Methotrexate (MTX) is a prescription treatment taken most often for rheumatoid arthritis and psoriasis. The great benefit of taking this medication is the dramatic improvement for most patients in the first couple of months and steady improvement thereafter.

The downside with MTX is that there is a chance of developing cirrosis of the liver. Cirrhosis is scarring of the liver and poor liver function as a result of chronic liver disease. Some symptoms of cirrhosis include:

• Bleeding hemorrhoids
• Confusion
• Impotence and loss of interest in sex
• Jaundice
• Nausea and throwing up
• Vomiting blood
• Swelling of the legs
• Fevers
• Decrease in urine
• Nosebleed or bleeding gums
• Pale or clay colored stools

While MTX is a potent drug, over the last 10 years, it has proved safer than expected. The dosage level for arthritis is fairly small, therefore bad reactions happen less frequently than was once thought. (Also note that women who are pregnant or planning on becoming pregnant should not take MTX. Men who are planning on having children should also be aware that MTX can cause sterility and birth defects.)

The good news is that there are literally millions of people taking this medication and only a handful will develop liver problems. If you get your blood work done regularly, liver problems will be detected early, allowing you time to find alternatives before it becomes a permanent problem. Most likely, people who develop liver cirrosis while on MTX either haven’t had their blood work done regularly, or they are drinking heavily while on this medication.

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