Modified: February 1, 2023


Dear @Name@,

Your healthcare team has discussed the following subject with you: methotrexate. The brand name is Trexall. Here is some additional information. Let us know if you have any questions regarding this information.

How it works: This medication belongs to a class of drugs called immunomodulators. It helps to reduce irritation and swelling (inflammation) in the intestines. It also decreases the long-term need for steroids. For that reason, it is sometimes referred to as a "steroid-sparing" drug. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.

How it is taken: Taken as a pill or injection once weekly, along with a folic acid supplement.

Common side effects: Infrequently reported side effects include flu-like symptoms (nausea, vomiting, headache, fatigue, and diarrhea), mouth sores, and low white blood cell count. Some of the side effects can be prevented by adding folic acid (a vitamin). 

Special considerations: Less common side effects include scarring of the liver and lung inflammation. This medication should be avoided by pregnant women. If you would like to become pregnant, this medication should be avoided several months before pregnancy.  In addition, the medication can be passed in semen; thus, men should also avoid the medication for several months before family planning. Alcohol should be minimized while taking this medication, with no more than 3 drinks per week. Please discuss this with your physician.

Monitoring: Blood tests should be performed frequently to check for medication effects on the bone marrow and liver.

Points to remember: Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or complementary therapies) you may be taking.

Other tips: The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own. If you have any side effects or you continue to have symptoms, speak to your healthcare team immediately.

For further information, please check out or follow this link:


PDF /sites/default/files/2020-03/immunomodulators.pdf