Low-dose methotrexate for Crohn’s disease
Crohn’s disease is a long-term condition that causes inflammation in the digestive system. This leads to symptoms such as abdominal pain and diarrhoea. Use this action plan to discuss methotrexate with your gastroenterologist and plan the best way to take your medicine.
Methotrexate acts to control the disease
Methotrexate does more than just relieve the symptoms of Crohn’s disease.
It is a type of medicine called an immunomodulator. This means it works by interrupting the activity of the immune system to reduce inflammation in the bowel.
Methotrexate:
- keeps symptoms under long-term control (called remission)
- prevents flares
- decreases the need for glucocorticoids (also known as corticosteroids or steroids)
- reduces the chance of complications caused by uncontrolled inflammation.
Focus on facts
Myths about methotrexate can be barriers to treatment. Knowing the facts helps people stick to their treatment and improves results.
| Fact | Fact | Fact | Fact |
|---|---|---|---|
| Methotrexate is safe and effective at low doses for Crohn’s disease – it’s not considered chemotherapy at these doses. | Methotrexate takes time to work – you might not feel better for 6–12 weeks. | Methotrexate injections can be safely given by yourself, or a friend or family member. | People taking methotrexate for Crohn’s disease can safely make physical contact with pregnant women. |
| Myth | Myth | Myth | Myth |
| Low-dose methotrexate is chemotherapy. | You will notice the benefits of methotrexate straight away. | Giving yourself methotrexate injections is unsafe | People taking methotrexate cannot be near pregnant women. |
Ongoing care
Blood tests
Regular blood tests are used to check treatment is working and monitor for side effects, measuring kidney and liver function, and doing a full blood count. Over time, these tests are needed less often.
Clinical review
Continue regular reviews of your Crohn’s disease. How often depends on how active the disease is.
Vaccinations
Keep your pneumococcal and influenza vaccinations up to date.
Skin checks
Methotrexate can slightly increase the risk of some forms of skin cancer. Annual skin checks are recommended for adults.
Reproductive health
You should seek specialist advice if you plan to have children.
Women should use birth control while taking methotrexate, stop methotrexate 3 months before planning a pregnancy, and avoid breastfeeding while on methotrexate.
Taking low-dose methotrexate
Share this action plan with your healthcare team to help you achieve your treatment goals.
When to contact my doctor
Further information
Crohn’s & Colitis Australia crohnsandcolitis.com.au
Gastroenterological Society of Australia gesa.org.au
The Australian Rheumatology Association rheumatology.org.au
- Information about how to safely inject methotrexate
- A video about how to give yourself an injection of methotrexate
NPS MedicineWise (nps.org.au)
Download the MedicineWise app to keep track of your medicines and access health information such as blood test results. (medicinewiseapp.com.au)
NPS Medicines Line: 1300 633 424
Download the original pdf of this article
Back to Inflammatory bowel disease hub