Methotrexate: What to Expect, Side Effects, and More
Methotrexate (brand names: Mexate, Folex, Rheumatrex) is a type of chemotherapy medicine called an antimetabolite. It is used in combination with other chemotherapy medicines, including in the CMF chemo regimen. to treat:
early-stage breast cancer after surgery and other treatments
advanced-stage breast cancer
Fluorouracil, Gemzar, and Xeloda are other antimetabolites.
See methotrexate prescribing information.
How Methotrexate works
Methotrexate disrupts the activity of the nutrient folate, which throws off DNA replication. The medicine’s ability to interfere with this process stops cell division and leads to cell death.
What to expect during Methotrexate treatment
Methotrexate is given intravenously, almost always in combination with other chemotherapy medicines such as cyclophosphamide and fluorouracil. It is usually given as an intravenous injection or a short intravenous infusion.
Methotrexate side effects
Like almost all breast cancer medicines, methotrexate can cause side effects, some of them severe.
The most common side effects of methotrexate are:
swelling in the feet and legs
irregular periods — this can include temporary cessation (usually resume after medication is completed) or permanent cessation of menstrual periods depending on your age and other factors
You should not take methotrexate if you’re pregnant or breastfeeding. Using contraception is recommended while undergoing treatment with methotrexate as well as for months after ending treatment.
Real patient reviews
Members of our community discuss their experiences with methotrexate in the community forum. Here are some of their comments. Remember, it's essential to talk to your doctor about any side effects you're having and ask about ways to manage them.
“I'm pretty lucky with chemotherapies, the side effects tend to be forgettably mild and so far this one seems no different.” —Heya24
“It made me feel dreadful for several days.” —Alyson
“My mom had an extended course of methotrexate and had a great deal of neuropathy and foot pain as a result.” —specialk
Read more in our Methotrexate discussion forum.
Paying for Methotrexate
The cost of methotrexate may vary. The price you’ll pay depends on the drug manufacturer, your health insurance provider and plan, where you live, and the pharmacy you use. You may also be charged for the office visits required for methotrexate infusions.
Note: Your insurance company may require you to get prior authorization before covering methotrexate.
Learn more about financial assistance and medicine cost-lowering tips.
— Last updated on March 29, 2025 at 3:19 PM