Methotrexate for psoriasis is a common approach when it comes to the drug treatment of moderate or severe forms of psoriasis. Methotrexate was a drug initially developed in the 1950’s to treat different kinds of cancer (chemotherapy) and is prescribed by your doctor to treat moderate or severe types of psoriasis, it has proven to be effective in psoriatic arthritis, erythrodermic, pustular, as well as severe plaque psoriasis. It is a very potent drug and can be very toxic indeed, particularly if take for too long. The dosage is generally once per week for three months.
Methotrexate works by reducing the rapid turnover of cells, and you will recall that the underlying process in psoriasis is the production of rapidly growing skin cells producing thick, scaling lesions. The problem is that methotrexate does not just discriminate and target the skin cells, it also suppresses the production and division of many different kinds of cells in the body, including healing cells along with those targeted rapidly dividing skin cells. Anybody who takes a cytotoxic drug must abstain from alcohol and most certainly avoid conception while taking it. This drug is the enemy of folic acid, a type of B Vitamin responsible for keeping rapidly dividing and growing cells healthy. It is also a powerful impediment to the enzymes necessary for DNA synthesis.
Methotrexate also has an anti-inflammatory effect on white blood cells (T-cells), which are important in the development of psoriatic lesions. By suppressing the immune system, you suppress an important underlying mechanism that develops psoriatic lesions. The only problem is you leave yourself wide open for countless different kinds of infections and immune dysfunctions. In my opinion, the cost of this kind of therapy is just too great long-term, the disadvantages outweigh the benefits.
If you are going to take methotrexate, be sure to take it for the shortest possible time and only under the supervision of your doctor. And more importantly, before you even contemplate taking methotrexate, consider that while these cytotoxic (“cell toxic”) drugs are no doubt very effective, their potential side effects are chronic damage to the blood-forming organs such as the liver and the kidneys, and because the proper functioning of these vital organs is critical to beautiful skin, first determine if your liver and kidneys can actually cope on this drug for any length of time.
Methotrexate – Unspoken Truths
Methotrexate is a drug that is also used to treat people who are suffering with rheumatoid arthritis. It is one of the most commonly prescribed drugs for rheumatoid arthritis, and is a drug known as disease-modifying anti-rheumatic drugs (DMARDs). This kind of drug works be slowing the progression of rheumatoid arthritis when it comes to the development of joint damage.
How this drug works is by attacking cells that cause inflammation in joint tissues (or in the rapidly growing and inflamed skin of the psoriasis patient) reducing its function, thereby reducing the inflammation along with any painful symptoms. A reduction in inflammation and pain is thought to have a knock-on effect in reducing the levels of fatigue felt by patients, in addition to increasing joint mobility, generally by way of a reduction in stiffness that is often felt in the joints of sufferers first thing in the morning.
I’ve commonly found that this drug is prescribed quite commonly in patients whose rheumatoid arthritis has not seen any improvement after their doctor has tried a more simple and less aggressive form of treatment, but it can take sometimes many months, before the full effect of Metho is noticeable to those with rheumatoid arthritis or psoriasis.And, the longer you stay on drugs like this, the more likely you will have to content with the numerous side-effects. During this initial phase of methotrexate therapy, your doctor will probably be recommending other drugs like anti inflammatories and corticosteroids to help manage your condition.
Less The Half Of Users Report Benefits From Methotrexate
New research has shown that less than half of those who take Metho really notice any benefits, and it has been discovered that women tend to respond less than men. Those who don’t smoke report that Methotrexate appears to work better than smokers, and those who start on Methotrexate in the earliest stages of psoriasis and rheumatoid arthritis tend to find that the drug works better as well. But as I mentioned, the longer you stay on Methotrexate, the more likely you will experience side effects, and some of these can be most unleasant and toxic indeed.
Don’t Drink Alcohol When You Take Methotrexate
Your doctor should be asking you if you have any problems with your liver of kidneys before even thinking about this drug. Do you drink alcohol regularly and are considering methotrexate? You are really silly if you are seriously contemplating drinking even casually while on this drug. The reason I’m saying this is because the long-term consequence of methotrexate is cirrhosis of the liver. It appears that patients who are at the highest risk of liver cirrhosis are:
- Those who are obese
- Those who drink alcohol while taking methotrexate
- Diabetic patients
- Long-term methotrexate users
Monitor Your Blood Tests On A Spreadsheet
By having very regular blood tests undertaken when on a cytotoxic drug, (weekly the first month, monthly the first three months, then three-monthly); you may want to plot your liver and kidney function test results on a spreadsheet (Excel spreadsheet) along with the dosages of the drug/s you are taking. That way you will be able to track your level of liver enzymes and kidney function, and thereby establish if there is any underlying drug-based cause of any unwanted side-effects.
I can’t recommend this approach highly enough. Take your own psoriasis health-care into your own hands. Your doctor has good intentions but is unable to make the time to do this for you. Don’t forget to print out the spreadsheet (landscape view is best) so your doctor will be able to see how things are tracking over a prolonged period of time. Clever approach.
Regular blood work is critical if you take cytoxic drugs, it allows your doctor to adjust the dosages accordingly (or to discontinue altogether) and will help in the early detection of any signs of injury or illness to your blood cells, liver and kidneys.
Drugs that interact and should not be taken with methotrexate include Penecilin and Trimethoprim, NSAIDS, (Aspirin, Ibuprofen, Paracetamol, etc), Barbituates, Triamterene (diuretic), Pyimethamine (anti-protozoan drug),
Methotrexate side effects include diarrhoea, dehydration, mouth sores, shortness of breath, and a cough or a rash. It can also make you more likely to become acutely sick and develop infection or allergies, because it lowers your white blood cells and subsequently your immunity. I have heard many psoriasis patients over the years report increased levels of bruising, thinning hair, headaches and chills while on this drug. Unfortunately, its effects on the unborn child are devastating, and any women who is taking methotrexate should take particular care not to become pregnant as it can cause spontaneous abortion. And if that wasn’t enough bad news, in addition to these immediate and toxic side effects, methotrexate can produce more serious long-term effects such as liver inflammation, kidney toxicity and severe immune system depression. Still interested in methotrexate for psoriasis?
- Common side effects include loss of appetite, nausea, anemia and fatigue.
- Short-term side effects include mouth blistering, sun sensitivity, vomiting, symptoms of an infection (sore throat, fever, cough), headaches, easy bruising, diarrhea.
- Long-term side effects include cirrhosis of the liver, lung toxicity, kidney toxicity, damage to your bone marrow (leukaemia).
Methotrexate Is Used For Abortions
Since 1953, methotrexate has been available in the United States as a treatment for cancer. A chemotherapeutic agent, methotrexate has also been used since the 1980s to treat ectopic (extra-uterine) pregnancies. However, when the political environment in the US delayed the approval and availability of mifepristone as a medication abortion regimen, providers and researchers began to investigate the possibility of expanding the use of methotrexate to early pregnancy termination. In 1993, investigators initiated the first study using low-dose methotrexate in combination with misoprostol for early abortion. Subsequent studies have shown that the methotrexate/misoprostol regimen constitutes an effective method of terminating early pregnancies.