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How long does it take for methotrexate to work?

How long can you take methotrexate for? How long does methotrexate work?

Medically reviewed by Melisa Puckey, BPharm. Last updated on Nov 9, 2020.

Official Answer


Methotrexate can start working for rheumatoid arthritis within 3 to 6 weeks and symptoms continue to improve over 3 months.

For other people it might take a few months before they notice any improvement in their rheumatoid arthritis symptoms. It is important to keep taking the methotrexate as usually methotrexate is working at reducing inflammation and swelling, it just takes a while before you notice pain relief and have less joint stiffness.

How long can you take methotrexate for?

Methotrexate can be taken long term to help treat rheumatoid arthritis symptoms and also to help slow disease progression and joint damage. Rheumatoid arthritis is a chronic illness that does not have a cure, so medicines like methotrexate are taken to reduce the symptoms and reduce that damage caused by the disease.

There have been clinical trials that have lasted 11 years which have studied rheumatoid arthritis patients taking long term methotrexate.

These studies showed:

  • sustained positive response with a 50% improvement in joint pain
  • greater than 65% reduction in joint swelling index
  • 11% of the patients left the study due to methotrexate toxic effects.

How long does methotrexate work for?

A clinical trial studied rheumatoid arthritis patients who took methotrexate for 12 weeks and then methotrexate was stopped. The methotrexate continued to be effective for 3 to 6 weeks after methotrexate was stopped and after this time the rheumatoid arthritis symptoms began to return.

Bottom line:

  • Methotrexate starts to show improvements in rheumatoid arthritis symptoms in 3 to 6 weeks.
  • Methotrexate is taken long term to reduce rheumatoid arthritis symptoms and reduce disease progression.
  • If you stop taking methotrexate it will take 3 to 6 weeks for the methotrexate effects to diminish and your rheumatoid arthritis symptoms to reappear.

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