Methotrexate side effects

What side effects can Methotrexate have?

Below you will find the most important information about possible known side effects of methotrexate.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).

Very common side effects:
loss of appetite, nausea and vomiting, increase in liver enzymes, abdominal pain.

Common side effects: inflammatory skin changes, itching, wound healing disorders, inflammation and lesions at the site of injection, headache, fatigue, drowsiness, diarrhea, inflammation of the oral mucosa, pulmonary complaints, dry irritable cough, shortness of breath, fever, reduction in the number of white blood cells , Reduction in the number of clotting cells.

Uncommon side effects:
photosensitivity, hives, increased skin color, joint pain, muscle pain, osteoporosis, dizziness, confusion, depression, gastric ulcers, intestinal ulcers, diabetic metabolism, fatty liver, severe reduction of all blood cells, decrease in granulocyte count, inflammation and Ulcers ranging from bladder or vagina, allergic reactions to anaphylactic shock.

Rare side effects:
Menstrual disorders, anemia.

Very rare side effects:
Stevens-Johnson syndrome, Lyell’s syndrome, increased staining of the nails, pain, muscle weakness or numbness in the extremities, acute hepatitis, reactivation of chronic hepatitis, acute liver decay, shortness of breath, bronchial asthma, Libido loss, impotence, poor sperm production, poor egg growth, severe course of bone marrow damage, reduced sperm density, lymph node enlargement, acute cutaneous nail irritation, seizures, paralysis, vomiting, hair loss, increase in rheumatoid nodules, shingles, pericardial effusion, cardiac tamponade, renal function disorders to acute renal failure, fever, blood poisoning and allergic diseases of small arteries.

Special features:
The incorrect dosage of methotrexate can lead to serious, sometimes even fatal, side effects. The active substance may only be used once a week for psoriasis and inflammatory rheumatic diseases. In case of cancer, the doctor has to calculate the dosage according to the body surface.

What interactions does methotrexate show?

Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).

The following substances potentiate the methotrexate effect:
painkillers such as acetylsalicylic acid, non-steroidal anti-inflammatory drugs, diphenylhydantoin (antiepileptic), barbiturates (hypnotics), tranquilizers, antibiotics such as tetracyclines, sulfonamides and trimethoprim, and chloramphenicol; Doxorubicin (cancer therapy), probenecid (rheumatism), para-aminobenzoic acid (helps to build red blood cells), para-aminohippuric acid (for diagnosis), the antibiotics cefalotin and penicillins.

The following substances reduce methotrexate activity:
glucocorticoids, the cytostatic drug L-asparaginase, the antibiotics bleomycin and penicillin; Triamteren (for drainage), the gout agent allopurinol, vitamin supplements containing folic acid or its derivatives (especially folic acid).

Because of the increased risk of liver damage, alcohol should be avoided, even in small amounts, and drugs with toxic effects on the liver should not be administered by the physician at the same time. In patients taking such medication during methotrexate therapy, a particularly regular medical check-up of the blood glucose enzyme values should take place.

Occasionally, increased bone marrow damage occurred during combination therapy with trimethoprim.
Prolonged pretreatment with bone marrow-damaging substances (for example, sulfonamides and trimethoprim, chloramphenicol, pyrazole derivatives, the anti-inflammatory drug indomethacin, the epilepsy agent diphenylhydantoin) is more pronounced Disorders of the hematopoietic system.

Potential Methotrexate side effects may include: