Methotrexate - Crohn's

Crohn's Disease Overview of Crohn's Disease Treatments

The purpose of this website is to provide unbiased medical information for Crohn's Disease. Click on these links if you are interested in the background or pathophysiology of Crohn's Disease. Below are both classic and modern treatments for Crohn's Disease.


Methotrexate (Rheumatrex, Mexate) is another fast-acting immunosuppressant. It is given weekly and may be an option for patients with severe Crohn's disease who have not been helped by other immunosuppressant drugs. Methotrexate (15mg/week) is effective for maintenance of remission in Crohn's disease, at least in patients of whom remission has been achieved with this agent (Stange EF et al, 2006)Stange EF, Travis SP, et al European Crohn's and Colitis Organization. European evidence based consensus on the diagnosis and management of Crohn's disease: definitions and diagnosis. Gut. 2006 Mar;55 Suppl 1:i1-15.. However, methotrexate can cause miscarriages and birth defects, as well as liver damage. Because of these pregnancy complications, both men and women who take methotrexate should use birth control. It starts working in about eight weeks or more. Short-term side effects include nausea, fatigue and diarrhea, and rarely, it can cause potentially life-threatening pneumonia. Long-term use can lead to scarring of the liver and sometimes to cancer.

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Side effects

COMMON SIDE EFFECTS are acne; chills and fever; dizziness; flushing; general body discomfort; hair loss; headache; infertility; irregular periods; itching; loss of appetite; lowered resistance to infection; miscarriage; nausea; sensitivity to sunlight; sore throat; speech impairment; stomach pain; swelling of the breast; unusual tiredness; vaginal discharge; vomiting.

SEVERE side effects are severe allergic reactions allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black or bloody stools; blood in the urine; bone pain; calf pain/swelling; change in amount of urine; chest pain; confusion; dark urine; diarrhea; dry cough; enlarged glands; fatigue; fever or chills; inflammation of the pancreas (stomach tenderness, nausea, vomiting, fever, increased pulse rate); irregular heartbeat; mental changes; mouth sores; muscle weakness; persistent sore throat; red, swollen, or blistered skin; seizures; serious infection (herpes, hepatitis, blood infection); trouble breathing; unusual bleeding or bruising; unusual pain and discoloration of the skin; vision changes; vomit that looks like coffee grounds; yellowing of skin or eyes.