Rasuvo (Methotrexate) for Psoriasis

What Members Say Top Tips Side Effects Copay Help FAQs

Rasuvo (methotrexate) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to control symptoms of severe, hard-to-treat, disabling psoriasis in adults who have not responded well enough to other treatments.

What Members Say

MHT logo These insights are based on 2,180 comments about Rasuvo from MyPsoriasisTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Weekly self-injection at home can feel more manageable than frequent clinic visits.
The injection form can ease stomach upset compared with methotrexate pills.
Once adjusted, treatment can keep psoriasis controlled for years.

Considerations:

Regular blood work and liver monitoring are a major part of treatment.
Liver problems can limit treatment, especially with long-term use.
Hair thinning or hair loss can happen during treatment.

How Rasuvo Works and How It’s Taken

Rasuvo is a type of medicine called a folate analog metabolic inhibitor. It blocks an enzyme called dihydrofolate reductase. This interferes with how cells make and repair DNA and how they reproduce.

In psoriasis, skin cells are produced much faster than normal. This is the basis for using Rasuvo to help control psoriasis.

Doctors prescribe Rasuvo when adults have severe, hard-to-treat, disabling psoriasis that has not responded well enough to other treatments. The diagnosis should be confirmed through a skin biopsy, a consultation with a dermatologist, or both.

Rasuvo is injected under the skin in the abdomen or thigh. Some people may give themselves the injection after a healthcare professional trains them and their doctor decides it is appropriate.

Typical Dosing for Psoriasis

The recommended starting dose of Rasuvo for psoriasis is 10 to 25 milligrams once weekly.

A doctor may slowly adjust the dose to get the best response. The dose should not usually be more than 30 milligrams per week.

After the best response is reached, the dose should be reduced to the lowest possible amount, with the longest appropriate rest period.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Rasuvo

MHT logo These insights are based on 2,180 comments about Rasuvo from MyPsoriasisTeam members.

Members who use Rasuvo often say it helps to set realistic expectations, keep a close eye on side effects, and stay in touch with their doctor about how treatment is going. Many also mention that weekly routines, blood work, and practical support for cost or access can make treatment easier to manage.

1

Get blood work when your doctor recommends it.
“The most important thing on methotrexate is getting regular liver profiles done. I had to come off when my enzymes became elevated.”
2

Talk to your doctor if pills are hard on your stomach.
“I was on the pill form always. I had to ask my doctor for medication for nausea, upset stomach, and other gastrointestinal issues. Now I am on the injections weekly; it’s better.”
3

Ask about assistance programs if cost is a problem.
“My doctor told me about a Rasuvo assistance program and helped me apply. I was approved, which covered the cost and copay and helped me get the self-injection pens.”

Connect with others who understand life with psoriasis. Join MyPsoriasisTeam for free.

Rasuvo Side Effects

In reports of methotrexate treatment for psoriasis, the most common side effects occurred in about 3 percent to 10 percent of people. These include:

Alopecia (hair loss)
Photosensitivity (sensitivity to sunlight)
Burning of skin lesions

Serious Side Effects and Warnings

Rasuvo can cause serious side effects that may require immediate medical attention. These include:

Myelosuppression (bone marrow suppression) — Low blood cell counts can lead to infections, anemia, or bleeding.
Hepatotoxicity (liver damage) — Fibrosis, cirrhosis, or liver failure can occur.
Pulmonary toxicity (lung problems) — Interstitial pneumonitis, an inflammation of the lungs, can be life-threatening.
Gastrointestinal toxicity — Severe diarrhea, mouth sores, intestinal bleeding, or intestinal perforation can occur.
Renal toxicity (kidney problems) — Acute kidney failure can occur.
Severe skin reactions — Stevens-Johnson syndrome or toxic epidermal necrolysis can cause widespread rash, blistering, or skin peeling.
Serious infections — Opportunistic infections, including Pneumocystis jirovecii pneumonia, can occur.
Embryo-fetal toxicity — Rasuvo can cause fetal harm or fetal death if used during pregnancy.
Hypersensitivity reactions — Severe allergic reactions, including anaphylaxis, can be life-threatening.
Secondary malignancies — New cancers, including lymphoproliferative disorders, can occur.
Tumor lysis syndrome (TLS) — This can occur in people with rapidly growing tumors.
Neurotoxicity — Serious brain or nerve problems can cause confusion, weakness, speech changes, or seizures.

Get medical help right away if you think you are having a serious reaction.

How To Save on Rasuvo

The Rasuvo website offers a copay assistance card that may provide up to $125 per month for up to 14 months. Restrictions apply.

CORE Connections also offers personalized support, including help understanding insurance coverage, determining eligibility for financial assistance, and completing applications for available financial support.

To learn more, visit the Rasuvo prescription savings page or call 855-336-3322.

What To Know Before Taking Rasuvo

Before starting Rasuvo, your doctor should check your blood counts, liver function, and kidney function. A chest X-ray should also be done.

Live-virus vaccines are not recommended during Rasuvo treatment. Tell your doctor if you recently received or plan to receive a vaccine.

Tell your doctor if you are allergic to methotrexate.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Tell your doctor if you:

Have kidney or liver problems
Drink alcohol
Have fluid in your abdomen, called ascites
Have fluid around your lungs, called pleural effusion
Have lung problems
Have a stomach ulcer or ulcerative colitis
Have an active or recent infection
Plan to receive nitrous oxide anesthesia

Call your doctor right away if you develop a fever or signs of infection during treatment.

Do not take Rasuvo if you:

Have alcoholism, alcoholic liver disease, or another chronic liver disease
Have an immunodeficiency syndrome
Have certain serious blood problems
Have a known allergy to methotrexate

Rasuvo is also FDA-approved to treat severe, active rheumatoid arthritis in selected adults and active polyarticular juvenile idiopathic arthritis in children.

Before starting Rasuvo, your doctor should check whether you are pregnant if you can become pregnant. Do not take Rasuvo if you are pregnant.

Rasuvo can harm your baby if you are pregnant. Females who can become pregnant should use effective birth control during treatment and for six months after the final dose. Males with female partners who can become pregnant should use effective birth control during treatment and for at least three months after the final dose.

Do not breastfeed during treatment or for one week after the final dose.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Rasuvo for psoriasis?

Rasuvo is used to help control severe, hard-to-treat psoriasis in adults when other treatments have not worked well enough. Clinical response rates and skin-clearance percentages for psoriasis are not provided for Rasuvo.

The recommended starting dose for psoriasis is 10 to 25 milligrams once weekly. A doctor may slowly adjust the dose. After the best response is reached, the dose should be reduced to the lowest possible amount, with the longest possible rest period.

What tests or monitoring are needed with Rasuvo for psoriasis?

Before starting Rasuvo, your doctor should order blood tests to check your blood cell counts, liver function, and kidney function. A chest X-ray should also be done.

During treatment, blood cell counts should be checked at least once a month. Kidney and liver function should usually be checked every one to two months. For people with psoriasis, liver tests, including a blood protein called albumin, should also be checked regularly before doses.

What happens if Rasuvo is taken during pregnancy for psoriasis?

Rasuvo should not be taken during pregnancy to treat psoriasis. It can seriously harm a developing baby.

Possible risks include miscarriage, birth defects, growth problems, and fetal death. If you become pregnant or think you may be pregnant while taking Rasuvo, contact your healthcare provider right away.