Leena Watts
Methotrexate is a strong drug used to treat several types of cancer, severe psoriasis, rheumatoid arthritis, lupus, multiple sclerosis, and polyarticular juvenile idiopathic arthritis (pJIA). It is also used to terminate pregnancies and treat inflammatory bowel disease (IBD). While on methotrexate, it is important to be cautious about your diet and overall health. In this article, we will discuss the dietary restrictions and recommendations to ensure a safe and effective treatment process while taking methotrexate. We will also explore potential side effects and interactions to be aware of during and after treatment.
| Characteristics | Values |
|---|---|
| Foods to avoid | Dark, leafy greens, broccoli, peas, beets, beans, caffeine, alcohol |
| Foods to consume | Folic acid tablet, milk |
| Side effects | Diarrhea, headache, lightheadedness, restlessness, insomnia, serious allergic reactions, anaphylaxis, infertility, liver problems, nerve problems, seizures, confusion, skin sensitivity to sunlight |
| Precautions | Do not take live viral vaccines, do not get pregnant, do not breastfeed |
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What You'll Learn
Avoid caffeine and alcohol
If you are taking methotrexate, it is important to avoid caffeine and alcohol. Methotrexate is a strong drug used to treat severe forms of psoriasis, rheumatoid arthritis, and certain types of cancer. It is also used to terminate pregnancies.
Caffeine
Caffeine may reduce the effectiveness of methotrexate in treating arthritis. If you are taking methotrexate for arthritis, it is recommended to limit your intake of caffeine-containing foods and products. Caffeine can decrease the effects of methotrexate, and your dose may need to be adjusted. Additionally, too much caffeine can cause unpleasant side effects such as headaches, lightheadedness, restlessness, and insomnia. It is best to avoid drinks, foods, or diet pills that contain caffeine, including coffee, tea, cola, and chocolate.
However, some studies have found that caffeine intake does not affect the efficacy of methotrexate in patients with rheumatoid arthritis. These studies suggest that caffeine does not reverse the anti-inflammatory effects of methotrexate in this specific context.
Alcohol
It is important to limit alcohol consumption when taking methotrexate. Alcohol may increase the risk of liver problems when combined with this medication. Methotrexate can already cause serious liver issues, and alcohol can further elevate this risk. Be vigilant for symptoms such as pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, and vomiting, as these could indicate a severe liver problem.
General Dietary Considerations
In addition to avoiding caffeine and alcohol, there are other dietary considerations when taking methotrexate. The medication can interfere with the absorption of folate, the natural form of folic acid. Therefore, it is important to be mindful of your folate intake. Additionally, if you experience diarrhea as a side effect of methotrexate, it is recommended to reduce or avoid high-fiber foods, including raw fruits and vegetables.
It is always advisable to consult your doctor or specialist nurse if you have any concerns or problems while taking methotrexate. They will closely monitor your progress and can make any necessary adjustments to your treatment plan.
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Limit or avoid foods containing folate (e.g. dark leafy greens, broccoli, peas, beets, beans)
It is important to note that methotrexate is a strong drug with a host of possible side effects and warnings. Consult your doctor about possible complications from combining methotrexate with other prescribed or over-the-counter medications. Your doctor may recommend dietary changes if you are taking this medication.
Methotrexate, also known as amethopterin or MTX, is used to treat severe forms of psoriasis, rheumatoid arthritis, and certain types of cancer. It is also used to terminate pregnancies.
If you are taking methotrexate, it is recommended that you limit or avoid foods containing folate. Folate is a type of vitamin B found in many foods, especially dark leafy greens, broccoli, peas, beets, and beans. Folate is known to help reduce the risk of birth defects and is important for heart health. However, when taking methotrexate, the consumption of folate may need to be reduced or avoided. This is because methotrexate can interfere with the absorption of folate in the body.
The Women's Health Center of Miami advises that foods containing folate should be avoided in the week after administration of methotrexate. This is because methotrexate is used to stop cells in the placenta from dividing and multiplying, and folate can interfere with this process. Therefore, it is crucial to limit or avoid dark leafy greens, broccoli, peas, beets, and beans, especially kidney, black, lima, and lentils.
In addition to limiting folate, those taking methotrexate should also reduce their consumption of caffeine. Caffeine can decrease the effects of methotrexate, and too much caffeine can cause unpleasant side effects such as headaches, lightheadedness, restlessness, or insomnia. It is recommended to avoid drinks, foods, or diet pills that contain caffeine, such as coffee, tea, cola, and chocolate.
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Avoid raw fruits and vegetables if you have diarrhoea
Methotrexate is a strong medication used to treat certain types of cancer, severe psoriasis, rheumatoid arthritis, lupus, multiple sclerosis, and polyarticular juvenile idiopathic arthritis. It is also used to terminate pregnancies.
