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Methotrexate and Tiredness: What Users Say

Brand names: Otrexup, Methotrexate LPF Sodium, Rasuvo, Trexall, Xatmep Jylamvo

Tiredness: mentioned by 46 users (13.7%)

Based on user experiences from 335 Methotrexate reviews, the following table shows the most commonly mentioned side effects.

All user comments are moderated by Drugs.com. Each review is verified for relevance and screened for inappropriate content. Side effects are user-reported and not clinically verified.

nausea 14.0%
tiredness 13.7%
fatigue 9.9%
hair loss 8.1%
pain 6.6%
headaches 4.8%
loss of appetite 4.2%
sick 4.2%
itching 3.9%
diarrhea 3.6%

Reviews for Methotrexate

Commonly mentioned side effects
  • rhi...
  • Taken for 1 to 6 months
  • November 6, 2018

For Rheumatoid Arthritis "I have been on methotrexate for a couple of months now. I'm not certain whether we just caught my disease at a good time, but this medication has been 110% effective for me. I have had no symptoms since it kicked in (took a while). The most that will happen because of the medication is the day after I take it, I will feel a little tired (was worse in the beginning). Anyways, please make sure you don't read reviews and judge the medication from that. I nearly scared myself silly doing that. Trust in your rheumatologist and follow the process. The medicine reacts with different people in different ways. I am definitely one of the lucky ones. I am 25, and methotrexate has given me back the lifestyle of a 25-year-old!"

10 / 10
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  • Bad...
  • Taken for 1 to 6 months
  • March 2, 2020

For Psoriatic Arthritis "Didn't want to take this drug methotrexate, was anxious after reading various reviews and stuff on the internet, but Dr. advised I needed it for my arthritis (psoriatic). He also said that when I felt the results, I'd wish I'd taken it before now. He also mentioned I like a drink, so he said I could have one, just don't go daft. So far, bloods are okay, and he was right - wish I'd tried methotrexate ages ago. Before taking it, I couldn't fasten laces, walk down stairs, hands were painful, found it hard to do my job, and had ankle pain. What a difference this drug has made, virtually pain-free. Now I am using stairs, etc., as normal. It took me a little while to get used to it, and it does make me tired for a day or so after I take it, but after that, I feel great. I hope this helps someone."

10 / 10
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  • jFr...
  • December 22, 2015

For Rheumatoid Arthritis "Methotrexate has been a miracle for me. For the past 3 years, experiencing extreme tiredness, no energy to do anything, thankful to get through a day's work. Tried every combination of vitamins the world has ever made without any results. Then, over the last one year, severe inflammation of hands, could barely make a fist, difficulty using hands. Under rheumatologist advice, used 2 other medications till placed on methotrexate with a dose of 5 pills per week. Have been on this dose for the past 8 months with great results. Have been walking, biking around from 2 to 4 miles frequently, mowing grass, doing property maintenance 6 to 8 hrs per day and still having energy to continue working on other things! Crossing fingers, THANKS METHOTREXATE!"

10 / 10
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Frequently asked questions

  • Coc...
  • Taken for 1 to 6 months
  • November 22, 2014

For Rheumatoid Arthritis "I have only been taking the Methotrexate since the end of September and I am on 25mg per week. I was also prescribed the Folic Acid but can't take that as it causes such an upset stomach that I stopped it altogether. So far, the only symptoms I have had were in the beginning, and that was feeling nausea and very tired the day after taking it. It has helped with the swelling and pain, and I have no pain in my knees anymore, just a bit in the hands, wrists, and my one foot."

8 / 10
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  • mam...
  • Taken for 1 to 6 months
  • February 27, 2019

For Rheumatoid Arthritis "I was on 12.5 mg of methotrexate per week for 6 weeks. I gradually got more tired and had more brain fog as each week went by. My hair was falling out at an alarming rate. By week 6, I was having heart palpitations. My joints felt good, but everything else not so much. I stopped using it, and after 3 days, I felt much better."

2 / 10
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89 Report

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  • Ann...
  • Taken for 1 to 6 months
  • July 31, 2015

For Rheumatoid Arthritis "When all other meds/combo of meds failed my rheumy put me on MTX (8 tabs @ 2.5 mg once a week). I still take 4 mg prednisone twice a day, 400 mg of Plaquenil at night, and folic acid every morning. It's been a long road and a lot of ups and downs but I have seen the most progress since MTX was added to my combo of meds. I still have some pain but the stiffness (which used to last most of the day) and the swelling have improved. I am always nauseous and feel lethargic the first 24-48 hours after the MTX dose but 1-2 days of that is better than the alternative. I've always been extremely active so it has been rough struggling to do simple things."

