Dr. Abdulaziz AlRashed — Consultant Dermatologist, Cosmetic & Laser
Advice for Patients on Methotrexate
A patient advice sheet — 9 practical points. Reviewed and updated by Dr. Abdulaziz AlRashed, July 2026.
Last reviewed: July 2026
The advice
- The dose is once WEEKLY only — on the same day each week, never daily; taking it daily is a dangerous error.
- The prescribed folic acid reduces side effects — take it as instructed (usually not on your methotrexate day).
- Avoid alcohol completely or keep it minimal — it multiplies the drug's effect on the liver.
- Regular blood tests (blood count, liver, kidneys) before treatment then on schedule — do not skip them.
- Tell every doctor and pharmacist you are on methotrexate before any new medicine; some antibiotics and painkillers interact with it.
- For married women: pregnancy and breastfeeding are not allowed during treatment — use effective contraception, and tell your doctor when planning pregnancy so it is stopped in advance.
- For men: recent evidence is reassuring — it usually does not need stopping when planning fatherhood; confirm with your doctor.
- Pause it and tell us immediately for: infection with fever, severe mouth ulcers, new cough or breathlessness, jaundice, or unusual bleeding.
- No live vaccines during treatment; the yearly (inactivated) flu vaccine is recommended.
See also the full treatment page: Psoriasis treatment — options, evidence and expected timelines.
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