Does Methotrexate Cause Hair Loss or Hair Thinning?
Yes, methotrexate can cause hair loss. However, hair loss is an uncommon side effect, and your hair should grow back after treatment. Learn more with this guide.
Rasuvo
Used for Psoriasis, Rheumatoid Arthritis
Used for Psoriasis, Rheumatoid Arthritis
Rasuvo (methotrexate) is a disease-modifying antirheumatic drug (DMARD) that treats rheumatoid arthritis (RA), polyarticular juvenile idiopathic arthritis (pJIA), and severe psoriasis when other treatment options haven't worked well. It's a once-weekly injection under the skin on the stomach or thigh. The medication can potentially cause many side effects in different parts of your body, so you'll need regular lab tests done so your provider can monitor you. Rasuvo (methotrexate) isn't safe during pregnancy because it can harm unborn babies.
What is Rasuvo (methotrexate)?
What is Rasuvo (methotrexate) used for?
- Rheumatoid arthritis (RA) in adults
- Polyarticular juvenile idiopathic arthritis (pJIA) in children
- Psoriasis in adults
How Rasuvo (methotrexate) works
Rasuvo (methotrexate) is a medication that belongs under the drug class known as antimetabolites. It's also considered a disease-modifying antirheumatic drug (DMARD).
The way Rasuvo (methotrexate) works to treat certain types of arthritis and psoriasis isn't fully clear. Research suggests that it helps lower the activity of the immune system to lessen inflammation. The medication might also help slow down the growth of skin cells.
Drug facts
| Common Brands | Rasuvo |
|---|---|
| Drug Class | Antimetabolite |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Rasuvo (methotrexate)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Change in liver lab test results
- Nausea or vomiting
- Diarrhea
- Swelling or sores in the mouth
- Burning of psoriasis skin lesions
- Skin more sensitive to sunlight
- Low platelet levels
Less Common Side Effects
- Headache
- Dizziness
- Rash
- Itchy skin
- Hair loss
- Low white blood cells
Note: Side effects listed here were reported by people who took either the oral or injectable version of methotrexate, including Rasuvo.
Rasuvo (methotrexate) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reaction: rash, trouble breathing, swelling in the face or throat
- Severe skin reaction: blisters, peeling skin, sores in the mouth, fever
- Lung problems: trouble breathing, cough, fever
- Liver damage: stomach pain, nausea, yellowing of the skin or whites of the eyes, dark urine
- Kidney problems: urinating less often than usual, itchy skin, bloody or foamy urine
- Brain or nerve problems: seizures, headache, confusion, weakness on one side of the body, coordination problems, vision problems
- Low blood cell counts: tiredness, easy bruising, blood in urine or stool, pale skin
- Infection: fever, cough, pain while urinating, chills, muscle weakness, vomiting
- Cancerous tumors
More on Rasuvo (methotrexate) side effects
The following Rasuvo (methotrexate) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Black, tarry stools
blood in the urine or stools
bloody vomit
joint pain
reddening of the skin
sores in the mouth or lips
stomach pain
swelling of the feet or lower legs
Less common
Back pain
bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, or warmth at the injection site
blurred vision
confusion
convulsions (seizures)
cough or hoarseness
dark urine
dizziness
drowsiness
fever or chills
headache
lower back or side pain
painful or difficult urination
pinpoint red spots on the skin
shortness of breath
unusual bleeding or bruising
unusual tiredness or weakness
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
N/A
GoodRx discount
$76.35
Pros and cons of Rasuvo (methotrexate)
Pros
- A good option for those who have trouble swallowing pills
- Only need to take it once a week
- Available as a prefilled autoinjector
- Conveniently stored at room temperature
Cons
- Must get lab tests done regularly to check for side effects
- Can make your skin more sensitive to the sun and raise your risk for sunburns
- Not available as a lower-cost generic
- Can't use while pregnant or breastfeeding
Pharmacist tips for Rasuvo (methotrexate)
- Rasuvo (methotrexate) is injected under the skin once a week. Pick a day of the week that's easy for you to remember. Mark your calendar or use a reminder app on your phone to help you remember to take the medication. This medication isn't meant to be used every day; otherwise, it could lead to serious and fatal side effects.
