When you hear methotrexate, a medication used to treat autoimmune diseases and some cancers by slowing down overactive immune cells. Also known as MTX, it's one of the most commonly prescribed drugs for conditions like rheumatoid arthritis and psoriasis. It’s not a painkiller. It doesn’t make you feel better right away. But for many people, it’s the difference between being able to move in the morning or staying stuck in bed.
Methotrexate works by interfering with how fast your body’s cells divide — especially immune cells that mistakenly attack your joints or skin. That’s why it’s used for rheumatoid arthritis, a chronic condition where the immune system damages joint tissue, and psoriasis, a skin disease caused by too-fast skin cell growth. It’s also used as a low-dose chemotherapy, a cancer treatment that targets rapidly dividing cells for certain types of lymphoma or leukemia. But unlike strong chemo drugs, the doses for arthritis or psoriasis are much lower, and most people take it just once a week.
People often worry about side effects. Fatigue, nausea, and mouth sores are common, especially when you first start. But many of these get better over time. Taking folic acid daily helps reduce side effects without making methotrexate less effective. Regular blood tests are a must — your liver and blood counts need checking. If you’re on methotrexate, you should avoid alcohol and certain antibiotics like trimethoprim-sulfamethoxazole. And if you’re trying to get pregnant or your partner is, talk to your doctor — it can harm a developing baby.
What you won’t find in most brochures is how many people rely on this old drug to live normally. It’s not glamorous. It doesn’t come in fancy packaging. But for someone with severe joint pain or scaly, itchy skin, methotrexate can be life-changing. The posts below cover real-world experiences: how it compares to newer biologics, what to do when it stops working, how to handle side effects without quitting, and why some people take it for years without issues. Whether you’re just starting out or have been on it for a while, you’ll find practical advice here — no fluff, no marketing, just what matters.
Hydroxychloroquine (Hsquin) is no longer the first choice for lupus or arthritis. Learn about safer, more effective alternatives like methotrexate, sulfasalazine, and biologics - and when to switch.
