Other Names

MTX, amethopterin, Trexall®, and Rheumatrex® (There may be other brand names for this medication.)

How is it Administered?

This drug may be given as an injection under your skin or into a muscle, a vein, or your spine. It is also available as an oral tablet.

What is it Used For?

This drug is used to treat leukemia, lymphoma, osteosarcoma, and lung, breast, and head and neck cancers.

How Does it Work?

Cancer is a group of diseases in which abnormal cells reproduce without control. Both normal and cancer cells go through cycles (resting phase, active growing phases, and division/reproduction). Your chemo schedule is based upon your cancer type, how fast the cancer cells reproduce, and when each drug is the most likely to be effective. This is why chemotherapy is typically given in cycles.

Methotrexate is in a class of drugs known as antimetabolites, drugs that interrupt the cell cycle. It is biologically similar to a nutrient (folic acid) that cells need. The cancer cells take in the methotrexate instead of the folic acid, and the cells die.

The faster cells reproduce, the more likely that chemo will damage or kill the cells. Unfortunately, methotrexate cannot tell the difference between cancer cells and normal cells that reproduce rapidly. These normal cells will eventually grow back and be healthy. During treatment, however, the cells that line your digestive tract (mouth, stomach, intestines), your hair follicles, and your blood cells may be affected causing nausea, vomiting, diarrhea, mouth sores, hair loss, and low blood counts (anemia, fatigue, increased risk of bleeding and infection).

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