Frequently Asked Questions
Will methotrexate cause cancer?
There is no evidence that low-dose weekly methotrexate used for rheumatoid arthritis causes cancer. The high doses used in oncology have different risk profiles. Some immunosuppressants used in transplant medicine are associated with lymphoma risk; the evidence for methotrexate at rheumatology doses is not comparable.
Can I take methotrexate if I have diabetes or high blood pressure?
Generally yes. Methotrexate does not directly worsen diabetes or hypertension. The main monitoring requirements are kidney and liver function, and some blood pressure medications require attention alongside methotrexate. Your rheumatologist coordinates with your other treating doctors.
I feel completely well after 6 months. Can I stop methotrexate?
This is a question for your rheumatologist, but the short answer is: usually not without specialist guidance. Rheumatoid arthritis is a chronic disease. Feeling well is typically the result of the drug working — stopping it causes the disease to return. In patients who have achieved sustained deep remission, cautious dose reduction may be considered, but this is a monitored process.
Can I have dental work done while on methotrexate?
Yes, routine dental procedures are safe. However, your dentist should know you are on methotrexate, particularly because of the infection risk with more invasive procedures. Avoid the antibiotic trimethoprim-sulfamethoxazole (Septran) — communicate this to your dentist.
My hands were X-rayed and there is erosion. Is methotrexate still useful?
Yes. Even in the presence of established joint damage, controlling ongoing inflammation with methotrexate prevents further damage and preserves function. It cannot repair erosions that have already occurred, but it can stop or substantially slow the progression of new ones.
This article is for educational purposes and does not constitute medical advice. If you have questions about your specific situation, discuss them with your rheumatologist. Dr. Keerthi Vardhan, MD (Internal Medicine), DM (Clinical Immunology & Rheumatology), Assistant Professor, NIMS Hospital, Hyderabad.