← Drug quick-reference

Methotrexate

Brand: Trexall

AntimetaboliteUsed for: Cancer, rheumatoid arthritis (weekly dosing)Other High-Yield
Key warning

Boxed warning: embryo-fetal toxicity, hypersensitivity reactions, severe adverse reactions, and RISK OF MEDICATION ERRORS — the box states that methotrexate tablets inadvertently administered once daily have resulted in death. For non-neoplastic disease it is contraindicated in pregnancy. That medication-error risk is why non-cancer dosing is WEEKLY: a daily-frequency slip is lethal.

Common side effects

  • Nausea
  • Mouth sores
  • Fatigue
  • Low blood counts
  • Hair thinning

Key interactions & cautions

  • NSAIDs raise toxicity risk
  • Avoid alcohol due to liver risk
  • Certain antibiotics increase levels
  • Folate affects its action

Counseling points

  • Take weekly, not daily, for arthritis
  • Report mouth sores or unusual bruising
  • Avoid alcohol
  • Report cough or trouble breathing
  • Use reliable contraception

High-yield study aid for exam prep — not a substitute for the package insert or a pharmacist’s dispensing reference.