Methotrexate is taken as a single ONCE A WEEK dose on the same day each week. It can be taken in two different ways – either by tablets or by injection. Sometimes people start off on the injection form, before moving to oral tablets.

  • Tablets:

Taken by mouth, after food. The tablets should be swallowed whole with a glass of water while sitting upright or standing. Do not crush or chew them

  • Injection:

Methotrexate injections can be either subcutaneous (under the skin) or intra-muscular (into muscle). These can be given at the clinic by the nurse, or alternatively your nurse may train you to inject the methotrexate yourself.

If you forget to take your methotrexate on your normal day, ask your doctor or pharmacist for advice. You may be able to take it up to two days later, but you should not take it if you are three or more days late. If this happens, take your next dose on your usual day the following week. Do not double up your dose.


Doctors and hospitals have different ways of prescribing methotrexate. Some doctors may recommend starting with weekly injections for 8-12 weeks to induce remission, and then move to weekly oral tablets if it is working well, while other doctors may recommend just the tablet form or the injection form.

Some specialists start at a low dose of methotrexate and slowly increase it to a maximum of 25 mg a week, while other doctors may start at 25 mg a week and slowly reduce it.

The methotrexate tablets come in two different strengths: 2.5 mg and 10 mg. The two strengths are different shapes, but the color is very similar. It is important that you take the correct strength and dose of tablets. If you think you have the wrong strength, do not use your medicine before checking with your doctor, pharmacist or nurse. Some hospitals and doctors have agreed to use only the 2.5 mg tablets to prevent any confusion. Your doctor, pharmacist or nurse will be able to tell you if this applies in your area. If you think you may have taken too much methotrexate, contact your doctor or go to your local Accident and Emergency department immediately.


Folic acid is a vitamin that can help your body cope with methotrexate and help reduce some of the possible side effects, such as nausea and vomiting. Usually it is taken once a week, but not on the same day as methotrexate. However, a number of different regimes may be used and some people are asked to take folic acid several times a week or every day except the methotrexate day.