Methotrexate works by inhibiting the metabolism of folic acid, which is necessary for cell replication and growth. Its immunosuppressive and anti-inflammatory effects help manage severe symptoms in various autoimmune conditions without significant steroidal side effects.

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Metoject, a formulation of methotrexate, is primarily used in managing autoimmune diseases such as rheumatoid arthritis, psoriasis, and juvenile idiopathic arthritis. It acts as a disease-modifying antirheumatic drug (DMARD). Methotrexate interferes with the growth of certain body cells, especially cells that reproduce quickly, such as cancer cells, bone marrow cells, and skin cells

Additional information



● Management of rheumatoid arthritis
● Treatment of severe psoriasis not responsive to other treatments
● Management of juvenile idiopathic arthritis

Patients Should:

● Adhere strictly to the prescribed dosage to manage symptoms effectively.
● Be aware of potential liver toxicity and monitor liver function regularly.
● Avoid alcohol consumption to prevent increased risk of liver damage.
● Consult healthcare providers if pregnant, since methotrexate can cause birth defects.
● Report any side effects such as sore throat, fever, or unusual bruising to their healthcare provider immediately.



● Injectable solution for subcutaneous injection, typically administered once per week.
● Precautions
● Contraindicated in patients with liver disease, alcoholism, or compromised immune systems.
● Regular monitoring of kidney function, liver enzymes, and blood cell counts are critical.
● Use cautiously in patients with pre-existing hematological disorders.

Drug Interactions

● Methotrexate may interact with nonsteroidal anti-inflammatory drugs (NSAIDs), certain antibiotics, and live vaccines.
● Concurrent use with other hepatotoxic drugs can increase liver damage risks.

Side Effects

● Nausea
● Fatigue
● Mouth ulcers
● Hair thinning

Severe side effects requiring immediate attention:

● Pulmonary symptoms (e.g., persistent cough, shortness of breath)
● Liver toxicity (e.g., yellowing of the skin or eyes, abdominal pain)
● Severe renal impairment
● Blood dyscrasias (e.g., leukopenia, thrombocytopenia)


● Store the injectable solution in a refrigerator, protected from light.

Special Precautions

● Prior to initiating therapy, it is essential to confirm the absence of latent infections or active tuberculosis.
● Patients must avoid conception (both male and female), as methotrexate can cause genetic defects.
● Regular screening for respiratory function and liver biopsy may be necessary for long-term users.


● Overdose symptoms can include severe gastrointestinal toxicity, bone marrow suppression, and acute renal failure. Immediate medical attention is crucial.


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