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Doctors' Answers to "Frequently Asked Questions" - Methotrexate
Methotrexate Side Effects [posted 7/31/98]
Answer: Methotrexate was initially used to treat different cancers because of its ability to inhibit rapidly dividing cells. It has subsequently been used with great success in diseases such as Rheumatoid Arthritis, Psoriasis, Inflammatory Bowel Disease, etc., to decrease the inflammatory response. However, the toxicity is mainly the same - aimed at cells that divide rapidly. These include white blood cells, platelets, mucosal surfaces (mouth, stomach, intestines), etc. Additional toxicities are liver fibrosis and occasional pulmonary fibrosis. These should be watched in all patients on methotrexate. Lastly, defective sperm and oocyte formation, renal toxicity, alopecia, dermatitis. Long term there is an increase in solid tumors - this looks dose dependent and the doses in RA are pretty small. Vascular complications are pretty minimal.