10 / 10
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  • Mrs...
  • Taken for 1 to 6 months
  • June 9, 2014

For Psoriasis "I have suffered with psoriasis since I was 19 years old, now in my 40s, I have tried everything on the market. I have been on methotrexate since New Year's Day, and I am so happy to say that it has nearly all gone. I can holiday with all my friends and don't feel embarrassed. I am so happy. I would recommend it. It's a slow process, but five months in and pretty much clear. No side effects, just tired on the day of medication, but that's not an issue."

9 / 10
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More FAQ

  • ACS...
  • July 5, 2014

For Rheumatoid Arthritis "I have been on methotrexate for almost a year. I am up to 20 mg a week. I take folic acid and leucovorin calcium 12 hours after the methotrexate. I was taking Enbrel but now take Xeljanz. Before the biologics, the methotrexate wasn't working very well. I take prednisone too. I am only 36 but at least I can function better than I did. I still flare about twice a month. I suffer side effects from methotrexate. My hair has severely thinned out and I get very tired after taking it. It looks like I'll be on it for a long time though. Hopefully it gets better. I would really like my hair to come back."

6 / 10
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107 Report
  • JJa...
  • Taken for 2 to 5 years
  • January 3, 2020

For Rheumatoid Arthritis "I was on methotrexate for 5 years. I started with pills, then injections, as I couldn’t handle the taste and it felt like it poisoned me. It made my brain feel awful - I couldn’t eat - it was the worst. I had 4 car crashes from poor judgment, either on the day or day after using it. I developed a bleeding disorder and exploded through my skin, they have called it abnormal platelet dysfunction. They don’t know what the cause is, but I think it was from methotrexate. I have had heart surgery and was diagnosed with angina and had a stent. Added to this, I have ulcerative colitis, as well as Raynaud's syndrome and SLE. I don’t work or even look sick, but I know one thing: methotrexate was a nightmare compared to all the heart issues I have had and am having. I’m still looking for a job, I’m not disabled but have no energy to even type this."

1 / 10
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59 Report
  • Nig...
  • Taken for 10 years or more
  • February 8, 2016

For Rheumatoid Arthritis "I am 62, and was diagnosed with RA about 10 years ago. I have been through a battery of drugs to suppress my immune system, ending up on subcutaneous methotrexate 10mg. I originally had a 'bad day' the day after my injections, however, it seems to be getting to be a bad couple of days lately. Intense pressure headache (I'm also a migraine sufferer), nausea, confusion, tiredness, and now really troubled sleep, nightmares, and some visual disruption (almost hallucinations), feelings of panic, unease, and claustrophobia. I know the alternatives, stop and face RA full on, but I would rather get 3/4 good days than be on the road to being completely disabled."

7 / 10
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  • Fra...
  • Taken for 1 to 6 months
  • January 14, 2020

For Psoriatic Arthritis "I've been taking a combo therapy of sulfasalazine and methotrexate for 5 months. Started at 15 mg per week and now down to 5 mg. Sulfasalazine remained the same. Each month, inflammation markers are lower. When diagnosed, the marker was 24, and the last visit was 3. The swelling decreased a lot, and I don't have the level of pain when I first started. Side effects are minimal. Tired the day after, but nothing too major. Hair thinning. Still able to bodybuild daily. As a matter of fact, after starting methotrexate, I've felt better overall and have been able to pack on more muscle. Overall, good experience."

9 / 10
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  • Sha...
  • July 19, 2015

For Rheumatoid Arthritis "I was diagnosed at 10 months old after a knee biopsy. I have been taking methotrexate on and off since I was 16 years old and I am now 41 years old. This medication has greatly reduced the activity of the disease and has increased the quality of my life greatly. I have just changed from methotrexate oral tablets to methotrexate injections. The tablets were making me feel nauseous so my specialist decided to put me on injections to bypass my stomach. The injections are easy to administer and relatively pain-free. I am presently just trying to find the right dose for me due to suffering side effects. 15 mg has caused me severe sore lips and mouth, nausea, dizziness, lethargy, and abdominal cramps. 12.5 mg is the correct dose for me."

