METHOTREXATE

Methotrexate is a pill used to treat psoriasis and a few other skin conditions. Below are important points to remember while on methotrexate.

• Methotrexate is taken once a week e.g., every Monday or every Friday, (NOT every day). It is common to start 4 pills per week (10 mg total) for the first month and then as determined by your doctor.
• The main serious potential side effect is cirrhosis (scarring) of the liver. This is uncommon, but is much more likely in those who consume a great deal of alcohol. Try to limit alcohol consumption while on methotrexate.
• The main side effect you may notice is stomach upset (e.g. nausea, less commonly vomiting).
• Take folic acid 1 mg per day on the days you don't take methotrexate to minimize stomach upset and to protect your liver. Folic acid may be purchased at any drug store or on Amazon.
• If you find you are still having trouble with an upset stomach, you can spread the pills out over 12-24 hours (e.g. Monday morning and Monday night or Monday morning, Monday night and Tuesday morning).
• Rare side effects of methotrexate include mouth sores, rash, decreased blood count and lung problems (especially if you smoke).
• You will need to get blood work before we start, 1 month and then every 3 months. The main reason for this is to check the liver to make sure you aren't having any problems.
  
• Always get the blood work just before your next dose (e.g. Monday AM if you take it Monday at noon. Or Tuesday if you take methotrexate on Wednesdays.)
• Don't take methotrexate if you are pregnant. Wait at least three months before attempting to become pregnant once you stop.

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