DMARDPrescription only

Methotrexate

Tablet or injection

Quick Summary

Methotrexate calms the immune system.

Rheumatoid arthritis
Psoriasis
Some cancers

Medical Uses

Rheumatoid arthritis: First-choice long-term medicine.
Psoriasis: Moderate to severe.
Some cancers: Under specialist care.

How it's taken

For arthritis and psoriasis it's taken ONCE A WEEK on the same day, not daily. Folic acid is usually taken on other days.

Your doctor decides the right dose for you and how long to take it.

Your doctor decides the right dose for you. Follow their instructions and the label.

Common Side Effects

Nausea

Day after the dose.

Mouth ulcers

Sometimes.

Tiredness

Sometimes.

Interactions

Cotrimoxazole

Dangerous combination.

NSAIDs

Use with care.

Alcohol

Liver damage.

Critical Warnings

Weekly, not daily

Black Box Warning: Taking it daily by mistake can be fatal.

Pregnancy

Black Box Warning: Must be avoided; stop months before trying for a baby.

Blood tests

Regular monitoring of blood, liver and kidneys.

Sources and further reading

Last updated 21 October 2026. For more detail, see these trusted health organisations.

Related Topics

Rheumatoid ArthritisPsoriasis