8 / 10
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83 Report
  • Anonymous
  • June 19, 2010

For Rheumatoid Arthritis "It definitely helps with the pain and mobility part of rheumatoid arthritis, but I am nauseous usually 2 or three days after I do the shot. I'm also tired a lot and feel weak after I take my weekly shot. Sometimes I don't take it consistently because I don't feel like being sick that week. I do enjoy it when my fingers actually bend though."

7 / 10
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111 Report
  • mas...
  • Taken for less than 1 month
  • July 29, 2014

For Rheumatoid Arthritis "I have been taking methotrexate for two weeks now. Before taking this, I had pain in my hips, knees, and ankle and could not walk on the heel of one of my feet. The pain was really bad. I am now walking on my foot again with little pain and do not feel so fatigued and tired. I do feel tired and a bit dizzy for a few days after the medication but not too bad. I am only taking 3 a week at the moment, and about to take four, then five and six. Hopefully I won't have too many side effects."

7 / 10
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  • Puz...
  • August 31, 2016

For Rheumatoid Arthritis "I was diagnosed with RA 2 years ago and am grateful that methotrexate allows me to live a normal life. I take 20 mg once a week. I have a flare every now and then, which is managed by a steroid injection. I take 5 mg of folic acid every day to counteract side effects. I am tired on MTX day but generally have not experienced anything negative with the drug. However, I take it last thing at night on the day I have to take it, and I take it with milk. I figure if there are any effects I would rather sleep through them. Also, I don't want to start taking a stomach acid medication, so I tried it with milk and it was fine. It's worked for me."

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70 Report
  • Gcq...
  • Taken for 6 months to 1 year
  • February 22, 2020

For Psoriatic Arthritis "I take 8 pills once a week. 4 in the morning, 4 in the evening. At first, I thought it was so awful: no appetite, no energy, upset stomach. Then I changed to taking the dosage 2 times in that day, which has helped. I still have appetite loss, and some foods make me feel ill. My pain is gone, so I applaud methotrexate. I take swim aerobics now, trying to build strength up. The only problem is I have low hemoglobin, but I am sure the doctor will figure it out. I take 2 folic acid daily. I am prediabetic, take metformin, but no drinking."

10 / 10
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47 Report
  • NW ...
  • Taken for 1 to 6 months
  • April 9, 2015

For Psoriasis "Age 59, F, living N W Eire. No history of psoriasis until it struck 2 years ago. Small plaques on scalp, left elbow, then palms of hands, fingers, and soles of feet. Itchy, shredding skin, burning as if stung by nettles. Open, painful cracks. Emollients, lotions, and prescription creams had no effect. Water and detergents irritated. Touch and walking were agony. Latex gloves for shower/chores, cotton gloves at work. Dermatologist found 'debilitating stage 2 psoriatic arthritis' and prescribed 2.5 Methotrexate x6 once weekly, plus Folic Acid and bloods checked weekly. Now in the 7th week. Plus: using hands and walking, no irritation. Neg: tired, poor focus, urinary infections, worse in bad weather, still avoiding water/detergents. Conclusion: Highly recommend Methotrexate."

7 / 10
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63 Report
  • Scr...
  • Taken for 1 to 2 years
  • July 23, 2020

For Eczema "Methotrexate stopped my rashes. I itched, scratched, and bled. I was diagnosed with acute eczema-atopic dermatitis-immune disorder. Because the problem is the skin making too many skin cells, the overabundant new cells try to kick out the older healthy cells. This makes you itch. My itch was uncontrollable with topicals and creams. Methotrexate works by destroying the work of folic acid (needed to build healthy cells). You need to know that a few people may develop lung webbing from methotrexate. You may feel a bit more tired and have more strange BMs a day or two after dosing. It worked for me and is generic and inexpensive. All drugs have side effects."

9 / 10
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  • wen...
  • September 11, 2016

For Rheumatoid Arthritis "I've been on methotrexate for 4 months now. The rheumatoid arthritis came out of nowhere. I went to my primary care physician with my feet and my thumbs, he basically said I was getting older, to take Aleve and get comfortable shoes. Well, a month later, I could barely walk, so my primary care physician did blood work. My RA factor was 1382. It took me another month to get an appointment with a rheumatologist. The rheumatologist is going to fail me on methotrexate on the 28th of this month because my levels are not coming down as expected. I am currently on 17.5 mg of methotrexate. I take them on Friday night, and Saturdays I am exhausted. I constantly have pain in my hands, wrists, ankles, knees, and feet. I am just afraid the next medication won't work either."

