Expert Review by

Cutaneous Lymphoma Foundation’s Medical Advisory Council

What is Methotrexate?

Brand Names: Rheumatrex®, Trexall®
Other Name:  MTX 

Methotrexate is an antimetabolite agent that is used in a variety of immune mediated diseases such as rheumatoid arthritis and psoriasis. It interferes with folic acid metabolism in cancer cells.

It is used to treat cutaneous T-cell lymphoma (CTCL). 

How is it delivered?

In patients with cutaneous T-cell lymphoma (CTCL) often involving blood, methotrexate (MTX) is administered 1 day per week as single agent oral or intramuscular injection chemotherapy. 

What is the expected result?

Methotrexate can yield a response rate of 30-50% in patients with CTCL.

Are There Special Considerations To Be Aware Of?

Daily folic acid (vitamin) pill administration may be recommended to take in concert with methotrexate treatment

Methotrexate can be combined with both UVB and PUVA to further boost the activity of the phototherapy.

Methotrexate can make patients more sensitive to light. Thus, if starting methotrexate while on phototherapy, be sure to notify your doctor, as the dosage of phototherapy may need to be adjusted or avoid toxicity (sunburn). 

The advisability of alcohol consumption should be discussed with your doctor while on methotrexate since it is also metabolized in the liver.

What are Common Side Effects?

The following is not an exhaustive list of the possible side effects. For a complete list of possible side effects, please see the manufacturer's available information on the specific therapy.

Side effects may include lowered blood counts, temporary taste alteration, loss of appetite, mouth sores and ulcers, diarrhea, skin darkening, and inflammation of the cornea (resulting in gritty eyes). Less common side effects include nausea and vomiting, blurred vision, hair loss, sensitivity of the skin to sunlight and rash. Periodic laboratory tests are required to assess bone marrow, kidney, and liver function.


Download printable sheet