Methotrexate — Nutrient Associations & Health Patterns
Also known as: Methotrexate (Rheumatrex, Trexall, Otrexup)
Drug Class: Disease-modifying antirheumatic drug (DMARD) / Chemotherapy agent
Folate antagonist used at low weekly doses for rheumatoid arthritis, psoriasis, and psoriatic arthritis — and at higher doses for certain cancers. At rheumatologic doses (7.5–25mg weekly), works as an immunomodulator. At cancer doses (much higher), is cytotoxic. The most prescribed DMARD for RA worldwide. Folate supplementation is universally co-prescribed to reduce toxicity — but must be timed away from the dose to avoid reducing efficacy. Only evidence-qualified catalog relationships are listed here. Other catalog entries remain unverified in this reference; absence from the list does not rule out other medication effects or interactions.
Medication and Nutrition Context
Only evidence-qualified catalog relationships are listed here. Other catalog entries remain unverified in this reference; absence from the list does not rule out other medication effects or interactions.
Common Side Effects of Methotrexate
- Nausea and vomiting (very common — often on day-of and day-after weekly dose)
- Fatigue ('methotrexate hangover' the day after weekly dose)
- Mouth sores (oral mucositis — folate depletion)
- Liver fibrosis and cirrhosis (cumulative dose risk — requires liver monitoring)
- Pulmonary toxicity (rare but serious — dry cough, shortness of breath)
- Bone marrow suppression (immunosuppression)
- Hair thinning
- Megaloblastic anemia (folate and B12 depletion)
Key Drug Interactions — Methotrexate
Methotrexate has 9 documented drug-drug interactions in WePattern's Pattern Health Intelligence database. Key interactions include:
- NSAIDs (reduce methotrexate clearance — toxicity risk at rheumatologic doses)
- Aspirin (raises methotrexate levels — bleeding and toxicity)
- Penicillin antibiotics including amoxicillin (reduce methotrexate clearance — toxicity)
- Proton pump inhibitors (raise methotrexate levels — reduce clearance)
- Trimethoprim/sulfamethoxazole (additive folate antagonism — dangerous megaloblastic anemia)
- Live vaccines (methotrexate is immunosuppressive — no live vaccines)
Frequently Asked Questions
What nutrient associations are reported for Methotrexate?
Only evidence-qualified catalog relationships are listed here. Other catalog entries remain unverified in this reference; absence from the list does not rule out other medication effects or interactions.
Which nutrient relationships are mapped for Methotrexate?
Only evidence-qualified catalog relationships are listed here. Other catalog entries remain unverified in this reference; absence from the list does not rule out other medication effects or interactions.
What are the side effects of Methotrexate?
Common side effects associated with Methotrexate include: Nausea and vomiting (very common — often on day-of and day-after weekly dose); Fatigue ('methotrexate hangover' the day after weekly dose); Mouth sores (oral mucositis — folate depletion); Liver fibrosis and cirrhosis (cumulative dose risk — requires liver monitoring); Pulmonary toxicity (rare but serious — dry cough, shortness of breath).