Methotrexate and Dosing

Dr. John Wade, MD, FRCPC, Rheumatologist, talks about what Methotrexate is typically used for and the standard dosing schedules commonly used.

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Dr. John Wade, MD, FRCPC, Rheumatologist, talks about what Methotrexate is typically used for and the standard dosing schedules commonly used.
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Video transcript

Featuring Dr. John Wade, MD, FRCPC, Rheumatologist

Duration: 2 minutes, 6 seconds

Methotrexate is a medication that we commonly use in rheumatology. It’s a medication that is our standard medication that we’ll use to treat diseases like rheumatoid arthritis, we’ll also use it in diseases like psoriatic arthritis, different types of vasculitis and also sometimes in systemic lupus erythematosus.

Methotrexate doesn’t work overnight. Methotrexate takes awhile to act, that’s why it’s called a slow disease-modifying agent. And typically the onset of the action of the methotrexate will be somewhere maybe starting around 6 weeks, but an effect may not happen until up to 12 weeks, and a maximum effect may be up to 52 weeks.

So, when your doctor starts you on this medication, it’s not going to be the next day or the next week, it’s going to be awhile, so you have to realize and be patient looking for the effect.

There are two ways to take methotrexate, one is to take a pill or a number of pills once a week. And the other way to do it is to take an injection under the skin once a week. The dose varies, we often start at a lower dose and then build up.

The dose may start from a dose of 7.5 milligrams a week, typically up to a dose of 25 milligrams once a week. The pills come in a very convenient 2.5 milligram tablet, so it will typically be your rheumatologist who will ask you to start perhaps 3 pills once a week, then you’ll build it up to 10 pills a week. If you’re having problems with the pills then it’s very convenient to get it by injection once a week.

Methotrexate, like other medications, will often interfere with metabolism or interact with other drugs you’re taking, so if you are going to go on methotrexate or you’re going to start new medications, it’s always a good idea to talk to your doctor or your pharmacist about these possible interactions.

If you have any questions or concerns about methotrexate, you should contact your healthcare practitioner or your specialist.

Presenter: Dr. John Wade, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.