Methotrexate is FDA approved to treat severe psoriasis that does not respond to other treatments and for a type of cancer that occurs during pregnancy. According to the FDA drug label, methotrexate is also approved for certain adults with severe rheumatoid arthritis and for use with other treatments for certain cancers. It works by disrupting cell division in cells that are actively dividing and growing. Some of methotrexate's most common side effects involve the digestive tract, bone marrow, liver and nervous system.
How It Works
Methotrexate is taken either in a pill form, by intravenous infusion or by injection. MedlinePlus states that it belongs to a family of drugs called antimetabolites. It works by blocking an enzyme needed for duplicating DNA, thus interfering with cell division and cell repair in tissues that are actively dividing, such as cancer cells, bone marrow, fetal cells and the mucous membranes protecting the mouth and intestines.
Side Effects
According to the FDA label, the most common side effects of methotrexate are mouth sores, including swollen and tender gums; vomiting; and diarrhea, which can lead to loss of appetite and dehydration. A less common side effect of methotrexate is suppression of bone marrow, causing a loss of infection-fighting white blood cells and blood-clotting platelets, according to the American Cancer Society. This can result in an increased risk of infections and bleeding as well as fever and chills. Kidney damage can also occur. The FDA label notes that blurred vision, blindness and slurred speech can occur with methotrexate treatment. Rarely, some patients have experienced impaired ability to think, altered moods and unusual sensations in the skull, according to the FDA label.
Cardiovascular Considerations
Possible cardiovascular adverse reactions listed on the FDA label include pericarditis, inflammation of the membrane sac that surrounds the heart and pericardial effusion, which is a buildup of fluid in the sac surrounding the heart. Blood clots can also form in the veins of the legs, eyes and lungs.
Liver Damage Precautions
The FDA label states that prolonged use of methotrexate---usually two or more years---can cause production of excess connective tissues within the liver, called fibrosis and cirrhosis. For this reason, methotrexate is contraindicated in people with alcoholism, hepatitis or other liver diseases.
Other Side Effects
According to the American Cancer Society, other side effects can occur with different doses of methotrexate and the patient's age. These include hair loss, rash, blurred vision, lung damage causing a cough, and holes or perforations in the intestines.
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