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Methotrexate is a medication used to treat arthritis, psoriasis, and inflammatory conditions. It is also used in higher doses to treat cancer. While it is generally well-tolerated, some people may experience side effects such as nausea, vomiting, mouth sores, and hair loss. More serious side effects include liver and lung problems, and a reduced platelet count. Muscle spasms are a rare but possible adverse reaction to methotrexate, according to some reports. It is important to be aware of any potential side effects and to consult a doctor if any symptoms occur.
| Characteristics | Values |
|---|---|
| Muscle Spasms | Rare adverse drug reaction |
| Occurrence supported by World Health Organization (WHO) VigiBase database | |
| 129 reports of muscle spasms associated with the use of methotrexate | |
| May be dose-related | |
| May be related to hyperhydration | |
| May be related to renal dysfunction | |
| May be related to non-steroidal anti-inflammatory agents (NSAIDs) | |
| May be related to toxicity | |
| May be life-threatening | |
| Methotrexate | Used to treat arthritis, psoriasis, and inflammatory conditions |
| Used to treat cancer | |
| Can cause side effects such as nausea, vomiting, fatigue, mouth sores, hair loss, and sun sensitivity | |
| Can affect liver function and blood cell production | |
| Can cause breathlessness and increase the risk of infections | |
| Should be taken weekly, not daily |
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What You'll Learn
Methotrexate is used to treat arthritis, psoriasis, and cancer
Methotrexate is a medication used to treat arthritis, psoriasis, and cancer. It is an antimetabolite or disease-modifying anti-rheumatic drug (DMARD) that works by decreasing inflammation in the body, slowing the progression of rheumatoid arthritis (RA), and relieving symptoms. It is typically taken orally, but can also be administered via injection.
For arthritis, methotrexate reduces the risk of uncontrolled inflammation, preventing long-term damage to joints and reducing pain. It slows the progression of RA and relieves symptoms by causing cells to release adenosine, which blocks other chemicals that promote inflammation. It can take up to 12 weeks for individuals to notice improvements in their arthritis symptoms. The dosage for arthritis is typically between 10 and 25 milligrams per week, and it is often taken alongside folic acid supplements to reduce potential side effects such as gastrointestinal issues and mouth sores.
Methotrexate is typically used to treat severe cases of psoriasis that have not responded to other treatments. It is an immunosuppressant that slows the growth of skin cells and suppresses the cells of the immune system that cause the psoriasis rash. It can take four to six weeks for individuals to notice improvements in their psoriasis symptoms, and up to six months to experience the full benefits.
Methotrexate is also used to treat cancer by slowing the growth and spread of cancerous cells. The dosage for cancer is usually much higher than that used for arthritis or psoriasis. It is important to note that methotrexate can cause side effects such as increased risk of liver and lung problems, hair loss, nausea, vomiting, mouth sores, headaches, fatigue, and skin sensitivity to sunlight. Regular blood tests and monitoring by a doctor are necessary to ensure safe use.
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It can cause nausea, vomiting, and fatigue
Methotrexate is a medication used to treat arthritis, psoriasis, and inflammatory conditions. It is also used in higher doses to treat cancer. While it is a useful medication, it can cause several side effects, including nausea, vomiting, and fatigue.
Nausea and vomiting are among the most common side effects of methotrexate, affecting between 20% and 65% of rheumatoid arthritis (RA) patients who take the drug. These symptoms can be managed by taking methotrexate with food or by splitting the dose, taking half in the morning and the other half 12 hours later. Additionally, folic acid supplements can be taken to reduce the risk of gastrointestinal (GI) problems, although they should generally not be taken on the same day as methotrexate. In cases of severe nausea and vomiting, a doctor may prescribe an anti-nausea medication such as ondansetron (Zofran).
Fatigue is another common side effect of methotrexate, often occurring a day after receiving a dose. This can be managed by taking dextromethorphan with the methotrexate dose and again 8 to 12 hours later, usually in the form of a tablet (Mucinex DM). It is important to note that fatigue can also be a sign of an infection, so if it occurs alongside a fever, coloured sputum, pain on passing urine, or a skin boil, it should be reported to a doctor immediately.
While muscle spasms have been reported as a rare adverse drug reaction to methotrexate, there is limited information specifically linking low-dose methotrexate to muscle spasms. However, as mentioned earlier, methotrexate can cause fatigue, which may indirectly contribute to muscle discomfort or weakness. Therefore, while muscle spasms as a direct result of low-dose methotrexate may be uncommon, it is important to monitor for any unusual muscle-related symptoms and consult a healthcare professional if concerned.
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It can cause skin sensitivity and sunburn
Methotrexate is a medication used to treat arthritis, psoriasis, and inflammatory conditions. It is also used in higher doses to treat cancer. While it can be an effective treatment, it does have side effects, although not everyone experiences them. One of the most common side effects is increased skin sensitivity, particularly to sunlight, which can lead to sunburn. This photosensitivity reaction can occur in more than 1 in 100 people taking the medication.
To reduce the risk of sun-related side effects, it is recommended that patients taking methotrexate avoid prolonged exposure to bright sunlight. When going outdoors, it is advisable to wear protective clothing and use a high-factor sunscreen with an SPF of 30 or above. Additionally, patients should refrain from using sun lamps or tanning beds. These precautions are especially important when first starting the medication, as patients may not be aware of their increased sensitivity.
