I was diagnosed with psoriatic arthritis towards the end of last year and methotrexate was the recommended treatment. I haven’t started taking it yet as i’m a bit daunted by all the side effects you read about. The initial dose was 25mg - I asked the nurse specialist why so high a dose and they said “everyone starts on that”. How severe & how common are the side affects of taking methotrexate, particularly how common are the milder side affects of methotrexate? Are they the price you pay for methotrexate slowing the progression of arthritis / better to have a few side effects taking a drug that works than not take methotrexate and arthritis gets worse. Many thanks for your advice.


  • Anna
    Anna Moderator Posts: 925

    Hello @FloraFlora and welcome to the online community,

    You have recently been diagnosed with psoriatic arthritis and advised to take methotrexate, but you haven’t yet started treatment as you are rather concerned by the possible side effects. I can understand how daunting it might be to begin a new treatment and I’m sure you’ll hear from some of our members who have experience of methotrexate and its side effects - and also the benefits of the treatment

    While you’re waiting for members to respond, you might be interested to read about the drug from the Versus Arthritis website:

    Best wishes, and do let us know how you’re getting on,

    Anna ( Mod)

    Need more help? - call our Helpline on 0800 5200 520 Monday to Friday 9am to 6pm

  • Hi@FloraFlora

    Thanks for your post to the Helpline. Reading about drugs, may not address what you might be concerned about, so we are there to talk to. The literature mentions that the more concerning drug reactions are rare and monitored with regular testing, but if you'd like a chat about the situation, why not ring us here at the Helpline so we listen and help?

    Calls are free and in confidence.

    Psoriatic arthritis | Psoriatic arthritis | Causes, symptoms, treatments (

    all the best

    Guy - Helpline Team

  • FloraFlora
    FloraFlora Member Posts: 3

    I’m trying to get a feel of what to expect. I know serious side effects affect only 1 in 10,000 and are monitored. It’s the common side effects that the NHS website say affects 1 in 100 people (loss of appetite, feeling sick or being sick; stomach ache or indigestion; diarrhoea; headaches; feeling tired or drowsy; hair loss) - does everyone taking methotrexate experience the common side effects to some extent but with only 1 in 100 experiencing them to a sufficient degree to report it? Or, to ask the question the other way round - do 99 in 100 people experience no side effects at all? Many thanks

  • jamieA
    jamieA Member Posts: 657

    Hi @FloraFlora

    I was put on MTX in February last year after being diagnosed with PsA the previous October when I was initially put on sulfasalazine. My initial dose of MTX was 15mgs which was increased to 20mgs a month later. I still take the sulfasalazine as well. I was then put on a biologic last July and my MTX was reduced to 10mg in October. I think the only issue I can be sure MTX causes me is tiredness. I take my MTX on a Thursday and can guarantee that either on the Friday or Saturday I suddenly feel I've been unplugged, usually in early afternoon. I'm less tired now it's been reduced to 10mg but still feel drained. I go for a lie down for a couple of hours and then I'm good to go.

    I assume the medics will have arranged regular 2-3 monthly blood tests for you to ensure any other side effects are picked up quickly.