Methotrexate and Lupus
Methotrexate (Rheumatrex®) is a drug used to treat cancer as well as several different rheumatic diseases. It is usually used for lupus when nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®) or naproxen (Naprosyn®) or antimalarials such as hydroxychloroquine sulfate (Plaquenil) don’t control the symptoms. Sometimes doctors prescribe it to control lupus during flares or times of increased disease activity. It works by suppressing the immune system, which is overactive in lupus.
Methotrexate works slowly, so it may take a few weeks before you notice its benefits. Although methotrexate is generally safe at the doses prescribed for lupus, it is still a powerful drug. It is important that you understand exactly how and when to use this drug, and what the potential side effects are. You will need to work closely with your doctor and nurse and undergo regular lab tests to make sure that the amount of the drug you are taking gives you the benefits you need with as few side effects as possible.
Take methotrexate pills with milk or food. Methotrexate injections should be given just beneath the skin on the thigh or abdomen unless your doctor advises otherwise.
Possible Side Effects
These include diarrhea, dizziness, hair loss, mouth ulcers, nausea and vomiting, and rashes or itching skin. Tell your nurse or doctor right away if you have any side effects.
- Do not take more than the recommended dose. Before starting methotrexate, let your doctor know if you drink alcohol or if you are taking other medications, including antibiotics, anti-inflammatories, asthma medications, or drugs that suppress the immune system.
- Avoid exposure to infections. Stay away from crowds and people known to have colds, the flu, or other infections. Report any signs of infection to your doctor immediately.
- Do not have immunizations while taking this drug without first checking with your doctor.
- WARNING! Do not take this drug if you suspect you are pregnant. Methotrexate can be dangerous to unborn babies. You must use an effective birth control method while you are taking this medication. You should consider pregnancy only after treatment has been stopped and your doctor says you are healthy enough to become pregnant.