Did you just say “Chemotherapy”?

There are lots of different drugs out there used for Rheumatoid Arthritis, such as Enbrel, Humira, Orencia, Remicade, Simponi, etc. etc.  Like I said, there’s a lot.  And while one medication may work perfectly for someone, someone else may need something completely different.  But the one drug most all RA patients take is Methotrexate.

If you ever watch the tv show House then you will have heard of this drug before.  It is a chemotherapy drug.  Sounds pretty scary, huh?  Cancer patients take methotrexate to slow down and hopefully stop the reproduction of cancerous cells.  It is used to stop the progression of RA in a similar way.  According to WebMD, it works by “competing with folic acid in cells. This blocks the way the cell is able to make genetic material, and the cell dies.”  This is also why you will be required to take folic acid tablets in conjunction with the methotrexate.

Methotrexate is taken orally or by injection.  Injections are more effective according to doctors, however if your RA symptoms become less of a problem it is possible to switch to oral.  The once a week injection requires a little more work to assemble, unlike the prefilled packets some RA meds come in, such as Enbrel.  When taken orally, your doctor will prescribe you to take anywhere from four to six small tablets.  These tablets are also taken once a week.

But the main reason I wanted to discuss methotrexate today is because of it’s side effects. This is a heavy duty drug, and patients need to be wary of their bodies and their actions while taking it.  Again from our trusty WebMD, here are the side effects:

  • Nausea, vomiting, and loss of appetite.
  • Fatigue and sleep disturbances.
  • Reduced white blood cell count.

Less common side effects include:

  • Sun sensitivity and easy sunburning.
  • Diarrhea or blood in the stool.
  • Mouth sores.
  • Easy bruising and bleeding.
  • Skin rash or sores.
  • Headaches.
  • Chills and fever.
  • Lightheadedness.
  • Hair loss

Long-term side effects may include:

  • Liver damage. The risk of liver damage is increased in people who have other problems, such as diabetes, liver disease, or a history of alcohol abuse.
  • Lung problems.

While WebMD states most of those side effects are less likely to occur, I would like to point out that I have had almost all of those symptoms at one point in time.

Patients must be responsible while taking methotrexate.  Consumption of alcohol can increase the damage done to your liver. Methotrexate can also cause birth defects.  Ladies, you will be required to take an oral contraceptive whether or not you are sexually active. This rule doesn’t only apply to us females, however.  Guys, you too could cause birth defects if you are on methotrexate, so it is very important to always use protection.

While taking this drug you must ALWAYS contact a physician or pharmacist before taking any other kind of medication (Motrin, for example, should NEVER be taken while on methotrexate).  Need an anti-acid?  Call Walgreens.  Need some cough syrup?  Call USA Drug.  I cannot stress enough how important this is.  Also, is you get strep throat, tonsillitis, etc., and your doctor prescribes you a medication for it, double check with your pharmacist to make sure it will not interact with the methotrexate.  Unless it is your rheumatologist, pharmacists usually know better than your local physician whether or not something will be bad for you.

Start making a list of things you know you can take and cannot take while on this drug, such as allergy medications, etc.  That way you’ll know when your sinuses are acting up you’ll already know what you need to buy.

In my next blog, I’ll discuss how to manage the side effects of methotrexate, and how to say your healthiest while taking the drug.  Even though the side effects seem scary, going through a lifetime of joint pain is even scarier.  Keep in mind that the methotrexate can help stop damage, and you’ll live a much free-er life because of it.

Stay healthy, friends



12 Comments (+add yours?)

  1. laura
    Feb 03, 2010 @ 19:39:33

    thank you for this…very well written, and yes I LOVE House LOL
    I am on Metho, lately I have been so VERY tired all the time. I told my Rumey and he tossed me some Lyrica..ugh. Any suggestions?
    I am so exhausted it is really interfering with my life, it is very aggrivating!


    • Cari Elliott
      Feb 04, 2010 @ 14:21:45

      The fatigue is my major issue with Methotrexate as well. Although I’ve never heard of using Lyrica for combating fatigue or any other arthritis associated symptom, I have heard of doctors who prescribe other meds to treat Methotrexate symptoms. The Methotrexate is too important to stop just because of its side effects. In my next blog I am planning on discussing a few other tips, but mainly try to conserve as much energy as possible when you are super tired. When you aren’t, still don’t use a lot of energy (meaning, don’t run to the bus stop because then you’ll just want to sleep again), but do walk brisker when you feel up to it. It sort of wakes you up, for lack of better terminology. Little things like that can help a lot, but that is only when you feel like you can. Never work a tender joint too much.

      Hope that helps, and thanks for reading!


  2. Kristi
    Feb 03, 2010 @ 21:23:39

    Your blog is very informative and well written. So many people are impacted by this disease. Your firsthand account and knowledge will be greatly appreciated and make a meaningful impact on their lives.


  3. Kate
    Feb 05, 2010 @ 06:27:20

    Hi Cari,

    I have also had RA for 4 years – I’m 20 and was diagnosed when I was 16. I really like your post to non-RAers – it is so difficult for people to understand your pain when they can’t see it. I also have a number of secondary complications to my RA (especially with my eyes) and people are constantly in disbelief when I explain that these symptoms ARE a part of RA. Just wanted to say that this is a fantastic idea!! There really needs to be more education about RA as it is so misunderstood.

    Keep well,

    Kate 🙂


  4. Chris
    Feb 05, 2010 @ 20:05:08

    Excellent job, Cari! Very informative. I will keep up with this blog as you go. My mother-in-law was just diagnosed with RA…I need to bone up on the subject.

    Keep up the good work, I am proud of you!!


  5. Fred
    Jan 28, 2013 @ 12:12:33

    Hey would you mind sharing which blog platform you’re using? I’m looking to
    start my own blog soon but I’m having a tough time selecting between BlogEngine/Wordpress/B2evolution and Drupal. The reason I ask is because your design and style seems different then most blogs and I’m looking for something completely
    unique. P.S My apologies for getting off-topic but I had to ask!


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    Aug 06, 2013 @ 03:50:59

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  8. susan
    Apr 13, 2014 @ 09:52:43

    Awesome blog! Thanks for all the tips on methotrexate.


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