- During treatment, be sure to get all of your lab tests and scans as instructed by your provider to check that Rasuvo (methotrexate) is safe for you. This medication can cause many side effects in different parts of your body that the tests and scans can help detect.
- Rasuvo (methotrexate) can make you feel dizzy or tired. Make sure you know how the medication affects you before driving or operating machinery.
- Rasuvo (methotrexate) can make your skin more sensitive to the sun, raise your risk for sunburns, and even make previous sunburns come back. Try to avoid direct sun exposure. When you go outside, wear sunscreen and clothes that protect your skin. Tell your provider if you get a sunburn or have painful skin while you're taking this medication.
- Before you get any vaccines, tell your provider that you're taking Rasuvo (methotrexate). Some vaccines (e.g., live vaccines) might work less well while you're taking this medication. Your providers can make sure the vaccine you're getting is safe for you.
Tips on how to use Rasuvo (methotrexate):
- Don't try to inject Rasuvo (methotrexate) until you've been trained by a healthcare provider. Make sure you understand the Instructions for Use. Ask your provider if you have any questions.
- Before each time you use Rasuvo (methotrexate), check that the solution in the viewing window looks yellow to brown and is free of particles. Air bubbles are normal. Otherwise, use another autoinjector.
- Carefully follow the instructions to use the Rasuvo (methotrexate) autoinjector. Remove the yellow cap when you're ready to inject. Then, inject the medication under the skin of your stomach or thigh. Make sure to avoid injecting the medication within 2 inches of your belly button or into skin that's bruised, tender, scarred, scaly, red, or hard.
- You'll know that you've injected the full dose of Rasuvo (methotrexate) when you see that there's no more liquid left inside the viewing window. Contact your provider or pharmacist if there's medication left.
- Each Rasuvo (methotrexate) autoinjector is meant for one-time use, so don't try to reuse it. After you've used an autoinjector, place it in a special sharps container for disposal. Don't throw it away in the trash. This helps prevent needle-stick injuries.
Risks and warnings for Rasuvo (methotrexate)
Rasuvo (methotrexate) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serious damage to different parts of the body
- Risk factors: Peptic ulcer disease | Ulcerative colitis | Heavy alcohol use | Kidney or liver problems| | Diabetes | Higher doses of Rasuvo (methotrexate) | Taking Rasuvo (methotrexate) for a long time | Taking NSAIDs | Considered obese | Fluid buildup in the body (e.g., stomach, lungs) | Older age
Rasuvo (methotrexate) can cause many serious problems all over the body that can be fatal. It can put stress on your lungs, digestive tract, liver, kidneys, skin, and nervous system.
These problems can happen at any time during treatment, so your provider will follow up with you often. Your provider might also order various lab tests, tissue samples (biopsies), or scans to help check for these problems. Most symptoms can be treated if they're recognized early.
Get medical help right away if you have any of the following symptoms.
Lung problems: trouble breathing, cough
Digestive tract problems: diarrhea, vomiting, stomach pain, mouth pain or inflammation
Liver problems: yellowing of your skin or whites of the eyes, pain in the right side of your stomach, dark urine, vomiting
Kidney problems: swelling in your feet or ankles, little or no urine
Nerve problems: changes in vision, not able to move one side of your body, confusion, seizure
Severe allergic and skin reactions
Rarely, Rasuvo (methotrexate) can cause life-threatening allergic reactions and skin reactions. Get medical help right away if you have trouble breathing, swelling in your face or throat, rash, blisters, peeling skin, red skin, mouth sores, muscle aches, or fever.
