Methotrexate Side Effects

Methotrexate is a drug used in treatment of cancer and autoimmune diseases. It is an antimetabolite and antifolate drug, and works by inhibiting the metabolism of folic acid. Methotrexate acts specifically during DNA and RNA synthesis and is cytotoxic during the S-phase of the cell cycle. Methotrexate is commonly used in combination with misoprostol to terminate early pregnancies, i.e. pregnancy in the early stages. It may also be used in case of missed miscarriage, in which fetal demise has occurred, but the body has not expelled the fetus.

Methotrexate is used in the treatment of various diseases like dermatomyositis, inclusion body myositis, ankylosing spondylitis, Crohn's disease, psoriasis and psoriatic arthritis. It is also used in the treatment of Behçet's disease, in which the medication is given along with folic acid. In the case of rheumatoid disorder, methotrexate is given in low dosage, in order to inhibit AICAR transformylase, which leads to increased AICA ribose. It is useful for cancer chemotherapy, as a part of combination chemotherapy regimens, to treat many kinds of cancers. Methotrexate is still the mainstay of the treatment of many neoplastic disorders like acute lymphoblastic leukemia.

Methotrexate Side Effects
There are some frequent and some rare side effects of methotrexate, which can be seen in patients who are on this medication.

Nausea, Vomiting and Diarrhea: Consumption of methotrexate can cause nausea and vomiting. However, these side effects can be reduced, if the drug is taken with food or in the evenings. Anti nausea tablets can be taken to reduce the effect of nausea. Some patients may also show symptoms of diarrhea, which is characterized by frequent loose or liquid bowel movements.

Ulcerative Stomatitis: Ulcerative stomatitis is characterized by the appearance of small ulcers on the oral mucosa, covered by a grayish exudate. These are small sores or painful swellings on the inside of the mouth, which disappear by themselves usually within ten days, leaving no scar. Consumption of methotrextae often results in ulcerative stomatitis, but it vanishes within a short span of time.

Pneumonia: A patient on methotrexate medication may catch infections like pneumonia, sepsis and nocardiosis. Besides these, there is a also a risk of severe adverse reaction, if penicillin is prescribed along with methotrexate. When methotrexate is given via intrathecal route, it may cause central nervous system reactions. Fortunately these side effects are not very frequent, and occur rarely.

Skin Dryness: Skin dryness is one of the common side effects of methotrexate leading to a variety of skin rashes and increased sensitivity to the sun. It is advisable for the patient to wear sunscreen and a hat, when out in the sun. Methotrexate suppressed hematopoiesis may sometimes cause anemia, pancytopenia, neutropenia, thrombocytopenia and lymphoproliferative disorders.

Mild Tiredness and Headache: While on this drug, the patient may start feeling mild tiredness throughout the day. Headaches, which may occur frequently or infrequently, are also one of the common side effects seen in patients on methotrexate medication. Besides these, other frequently reported adverse reactions include leukopenia, abdominal distress, sore throat and pain while passing urine. Some patients also experience a temporary increase in muscle and joint pain, after taking their weekly dose.

Although methotrexate is useful in the treatment of many diseases, the side effects should not be overlooked while one is on this medication.