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Cancer Treatment Centers of America

Methotrexate (Folex®, Mexate®)


Brand Names: Folex®, Mexate®, MTX, Methotrex® (formerly Amethopterin)

Methotrexate is used to treat some cancers of the breast, skin, head and neck, and lungs, along with some leukemias and lymphomas.

Methotrexate is a type of antimetabolite. Both healthy and cancerous cells use folate to make DNA and RNA. Methotrexate interferes with this process, helping to stop the reproduction of cells. This drug is especially effective at killing cells that tend to reproduce quickly, a main characteristic of cancer cells.

This medication may be given as a tablet taken by mouth, an injection into a vein (intravenous), or an injection into a muscle (intramuscular). Intravenous injections usually take up to 20 minutes. Sometimes, methotrexate may be injected into the spinal cord in order to kill cancer cells in that region. The exact approach, dose, and schedule varies depending on the type of cancer being treated, the extent of disease, and other factors. For people given a particularly high dose of methotrexate, leucovorin calcium will be given alongside treatment to help save healthy cells. It is also important that people taking methotrexate drink extra fluids and take bicarbonate pills in order to lower the risk of kidney damage

Methotrexate side effects

To prevent problematic interactions between methotrexate and other drugs, be sure to tell your doctor if you are allergic to any medications, and what other medications and supplements you are currently taking. You should also inform your doctor if you have or ever had excess fluid around your stomach or lungs, any problems with blood cells, diabetes, high blood pressure, stomach ulcers, liver tumor, liver disease, or kidney disease, if you are pregnant or planning to become pregnant, or if you are breastfeeding. Women should not breastfeed while taking methotrexate.

Possible side effects of methotrexate may include:

  • Headache
  • Dizziness
  • Drowsiness
  • Swollen, tender gums
  • Decreased appetite
  • Reddened eyes
  • Hair loss

Some of methotrexate’s side effects can be serious. Call your doctor immediately if you experience any of these symptoms:

  • Mouth sores
  • Diarrhea
  • Black, tarry, or blood stools
  • Vomit that is bloody or looks like coffee grounds
  • Fever, sore throat, cough, chills, or other signs of infection
  • Rash
  • Blisters or peeling skin
  • Blurred vision or sudden loss of vision
  • Seizures
  • Confusion
  • Weakness or difficulty moving one or both sides of the body
  • Loss of consciousness

Please note that this is not a comprehensive list. Patients may experience additional effects not mentioned above.

At Cancer Treatment Centers of America (CTCA), your team of cancer experts will explain each of the side effects of methotrexate with you in detail, as well as the side effects and expectations of all other medications planned as part of your individualized treatment plan.

Methotrexate for cancer treatment

Methotrexate may be used in the treatment of:

  • Choriocarcinoma
  • Leukemia in the spinal fluid
  • Osteosarcoma
  • Breast cancer
  • Lung cancer
  • Non-Hodgkin lymphoma
  • Head and neck cancers

At Cancer Treatment Centers of America (CTCA), our integrative approach to cancer treatment works to fight your disease on all fronts and ensures that you remain at the center of everything we do. We encourage participation from both you and your family to make certain you are comfortable with all decisions made regarding your treatment.

The information provided here is for educational purposes only. In no way should it be considered as offering medical advice. Cancer Treatment Centers of America assumes no responsibility for how this material is used. Please check with a physician if you suspect you are ill. Also note that while Cancer Treatment Centers of America frequently updates its contents, medical information changes rapidly. Therefore, some information may be out of date.