According to the National Institutes of Health, unless directed otherwise by a doctor, those taking methotrexate for the above reasons should continue to follow their regular diets. However, if diarrhoea is a side effect of the medication, it is recommended to reduce or completely avoid high-fibre foods, including raw fruits and vegetables. This is because methotrexate can interfere with the absorption of folate, the natural form of folic acid, which can result in slowed growth in children, certain types of anaemia, digestive and behavioural disorders, weakness, heart palpitations, and an elevated level of homocysteine in the blood, a risk factor for heart disease.
If you are experiencing diarrhoea as a side effect of methotrexate, it is important to stay hydrated by drinking plenty of fluids such as water or squash. It is also recommended to eat smaller meals more frequently and snack when hungry. These snacks should be nutritious and high in calories and protein, such as dried fruit and nuts. It is important to note that raw fruits and vegetables should be avoided, but you can still eat cooked fruits and vegetables, ensuring you are still getting the nutritional benefits.
It is always best to consult with your doctor or pharmacist if you have any questions or concerns about your diet while taking methotrexate, especially if you are experiencing side effects such as diarrhoea. They may recommend dietary changes or adjustments to your medication.
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Avoid sun exposure
While taking methotrexate, it is important to be cautious about sun exposure. Methotrexate can cause your skin to become more sensitive to sunlight, which can lead to serious skin reactions. It is crucial to take the necessary precautions to protect yourself from the sun.
Firstly, it is recommended to always use sunscreen when going outdoors. Look for sunscreens with a high sun protection factor (SPF) of at least 30 or higher. Sunscreens containing titanium dioxide or zinc oxide are generally more effective in blocking ultraviolet A (UVA) rays, which are the type of rays that methotrexate-sensitive skin is particularly vulnerable to. Don't forget to apply sunscreen generously and reapply it frequently, especially if you are swimming or perspiring heavily.
In addition to sunscreen, wearing protective clothing is essential. Cover your skin as much as possible by wearing long-sleeved shirts, long pants, and wide-brimmed hats. Light-coloured clothing that is tightly woven can also provide better protection against the sun's rays. Consider investing in specialised sun-protective clothing, which offers even greater defence against UV rays.
It is also advisable to limit your time in the sun, especially during the peak hours of sunlight intensity, typically between 10 am and 4 pm. If possible, plan your outdoor activities for early morning or late afternoon when the sun's rays are less direct. Remember to seek shade whenever you can, particularly during the aforementioned peak hours.
Lastly, be vigilant about monitoring your skin for any signs of sun-related reactions. This includes not only sunburn but also more severe reactions such as blistering, peeling, skin discolouration, or sores. If you notice any unusual skin changes, seek medical advice promptly. Additionally, inform your doctor if you experience other symptoms such as fever, chills, unusual tiredness, or weakness, as these could be indicative of a more serious condition.
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Do not consume with other medications without medical advice
Methotrexate is a medication used to treat arthritis, psoriasis, and some types of cancer. It is also used to terminate pregnancies. It is important to note that methotrexate can interact with various other medications and substances, and consuming it alongside certain other drugs can lead to serious or even fatal consequences.
Therefore, it is imperative that you do not consume methotrexate with other medications without seeking medical advice first. Before starting to take methotrexate, inform your doctor if you are taking any of the following:
- Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, or cough and cold remedies containing NSAIDs.
- Co-trimoxazole, trimethoprim, or other antibiotics for bacterial infections.
- Diuretics, such as indapamide or bendroflumethiazide.
- Epilepsy medications such as phenytoin or levetiracetam.
- Folic acid or vitamin supplements containing folic acid (folate). Your doctor may prescribe folic acid to be taken with methotrexate, but do not take these supplements if you are already taking prescribed folic acid.
- Herbal remedies, vitamins, or other supplements. There is not enough information to determine whether it is safe to consume these with methotrexate, so always consult your doctor or pharmacist.
Additionally, it is important to limit alcohol consumption while taking methotrexate as it may increase the risk of liver problems. Furthermore, caffeine should be avoided as it can decrease the effects of methotrexate and increase the risk of unpleasant side effects such as headaches, lightheadedness, restlessness, and insomnia.
Always follow the advice of your doctor or healthcare provider regarding your medication and any necessary dietary changes.
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Frequently asked questions
According to the National Institutes of Health, unless directed otherwise by a doctor, patients taking methotrexate for psoriasis, cancer, or rheumatoid arthritis should continue to follow their regular diets. However, it is recommended to reduce or avoid high-fibre foods, including raw fruits and vegetables, if diarrhoea is a side effect. It is also advised to limit caffeine and alcohol intake.
It is recommended to avoid foods that contain folate, such as dark leafy greens, broccoli, peas, beets, and beans, especially kidney, black, lima, and lentils. This is because folate can interfere with the process of methotrexate, which is also known to interfere with the absorption of folic acid.
Methotrexate is a strong drug that may cause serious allergic reactions, including anaphylaxis, and can increase your risk of certain infections. Other possible side effects include headache, lightheadedness, restlessness, insomnia, and increased sensitivity to sunlight.
