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Methotrexate, sold under the brand names Trexall and Rheumatrex, is a prescription medication approved by the Food and Drug Administration (FDA) in 1988 for treatment of rheumatoid arthritis. Methotrexate can reduce joint pain and swelling as well as allow for a reduction in dosage of other drugs such as Prednisone.

Methotrexate is an immunomodulator, or in other words, a drug that modulates the immune system. Methotrexate is also referred to as a disease-modifying antirheumatic drug (DMARD) or a slow-acting antirheumatic drug (SAARD). It is an antimetabolite that blocks the synthesis of purine, a protein the body needs in order to produce lymphocytes. Lymphocytes are a type of white blood cell active in the immune system. Methotrexate is believed to work by interfering with lymphocytes and preventing them from attacking the joints.

How do I take it?
Methotrexate is taken once a week, either by mouth or as an injection.

Side effects
Side effects from Methotrexate may be worse among older adults and in those who receive higher doses of the drug.

The most commonly reported side effects of Methotrexate are malaise, fatigue, nausea, mouth ulcers, abdominal distress, dizziness, changes in blood cell count, abnormal liver function test results, and lowered resistance to infection.

Many drugs can cause allergic reactions that, in the most serious cases, can result in death. Seek immediate medical help if you experience signs of a severe allergic reaction such as difficulty breathing or swelling in the face, throat, eyes, lips or tongue.

For answers to frequently asked questions about exposure to Methotrexate during pregnancy and breastfeeding, visit the experts at

Methotrexate for Rheumatoid Arthritis Questions

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