Methotrexate (Non-Cancer)

• Methotrexate should be taken as prescribed by the doctor. It is usually given orally once weekly, taken at the same day of each week.
  
• A typical adult dose ranges from 7.5 milligrams to 25 milligrams per week. The dose varies for each person depending upon many factors such as how active your disease is and how you respond to or tolerate the medicine. Your doctor may reduce the dose if you develop side effects.
• Methotrexate should be taken after food to avoid gastric discomfort. If you vomit within a few hours of taking Methotrexate, do not take another dose. Make a note and let your doctor know if this happens again the following week.
• Methotrexate tablets should be swallowed whole. The tablets should not be crushed or chewed.
• However, for people who are unable to swallow tablets whole, your pharmacist may advise you to soak the tablets in water for a few minutes before grinding them to minimise the inhalation of medicine powder. Talk to your pharmacist for further details if you have difficulty swallowing.
• Rarely, your doctor may prescribe Methotrexate injection to replace the oral tablet to achieve better result. It is to be given via injection under the skin (subcutaneously) of your stomach, thigh or upper outer arm. You or your carer should receive training on how to inject Methotrexate from your doctor, pharmacist or specialty nurse prior to attempting the administration on your own. Always remember to rotate the injection site.
• You may start to see improvement within a few weeks, but it may take up to 3 months to experience its full benefit.
• Do not stop taking your medication without checking with your healthcare professional.

If you forget to take a dose (e.g. every Monday), take it as soon as you remember (i.e. Tuesday). If you forget to take the dose for 2 days, omit the dose that week and take your next dose on the usual day (i.e. Monday). Do not take two doses to make up for the missed dose.