Methotrexate as a Treatment for Rheumatoid Arthritis

Methotrexate has been used to treat people with rheumatoid arthritis since the 1970s. It has been one of the most effective treatments for rheumatoid arthritis since it was approved by the United States Food and Drug Administration. Since it can have life-threatening side effects, some people are hesitant to take methotrexate.

Types

• Methotrexate can be taken orally (pills) or through injection. Pills are usually taken weekly in the recommended dose. Some rheumatoid arthritis patients can take up to 10 pills per week, but most start with a lower dose. Injections are also given weekly and can be injected at a doctor's office or self administered if a person is comfortable with that method.

Function

• Rheumatoid arthritis is an auto-immune disease. The immune system of a person with rheumatoid arthritis misjudges some of the linings in joints and attacks the cells in the linings. This causes painful inflammation and, if left untreated, complete destruction of the joint lining. Methotrexate works by suppressing the immune system and preventing it from attacking the joint linings.

Time Frame

• It can take several months for methotrexate to work, although most people with rheumatoid arthritis notice improvement within a month or two. Methotrexate is considered a long-term treatment drug. The dose may be changed, but a person with rheumatoid arthritis who is successfully treated with methotrexate will probably use methotrexate for the rest of his life.

Side Effects

• Methotrexate has several side effects, some of which are life-threatening. Your doctor will monitor you closely for liver, blood and skin damage while you take methotrexate. Each of these side effects can lead to deadly conditions, so it is important not to skip tests that check for these side effects. Most people who take methotrexate experience some stomach upset when they take their weekly dose. Other common side effects include diarrhea, shortness of breath and hair loss.

Alternatives

• There are alternatives to methotrexate. Methotrexate is considered a disease-modifying anti-rheumatic drug, or DMARD. Other DMARDs include hydroxychloroquine, cyclophosphamide and minocycline.

Warning

• Methotrexate can cause harm to an unborn child, so women who intend to become pregnant and their partners should not use it.