Why have I been prescribed this medication?

Methotrexate is used to treat a variety of conditions, such as rheumatoid arthritis, psoriasis, Crohn’s disease, and cancer. Methotrexate is also used to treat neurological disorders. It is often referred to as a ‘steroid-sparing agent’ or an immunomodulator. This means that it allows the dose of corticosteroid a patient is prescribed to be kept at a minimum.

How it works

Methotrexate is another medication that behaves as an immunosuppressant. It works to reduce the impact your immune system has on the communication between nerve and muscle cells and operates as an anti-inflammatory. It can be used in place of Azathioprine as a steroid-sparing agent if the symptoms of Azathioprine are too severe.

How it is delivered

Methotrexate can be taken as tablets, a syrup, or as pre-filled injection pens or syringes that you inject into your skin. The dose is determined by your neurologist. Usually, the initial starting dose is 7.5 mg, and this is increased as necessary by 2.5 mg increments to a maximum dose of 15 mg weekly. In exceptional circumstances, your doctor may advise higher doses up to 25 mg.

When you have it and how long you will be taking it

This medication should be taken as your clinician prescribes and is generally taken on the same day once a week. If you forget to take a dose, take it as soon as you remember the next day or day after. If you miss a dose by more than 2 days, contact your doctor for advice on what to do. Never take 2 doses together. The length of time you will be taking methotrexate depends on the condition being treated. Do not stop taking your medication unless your doctor tells you to, however well you feel.

Side effects

Unwanted side effects can happen when beginning a new treatment. The following side effects can occur when taking Methotrexate:

  • Loss of appetite
  • Nausea
  • Stomach pain or indigestion

For an extended list of possible side effects, refer to the patient information sheet supplied with your medication. If you have any concerns or questions regarding treatment or side effects, consult your doctor. If you seek reassurance about taking Methotrexate or are worried about possible side effects, speak to your doctor or contact the team at myaware for support.

Known UK suppliers

AAH Pharmaceuticals Ltd, Alliance Healthcare (Distribution) Ltd, DE Pharmaceuticals, Medihealth (Northern) Ltd, Morningside Healthcare Ltd, Orion Pharma (UK) Ltd, Sigma Pharmaceuticals Plc, Advanz Pharma, Almus Pharmaceuticals Ltd, Cipla EU Ltd.


Long-term use of Methotrexate may increase the risk of problems with your liver or lungs, and so your doctor will monitor you routinely with check-ups and blood tests to keep on top of this.

You should not take Methotrexate if pregnant, but if you become pregnant while receiving treatment please speak to your doctor as soon as possible.

For breastfeeding, it has been found that Methotrexate can pass into breast milk in tiny amounts. Consult your doctor for advice on what is best for you and your baby.

If you suffer from mouth or stomach ulcers you may not be able to take Methotrexate, please speak with your doctor for advice.

It is okay to consume alcohol if you are on low-dose Methotrexate (25 mg or less). If you are on a higher dose, consult your doctor to see whether or not this is acceptable.

Methotrexate can interact with other medications. You should consult your neurologist or GP if you are taking any of the following:

  • Antibiotics, such as amoxicillin, tetracycline, and chloramphenicol.
  • Inflammation reducing drugs, such as ibuprofen and naproxen.
  • Proton-pump inhibitors (PPI), such as omeprazole and lansoprazole.
  • Phenytoin
  • Anti-malarial drugs
  • Theophylline