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Methotrexate Hair Loss, Headaches, Side Effects

Minor side effects of methotrexate hair loss which is temporary and reversible. Methotrexate is commonly used to treat rheumatoid arthritis and many other autoimmune and inflammatory conditions. In fact, it’s the first line of treatment for most people after they’re diagnosed.

Methotrexate Hair Loss & Side Effects

Minor side effects might include hair loss which is temporary and reversible. Loss of appetite, nausea or vomiting, headaches and feeling foggy or unclear. Typically that’s the day after taking the methotrexate. Sometimes mouth ulcers will occur. Most of the time these would lessen as your body gets used to the methotrexate but if side effects continue or really become troublesome, check with your doctor or nurse.

Folic Acid & Folinic Acid

In most people, methotrexate does not cause any problems. We also give a prescription for a vitamin called folic acid to take every day while you are on methotrexate. This helps to cut down many of the possible side effects. Sometimes another vitamin, Folinic acid or Leucovorin is also used. Methotrexate hair loss can infrequently have some effects on the blood. For example like lowering white blood cells and red blood cells.

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Methotrexate on Liver

Methotrexate is also metabolized in the liver. To be sure there are no problems with your liver, blood tests will need to be done. Usually, this is about once a month when you first start methotrexate and then when you’re on a stable dose, this usually spreads out to about every three months. According to a case study for Methotrexate abortions rate published in the journal Arthritis Care & Research.

Let Your Doctor Know

Get emergency help if you ever have any signs of an allergic reaction like hives, difficulty breathing, swelling in your face, lips, on that’s very very rare though. For years, patients taking methotrexate and alcohol had been told by rheumatologists just to avoid alcohol altogether. Methotrexate hair loss can sometimes rarely cause inflammation in your lungs. If you experience a call for shortness of breath, let your doctor know.

methotrexate and alcohol

Risk of Cancer?

Some say it may have a risk of cancer. Actually, it is not. But it’s important to recognize the people with autoimmune diseases do have a risk for cancer anyway, just because they have an autoimmune disease. There are some medications you should generally avoid with methotrexate. However, Trimethoprim, Bactrim or Septra acts on some of the same pathways. Therefore, while you’re on those medications, methotrexate may need to be held.

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Possible Interaction

There is a possible interaction with anti-inflammatory d rugs like Ibuprofen or Naproxen. However, many people with RA take those on an ongoing basis and blood tests ensure that there’s not a problem. According to a case study for methotrexate abortions rate published in the journal Arthritis Care & Research. In fact, women exposed to methotrexate in early pregnancy had fewer abortions than those with RA not given the drug.


Victoria Ruffing
RN, BC-Rheum
Director of Nursing and Patient Education
Johns Hopkins Rheumatology

This content is strictly an overview and study and is for informational and educational purposes only. Hence, all readers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any medication.


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This Post Has 4 Comments

  1. Karen bennett

    Thanks for imformation very imformative im on methorexate also humira i have ra and oa

  2. kate murrell

    This is a wonderful description of Methotrexate calculated to put anyone off taking it. No mention of injecting it which is the next stage after the inevitable intolerances? Also the fact that so many folk are given it early on is because it is so cheap. Not really patient led, just cash led treatment.

  3. arbe

    There is no indication what to do to correct hair loss for example!

  4. Mel Brzonkalik

    Caffeine based shampoo is helpful with hair loss to stimulate follicles.

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