What are the side effects of methotrexate injection in Rheumatoid Arthritis?

 

Methotrexate is a commonly used disease-modifying anti-rheumatic drug (DMARD) for the treatment of rheumatoid arthritis (RA). It is usually administered orally or via injection, and is effective in reducing pain, swelling, and joint damage in patients with RA. However, like all medications, methotrexate is associated with a range of side effects, some of which can be serious. In this article, we will discuss the common and rare side effects of methotrexate injection in rheumatoid arthritis.

Common Side Effects of Methotrexate Injection in Rheumatoid Arthritis:

1. Nausea and vomiting: These are the most common side effects of methotrexate. They occur in up to 20% of patients and are usually mild. However, some patients may experience severe nausea and vomiting, which can lead to dehydration and malnutrition.

2. Fatigue: Methotrexate can cause fatigue in up to 20% of patients. This can be due to the drug's effects on the bone marrow, where it can decrease the production of red and white blood cells.

3. Hair loss: Methotrexate can cause hair loss in up to 10% of patients. This is usually reversible once the drug is stopped, but can be distressing for patients.

4. Mouth sores: Methotrexate can cause sores in the mouth and throat, which can be painful and can make it difficult to eat or drink.

5. Skin rash: Methotrexate can cause a rash on the skin, which can be itchy and uncomfortable.

6. Diarrhea: Methotrexate can cause diarrhea in up to 10% of patients. This can be due to the drug's effects on the lining of the intestine.

7. Liver toxicity: Methotrexate can cause liver toxicity in some patients. This can lead to elevated liver enzymes, which can be detected through blood tests. In rare cases, methotrexate can cause liver failure, which can be life-threatening.

8. Lung toxicity: Methotrexate can cause lung toxicity in some patients. This can lead to shortness of breath, coughing, and chest pain. In rare cases, methotrexate can cause interstitial lung disease, which can be life-threatening.

9. Infections: Methotrexate can increase the risk of infections in some patients. This is because the drug suppresses the immune system, making it harder for the body to fight off infections.

10. Headaches: Methotrexate can cause headaches in some patients. These are usually mild and can be treated with over-the-counter pain medications.

Rare Side Effects of Methotrexate Injection in Rheumatoid Arthritis:

1. Severe allergic reactions: Methotrexate can cause severe allergic reactions in some patients. These can include difficulty breathing, swelling of the face or throat, and hives. If you experience any of these symptoms, seek medical attention immediately.

2. Kidney toxicity: Methotrexate can cause kidney toxicity in some patients. This can lead to elevated creatinine levels, which can be detected through blood tests. In rare cases, methotrexate can cause kidney failure, which can be life-threatening.

3. Bone marrow suppression: Methotrexate can cause bone marrow suppression in some patients. This can lead to a decrease in the production of red and white blood cells, as well as platelets. This can increase the risk of infections and bleeding.

4. Neurological side effects: Methotrexate can cause neurological side effects in some patients. These can include seizures, confusion, and hallucinations. These side effects are rare, but can be serious.

5. Fertility issues: Methotrexate