Methotrexate (Trexall)

Rheumatology / Oncology (DMARD / Antimetabolite)

Dosing & Administration

Adult Dose

RA: 7.5-15 mg PO ONCE WEEKLY (never daily). Ectopic: 50 mg/m2 IM.

Pediatric Dose

JIA: 10 mg/m2 PO ONCE WEEKLY.

Renal Adjustment

CrCl 10-50: Reduce dose by 50%. CrCl < 10: Avoid.

Hepatic Adjustment

Avoid in severe liver disease.

Safety & Special Populations

Pregnancy Category

X - Teratogenic / Abortifacient.

Lactation Safety

Contraindicated.

Contraindications & Adverse Effects

Contraindications

  • Pregnancy
  • Breastfeeding
  • Severe renal/hepatic impairment
  • Bone marrow suppression

Common Adverse Effects

  • Hepatotoxicity
  • Stomatitis
  • Bone marrow suppression
  • Pulmonary fibrosis