Methotrexate 10 mg is a powerful oral medication used to treat conditions like cancer (e.g., Non-Hodgkin lymphoma), rheumatoid arthritis, juvenile arthritis, and psoriasis. It works by either stopping fast-growing cells from multiplying and for autoimmune disease by calming an overactive immune system. Since it’s processed by the liver and flushed out through the kidneys, people with liver or kidney issues should speak to their doctor before starting it. It’s also not recommended during pregnancy unless absolutely necessary under close medical care. 

Common side effects include nausea, fatigue, mouth sores, and in some cases, unusual bleeding or infections. It’s important to take methotrexate exactly as prescribed and avoid alcohol while on it. Store it in a cool, dry place out of children’s reach. If someone takes too much and starts feeling very sick – like having mouth ulcers, fever, or extreme tiredness — get them medical help right away. 

Methotrexate 10 mg is an oral medicine belonging to the antineoplastic agent class of medicines. It is used for the following indications: 

1. Polyarticular juvenile arthritis 
2. Psoriasis 
3. Rheumatoid arthritis 
4. Acute lymphoblastic leukemia (cancer) 
5. Mycosis fungoides 

More Common

1. Black, tarry stools 
2. Bleeding gums 
3. Blood in the urine or stools 
4. Bloody vomit 
5. Diarrhea 
6. Increased heartbeat 
7. Itching, rash, reddening of the skin 
8. Joint pain 
9. Nausea 
10. Pinpoint red spots on the skin 
11. Sores in the mouth or lips 
12. Stomach pain 
13. Swelling of the eyelids, face, lips, hands, feet, or lower legs 
14. Swelling or inflammation of the mouth 
15. Trouble breathing 
16. Unusual bleeding or bruising 
17. Vomiting 
18. Yellow eyes or skin 

Less Common

1. Back pain 
2. Bloody nose 
3. Blurred vision 
4. Body and muscle pain 
5. Burning while urinating 
6. Confusion 
7. Continuing ringing, buzzing, or other unexplained noise in the ears 
8. Cough or hoarseness 
9. Cracked, dry, scaly skin 
10. Dark urine 
11. Dizziness 
12. Drowsiness 
13. Ear congestion 
14. Fever or chills 
15. Headache 
16. Loss of appetite 
17. Loss of hearing 
18. Loss of voice 
19. Lower back or side pain 
20. Painful or difficult urination 
21. Pale skin 
22. Runny nose 
23. Seizures 
24. Sneezing 
25. Sore throat 
26. Stuffy or runny nose 
27. Unusual tiredness or weakness 
28. Weight loss 
29. White or brownish vaginal discharge 

Methotrexate works in two ways: for cancer, it stops fast-growing cells from making their DNA; and for autoimmune issues, it calms down a hyperactive immune system by stopping certain signals in the body that cause inflammation and helping to lower inflammation levels. 

Liver Dysfunction

Patients with liver dysfunction should inform their doctor about their condition beforehand, as methotrexate is primarily metabolized by the liver. This can put additional strain on the liver and may lead to further damage.

Renal Impairement

If your kidney’s filtration rate is less than 15 ml/min, it is important to inform your doctor, as methotrexate is excreted through the kidneys. To prevent further kidney damage, always disclose any existing renal conditions to your healthcare provider.

Pregnancy

This medication should be avoided during pregnancy. However, in pregnant women with cancer, a preservative-free formulation of methotrexate may be considered under strict medical supervision.

Avoid taking methotrexate 10 mg with the following medicines, as it may increase or decrease the desired effect, or in worse cases, it could be fatal: 

Methotrexate does not interact with any food products, but alcohol should be avoided before and after taking the medicine, as it can increase or decrease the effect of methotrexate. 

1. Take methotrexate exactly as prescribed by your doctor, regularly at the same time each day. 
2. Do not stop taking methotrexate without your doctor’s approval, even if you feel better. 
3. If you forget to take the medicine, take it as soon as you remember, unless it’s almost time for the next one, then just skip it. 

1. The medicine should be stored at cool temperature  
2. Keep away from sunlight and moisture  
3. Keep away from the reach of children 

IUPAC (International Union of Pure and Applied Chemistry)/ Chemical name- 

N-[4-[[(2,4-diamino-6-pteridinyl)methyl]methylamino]benzoyl]-L-glutamic acid. 

Daily Dose

Take methotrexate exactly as your doctor recommends. The dose may change based on your condition and how well you respond. Do not take more than prescribed without consulting your doctor.

Missed Dose

If you forget to take your medicine, take the medication soon as you remember. If it’s nearly time for your next dose, skip the missed one and continue with your regular schedule. Always consult the doctor before making any changes to your dosage.

Overdose

A dose higher than 500 mg/ml can cause toxicity. The patient may experience nausea, mouth ulcers, fatigue, and fever. If you know someone who takes this medicine and has these symptoms, rush them to the hospital immediately.

1- What is methotrexate used for?

Depending on the dose, methotrexate is used for the treatment of leukemia, certain types of cancer (such as mycosis fungoides), juvenile arthritis, and rheumatoid arthritis. 

2- What is mechanism of action of methotrexate?

Methotrexate works in two ways: for cancer, it stops fast-growing cells from making their DNA; and for autoimmune issues, it calms down a hyperactive immune system by blocking signal transfer and reducing inflammation. 

1. Hanoodi M, Mittal M. Methotrexate. [Updated 2024 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from. 
2. Mayo Foundation for Medical Education and Research. Methotrexate (oral route) [Internet]. Rochester (MN): Mayo Clinic; 2023 [cited 2025 Apr 9]. Available from.