Rheumatology · Antifolate DMARD
Methotrexate (Rheumatology)
Dose
7.5–15 mg PO/SC ONCE WEEKLY; folic acid 5 mg on a different day. Max 25 mg weekly.
Contraindications
- • Pregnancy and breastfeeding
- • Significant renal impairment
- • Active infection
Use
Anchor DMARD in rheumatoid arthritis, psoriatic arthritis, psoriasis.
Monitoring
FBC, LFT, U&E at 2 weeks then monthly ×3 then 3-monthly; CXR baseline.
Side effects
- • Mouth ulcers, nausea
- • Myelosuppression
- • Transaminitis
- • Pneumonitis (dry cough, dyspnoea — stop drug)
Pregnancy safety
Contraindicated — teratogenic; stop 3 months before conception in both sexes.
Related in WardRound
Always confirm dose against your local formulary / BNF before prescribing.
