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Real members of MyPsoriasisTeam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Just diagnosed and am worried about side effects of Methotrexate

A MyPsoriasisTeam Member asked a question 💭
Michigan, MI

I am 61 years old and have just been diagnosed with Psoriatic Arthritis. My symptoms thus far are limited to dactylitis (swollen pinky and thumb on left hand) and psoriasis of the scalp and ears. Overall my symptoms compared to most people here seem pretty mild (though still irritating). My rheumatologist prescribed a 3 week course of steroids to get the swelling under control and started me on Methotrexate. I took my first dose of Methotrexate three days ago with no observed side effects… read more

August 24
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A MyPsoriasisTeam Member

Methotrexate for 5 years- After about 2 months in, and prior damage to my gut from 5 years of daily NSAIDS, my stomach couldn't handle the 8 pills I needed to take once a week. So, I have been injecting Methotrexate in my gut (subcutaneous), weekly for 5 years (: I can feel a bit of the nausea sometimes, but I have handled it way better by injection (:

August 24
MyPsoriasisTeam

First off, it's completely understandable to feel anxious about starting a new medication — especially one with a list of side effects that could rival a novel! The good news is that many people tolerate methotrexate well, particularly at the lower doses typically prescribed for psoriasis and psoriatic arthritis.

Side Show Full Answer

First off, it's completely understandable to feel anxious about starting a new medication — especially one with a list of side effects that could rival a novel! The good news is that many people tolerate methotrexate well, particularly at the lower doses typically prescribed for psoriasis and psoriatic arthritis.

Side effects, if they occur, can vary widely from person to person. Some people notice them within the first few weeks, while others may not experience them for months — or at all. The most commonly reported side effects include:

- Fatigue
- Nausea and vomiting
- Diarrhea
- Headaches
- Mild hair loss
- Mouth sores

More serious side effects to watch for include:

- Fever or sore throat
- Stomach pain
- Yellowing of the skin or eyes
- Unexpected bruising or bleeding
- Shortness of breath A MyPsoriasisTeam member shared that they took methotrexate for nine years without much trouble before it became harder to tolerate — showing that side effects aren't always immediate or inevitable.

Doctors typically prescribe folic acid alongside methotrexate to help reduce some side effects, so make sure that's part of your plan if it isn't already.

Regular blood tests will also be done to monitor your kidney and liver function, which is an important safety net. If nausea does become an issue, splitting the weekly dose into smaller amounts taken every 12 hours can sometimes help.

Always flag any new symptoms to your rheumatologist promptly.

August 24

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