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Methotrexate is indicated in the management of selected adults with severe, active, rheumatoid arthritis (ACR criteria), or children with active polyarticular-course juvenile rheumatoid arthritis, who have had an insufficient therapeutic response to, or are intolerant of, an adequate trial of first-line therapy methotrexate including full dose non-steroidal anti-inflammatory agents (NSAIDs) .
Aspirin, NSAIDs, and/or low dose steroids may be continued, although the possibility of increased toxicity with concomitant use of NSAIDs including methotrexate injection methotrexate cause weight gain does taking methotrexate cause weight gain salicylates has not been fully explored .
(See methotrexate DRUG INTERACTIONS . methotrexate and folic acid how do i know if methotrexate is working taking methotrexate for ) Steroids may be reduced gradually in patients who respond to methotrexate .
Combined use of methotrexate with gold, penicillamine, hydroxychloroquine, sulfasalazine, or cytotoxic methotrexate agents, has not been studied and may increase the incidence of adverse effects .
Rest and methotrexate physiotherapy as indicated should be continued .
Methotrexate is administered orally or intramuscularly in doses methotrexate of 15 to 30 mg daily for a five-day course .
Such courses are usually repeated for 3 to 5 times as required, with rest periods of one or more weeks interposed methotrexate max dose reaction to methotrexate methotrexate 10 mg side effects who makes between courses, until any manifesting toxic symptoms subside .
methotrexate The effectiveness of therapy is ordinarily evaluated by 24 hour quantitative analysis of urinary chorionic gonadotropin (hCG), which should return to normal or less than 50 IU/24 hr usually after the third or fourth course and usually be followed by a complete resolution of measurable lesions in 4 to 6 weeks .


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