The skin sensitivity and sunburn side effects of methotrexate are believed to be related to the drug's impact on the body's folate levels. Folate, a form of vitamin B, is essential for healthy cell growth and function. By blocking the body's access to folate, methotrexate can affect both cancerous and healthy cells, particularly those in the gastrointestinal tract, mouth, and skin. This depletion of folate can result in various side effects, including skin sensitivity and an increased risk of sunburn.
To mitigate these side effects, doctors often recommend taking folic acid supplements in conjunction with methotrexate. Folic acid is the synthetic form of folate, and it can help reduce the risk of GI problems and mouth sores, and skin issues. However, it is important to take the folic acid supplement at the recommended time, usually 24 hours after receiving a dose of methotrexate, as taking them together can affect the effectiveness of the medication.
While skin sensitivity and sunburn are common side effects of methotrexate, they can often be managed through simple precautions and, in some cases, by adjusting the dosage or taking additional supplements. However, if these side effects become bothersome or persistent, it is important to consult a doctor or pharmacist for further advice and potential alternative treatments.
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It can cause hair loss and mouth sores
Methotrexate is a medication used to treat arthritis, psoriasis, and other inflammatory conditions. It is also used to treat some types of cancer. While it is an effective treatment, it can cause various side effects, including hair loss and mouth sores.
Hair loss is a known side effect of methotrexate, although it is relatively uncommon, especially at lower doses. However, even low-dose methotrexate can cause hair loss to some extent. The drug can damage hair follicles, leading to hair thinning and hair fall. If you are experiencing hair loss due to methotrexate, it is important to consult your doctor. They may recommend lowering your dose or switching to a different medication.
Mouth sores are another common side effect of methotrexate. They can cause pain, discomfort, or sensitivity when eating, chewing, or swallowing. These sores may appear as small ulcers, white or yellow patches, or bleeding in the mouth. Up to one-third of people taking methotrexate for rheumatoid arthritis develop mouth sores or ulcers.
To relieve mouth sores, there are several strategies that can be employed:
- Saltwater rinse or a special mouthwash containing lidocaine, a pain reliever, can help soothe and relieve pain associated with mouth sores.
- Folic acid supplements taken on non-methotrexate days can help minimise the occurrence of mouth sores.
- Reducing the dose of methotrexate may also help decrease the severity of mouth sores.
It is important to consult your healthcare provider if you are experiencing any side effects from methotrexate, including hair loss and mouth sores. They can provide guidance and recommendations to help manage these side effects effectively. Additionally, it is advised to monitor liver function while on methotrexate, as it may increase the risk of liver problems, especially at higher doses.
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It can cause breathlessness and lung inflammation
Methotrexate is a medication used to treat arthritis, psoriasis, and inflammatory conditions. It is also used in higher doses to treat cancer. It works by decreasing inflammation, which can reduce pain and prevent long-term injury to the joints and skin.
Like all medicines, methotrexate can cause side effects, although not everyone experiences them. Some common side effects include nausea, vomiting, mouth sores, hair loss, and sun sensitivity. Serious side effects are rare, occurring in less than 1 in 10,000 people. However, it is important to be aware of potential symptoms to report them promptly to your doctor.
One of the rare but serious side effects of methotrexate is breathlessness, which in rare cases, can lead to lung inflammation. Lung inflammation, or pneumonitis, is a potentially serious condition that requires medical attention. It is characterized by symptoms such as persistent cough, chest pain, and difficulty breathing. If left untreated, it can progress and cause permanent damage to the lungs. Therefore, it is crucial to seek medical advice if you experience any respiratory symptoms while taking methotrexate.
The risk of lung inflammation is higher in people taking high doses of methotrexate. However, it is important to note that even low doses of methotrexate can cause breathlessness and lung inflammation in rare cases. The time it takes for methotrexate to leave your system depends on various factors, including the dosage and the health condition being treated. In general, methotrexate can remain in your system for 16 to 55 hours after your last dose when taken in low doses and 44 to 83 hours after your last dose when taken in high doses.
To reduce the risk of lung inflammation and other side effects, it is recommended to follow the instructions provided by your doctor. Regular monitoring, including blood tests and lung function tests, is essential to identify any potential complications early on. Additionally, maintaining a healthy lifestyle, such as limiting alcohol consumption and avoiding sun exposure, can help minimize the risk of side effects associated with methotrexate use.
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Frequently asked questions
According to the World Health Organization (WHO) VigiBase™ database, there have been 129 reports of muscle spasms associated with the use of methotrexate. However, the dose at which these patients were administered methotrexate is unclear.
Methotrexate is a drug used to treat inflammatory conditions such as arthritis, psoriasis, and cancer.
The most common side effects associated with methotrexate are nausea, vomiting, mouth ulcers, and fatigue. Other side effects include hair loss, sun sensitivity, and GI problems.
The amount of time methotrexate stays in your system depends on the dose and the health condition being treated. In low doses, it can stay in your system for 16 to 55 hours, while in high doses, it can stay for 44 to 83 hours.
Yes, you can usually continue taking painkillers like paracetamol unless your doctor advises otherwise.
