Millions of people across the UK living with the pain and inflammation of arthritis rely on medication to manage their condition. For those diagnosed with rheumatoid arthritis, a common first-line treatment is a medicine called Methotrexate.
While this drug can be highly effective in managing the autoimmune disease, the National Health Service has issued crucial guidance on its potential side effects. Patients are being urged to recognise the difference between common reactions and rare but serious symptoms that require urgent medical attention.
Understanding Arthritis and the Role of Methotrexate
Arthritis is a widespread condition that causes joint pain and stiffness, significantly impacting quality of life. In the UK, the NHS states that millions live with arthritis or similar joint-affecting conditions.
The two primary forms are osteoarthritis, the most common type often developing in people over 45, and rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease where the body's immune system attacks the joints, leading to swelling and pain.
Although there is no cure, various treatments can help. Methotrexate is frequently the first medicine prescribed for rheumatoid arthritis. However, its use comes with important warnings and a need for careful monitoring.
Common vs. Serious: Recognising the Symptoms
Many patients on Methotrexate experience manageable, common side effects. According to NHS advice, these typically include:
- Feeling sick (nausea)
- Loss of appetite
- A sore mouth
- Diarrhoea
- Headaches
- Hair loss
The medicine can also affect blood cells and the liver, necessitating regular blood tests. Less commonly, it may impact the lungs. Patients are also advised that their skin may become highly sensitive to sunlight, making the use of a high-factor SPF 30+ sunscreen essential.
Critical Warning Signs: When to Act Fast
The NHS stresses that while serious side effects are rare, affecting fewer than 1 in 10,000 people, recognising them is vital. Patients should contact their doctor or call NHS 111 immediately if they notice any of the following:
Yellowing of the skin or eyes: This could be a sign of liver problems.
A persistent cough, chest pain, or difficulty breathing: These may point to inflammation of the lungs.
Swollen hands, ankles, or feet, and changes in urination: These could indicate kidney issues.
A high temperature, muscle aches, or a sore throat: These may suggest an infection.
Bleeding gums, blood in urine, vomiting blood, or unexplained bruising: These are potential signs of a blood disorder.
Dial 999 for a Severe Allergic Reaction
In rare cases, a serious allergic reaction (anaphylaxis) to Methotrexate can occur. The NHS says to call 999 immediately if you or someone else experiences:
- Swelling of the lips, mouth, throat, or tongue.
- Breathing very fast, struggling to breathe, or a tight throat.
- Skin, tongue, or lips turning blue, grey, or pale.
- Sudden confusion, drowsiness, or dizziness.
- Someone fainting and not waking up.
- A child who is limp, floppy, or unresponsive.
An accompanying swollen, itchy, or blistering rash may also be present.
Who Should Not Take Methotrexate?
Methotrexate is not suitable for everyone. Patients should inform their doctor if they:
- Have had a previous allergic reaction to the drug.
- Are pregnant, trying to conceive, or breastfeeding.
- Have severe liver or kidney disease, or a blood disorder.
- Have an infection, mouth ulcers, or a diagnosed stomach ulcer.
- Are due to have a live vaccine, including the live flu vaccine for children.
Several other medicines can interact with Methotrexate. It is crucial to tell your doctor if you are taking NSAIDs (like ibuprofen), certain antibiotics, diuretics, epilepsy medicines, theophylline for asthma, indigestion remedies like omeprazole, or any supplements containing folic acid.
For comprehensive information on dosage, monitoring, and further safety advice, patients are directed to consult the official NHS website or speak directly with their healthcare professional. Vigilance and clear communication with your medical team are key to safely managing treatment with this powerful medication.
