you with blood tests more frequently early on in treatment. These blood tests may include: CBC (complete blood count, especially to check your white blood cell count,) liver chemistries and kidney function. Close follow-up of these laboratory tests is essential, since methotrexate can, at times, cause a drop in white blood cell count, for example. It can also at times cause an elevation of liver chemistries. These are generally reversible when dose is decreased or medication stopped, but it’s good to pick them up earlier than later.
When you are started on methotrexate, ask about your doctor's practice for monitoring and follow-up. For example, some physicians will contact you only if your test results are abnormal, while others will contact you about all results, even if normal.
Other side effects, both minor and serious, do cause symptoms.
Some aspects of your lifestyle may need to be changed while taking methotrexate. This can include reducing alcohol intake, reducing or switching other medications, and, in some people, reducing exposure to sunlight.