What is methotrexate?

Donna Hill Howes, RN
Family Practitioner

Methotrexate (Trexall) is taken as a weekly pill or injection. It is one of the most common DMARDs (disease-modifying antirheumatic drugs), and is usually the first drug given right after diagnosis of rheumatoid arthritis (RA). It may be used alone, or combined with other DMARDs or biologics. Because methotrexate must usually be taken for several weeks before it reaches its full effect, doctors often also prescribe a faster-acting corticosteroid for those first few weeks.

When people take methotrexate for 3 months or more and still have signs and symptoms of moderate or high RA disease activity, doctors usually try adding another drug to be taken along with methotrexate. Usually, this is another DMARD, such as sulfasalazine or hydrochloroquine. But it may also be a biologic drug, such a TNF inhibitor, abatacept, or rituximab. 

This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. 

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