4 / 10
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  • Gmh...
  • Taken for 2 to 5 years
  • June 1, 2016

For Psoriasis "I was on methotrexate for 3-4 years after trying every option. I started 17.5 mg when I was 19. It cleared my psoriasis perfectly! I struggled with side effects: weakness and exhaustion, loss of appetite which led to severe weight loss, and nausea. I changed to the injections at 20 mg and found a huge difference in side effects. Still not a lot of energy, but not going through my stomach was better for the nausea and appetite, so I could get healthy. I stayed on methotrexate for as long as I could before I felt it was draining me. Now I am off it for 1 year and have bad psoriasis again. I'm wondering if it's best to go back on. Both affect you in different ways, emotionally and physically."

8 / 10
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46 Report
  • bro...
  • Taken for 1 to 6 months
  • April 5, 2015

For Psoriasis "Started with the pill form of methotrexate at a 15 mg dosage per week. Moved to injection form and increased the dosage to 25 mg per week. Seen lots of improvement in my psoriasis. Tired the day of and the day after the injection but not concerned. Stomach a bit irritated, but a little drawback for the good benefits."

9 / 10
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49 Report
  • RZC...
  • Taken for 2 to 5 years
  • March 4, 2017

For Rheumatoid Arthritis "I was on this medicine for about 4 years. I tried the pill form, which caused severe vomiting. After 2 doses, it was intolerable, and I was switched to injectable. I felt exhausted and had nausea and diarrhea for 3-4 days, but I was able to get out of bed for the other days, so this was a plus. Unfortunately, I picked up a nasty case of pneumonia even after getting the vaccine. Either I had exposure or it was caused by the methotrexate. I had to stop methotrexate. It took at least 2 months to recover, and I'm still having asthmatic reactions. My doctor says I should continue to stay off it for now. He wants me to restart if RA symptoms return (which they are). I'm terrified to restart. He wants to switch to Simponi, but I'm afraid of that too."

5 / 10
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35 Report
  • one...
  • March 30, 2013

For Psoriasis "My mother broke out, seemed like overnight, with red bumps that quickly turned into dry patches. The dermatologist knew right away what it was. We have been on the methotrexate for 6 weeks, and the flaking is totally gone and is healing. The dose was 2 Friday mornings, 2 Friday evenings, and 2 Saturday mornings. The only side effect was appetite and being very tired for 2 days."

10 / 10
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47 Report
  • Spa...
  • January 23, 2016

For Rheumatoid Arthritis "I have had rheumatoid arthritis for 15 years, severe and aggressive. Finding a good rheumatologist has been impossible. I take Humira, methotrexate, and folic acid. Taking the prescribed dose of methotrexate, 10 mg once a week. I am so lethargic, still stiff hands, feet, joints, as well as pain. It is better than no medication because that pain is fire, this has dulled the fire. Had one surgery on my shoulder. My hair has been rapidly falling out again, I can't eat normally. After reading this blog, I realize I may do better with either injections or stopping completely. Plaquenil and sulfasalazine were of no benefit. Allergic to biologics. Had to find one that has been a game changer."

5 / 10
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  • wri...
  • August 7, 2015

For Psoriasis "I started methotrexate in September 2014 as my body was 75% covered with psoriasis, and I had tried every topical/light treatment going. The drug worked wonders, and I couldn't believe how my skin was clearing up. By Jan/Feb, I'm actually wearing dresses without tights and short sleeves (especially at work, which I'd never done before). The only downside was that the day after I took methotrexate, I felt so tired. I've ended up having days off work because of it. I decided to come off it in about May 2015 and am now waiting to try a new drug, Adalimumab (spelling!?) and my skin has come back worse from methotrexate. I'm in so much pain, and I'm covered in guttate :("

5 / 10
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35 Report

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Reviews may be edited to correct grammar/spelling or remove inappropriate content. Reviews appearing to come from parties with a vested interest are not published. This information is not intended to endorse any medication and should not replace the expertise and judgment of healthcare professionals.