Methotrexate (Rheumatrex or Trexall)

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Methotrexate (Brand names Rheumatrex or Trexall) is a drug used to treat inflammation in people with various conditions such as rheumatoid arthritis, cancer, psoriasis, systemic lupus erythematosus, Inflammatory Bowel Disease, and Crohn’s disease.

How should it be used?

This drug can be given by mouth, by injection, or an infusion.

  • Follow your doctor’s instructions exactly if you are taking by mouth, and do not take the medication for longer than prescribed.
  • Take with or without food.
  • Call your doctor if you miss a dose.
  • Contact 911 in the event of accidental overdose.

Special Precautions/Instructions

Before you start taking this medicine, tell your doctor about any other medicines, including over-the-counter, vitamins or herbal remedies.

  • Do not take aspirin, or products containing aspirin unless your doctor approves.
  • Do not take non-steroidal anti-inflammatory medicines (NSAIDS) like ibuprophen or naproxen unless your doctor approves.
  • If you are on warfarin (Coumadine) as a blood-thinner, adjustments may need to be made to your dose based on blood work.Do not get any vaccinations or immunizations without your doctor’s approval.
  • Tell your doctor if you are pregnant or breastfeeding. You should not take this medicine if you are pregnant because it can cause harmful effects on the baby.
  • Do not breastfeed while taking this medicine.
  • Don’t drink alcohol while on this medication.

Tell your doctor is you have kidney disease, liver disease, lung disease or pneumonia, stomach ulcers, or any infection as your doctor may need to adjust your dosage.

Self-care tips:

  • Drink at least two to three quarts of fluid each day unless the doctor tells you to do something else.
  • Avoid people with colds and people who may be sick. Tell your doctor if you get any kind of infection.
  • To help prevent or treat mouth sores, use a soft toothbrush, and rinse three times a day with ½ to 1 tsp. of baking soda or ½ to 1 tsp. of salt mixed with 8 oz. of water.
  • Avoid contact sports or activities where you might get an injury.
  • Eat small, frequent meals to avoid or reduce any nausea. Your doctor may prescribe anti-nausea medicines as well.
  • Avoid sun exposure. Wear SPF 15 or higher sunblock and protective clothes.
  • Get plenty of rest.
  • Take folic acid supplements.
  • Eat foods that will give you the best nutrition.
  • Make sure you tell your doctor about any side effects of this medicine so they can prescribe or offer suggestions on managing these symptoms.

Talk to your doctor if you experience any of the following most common side effects of methotrexate: nausea, fatigue, headache, dizziness, blurred vision, and bleeding gums.

Other more serious side effects may occur. You should contact your doctor immediately if you experience:

  • Dry cough and/or shortness of breath
  • While patches or sores in your mouth or on your lips
  • Blood in your urine or stools
  • Urinating less than usual or not at all
  • Fever, chills, aches, flu-like symptoms
  • Sore throat with severe blistering and peeling skin
  • Easy bruising and/or bleeding
  • Low fever, stomach pain, dark urine, clay colored stools, or jaundice (yellow skin or eyes)

Storage Conditions

Store methotrexate at room temperature and away from heat or moisture.


Call the national poison control center 1-800-222-1222 or 911 in the event of overdose. Symptoms of an overdose include vomiting, diarrhea, sore throat, fever, chills, and other signs of infection.