Risk of infections, bleeding, and anemia due to low blood cells
- Risk factors: Blood problems | Current infection | Weak immune system
Rasuvo (methotrexate) can affect your bone marrow and cause your body to make fewer blood cells. This can cause many side effects. It can raise your chance of bleeding and make you more likely to have anemia and get infections. Your healthcare provider will probably ask to have your blood drawn periodically during treatment to check your blood cell counts. Talk to your provider right away if you suddenly have muscle weakness, unexplained bruising or bleeding, or develop a fever.
Harm to unborn babies
- Risk factors: Pregnancy
Rasuvo (methotrexate) can cause life-threatening harm to an unborn baby if it's taken during pregnancy. For this reason, avoid taking this medication if you're pregnant. If you or your partner can become pregnant, it's important for you to use birth control whenever you have sex during treatment. Continue to avoid becoming pregnant for at least 6 months (for females) and for at least 3 months (for males) after the last dose. Talk to your provider about other options if you become or would like to become pregnant.
Possible infertility (not able to have children)
It's possible for Rasuvo (methotrexate) to make it harder for you to have children (a loss of fertility, or infertility). This medication has been linked to low sperm count and menstrual problems. This might not be reversible, so it's important that you discuss the risks with your healthcare provider if you're considering having children in the future.
Risk of cancer
Some people who took low-dose methotrexate by mouth developed certain types of cancer and tumors, such as skin cancers and blood cancers. The risk for cancer with Rasuvo (methotrexate) can't be ruled out. Tell your provider if you have an unexplained fever, feel very tired, have swollen lymph nodes in your neck or armpits, or spots or moles on your skin that seem unusual.
Tumor lysis syndrome
Taking methotrexate might cause a serious condition called tumor lysis syndrome (TLS) in people who have certain cancers or tumors. Typically, people who are prescribed Rasuvo (methotrexate) for arthritis or psoriasis have a low chance of developing TLS unless they have a known or undiagnosed tumor. Call your provider right away if you have nausea, vomiting, low appetite, tiredness, side pain, muscle cramps, a pounding chest, dark urine, or less urination. These can be symptoms of TLS.
More on Rasuvo (methotrexate) warnings
Rasuvo (methotrexate) dosage
The average cost for 1 package of 4 auto-injectors of 25mg of Rasuvo (methotrexate) is $546.37 with a free GoodRx coupon. This is 22.53% off the average retail price of $705.25. 
Autoinjector
Package
Autoinjector| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 7.5mg | 4 autoinjectors | $546.37 | $136.59 |
| 10mg | 1 autoinjector | $76.35 | $76.35 |
| 12.5mg | 4 autoinjectors | $546.37 | $136.59 |
| 15mg | 1 autoinjector | $145.52 | $145.52 |
| 17.5mg | 4 autoinjectors | $546.37 | $136.59 |
| 20mg | 4 autoinjectors | $546.37 | $136.59 |
| 22.5mg | 1 autoinjector | $145.52 | $145.52 |
| 30mg | 1 autoinjector | $123.25 | $123.25 |
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 4 auto-injectors of 7.5mg | 1 package | $546.37 | $546.37 |
| 4 auto-injectors of 10mg | 1 package | $546.37 | $546.37 |
| 4 auto-injectors of 12.5mg | 1 package | $546.37 | $546.37 |
| 4 auto-injectors of 15mg | 1 package | $546.37 | $546.37 |
| 4 auto-injectors of 17.5mg | 1 package | $546.37 | $546.37 |
| 4 auto-injectors of 20mg | 1 package | $546.37 | $546.37 |
| 4 auto-injectors of 22.5mg | 1 package | $546.37 | $546.37 |
| 4 auto-injectors of 25mg | 1 package | $546.37 | $546.37 |
| 4 auto-injectors of 30mg | 1 package | $546.37 | $546.37 |
Interactions between Rasuvo (methotrexate) and other drugs
Rasuvo (methotrexate) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Rasuvo (methotrexate). Please note that only the generic name of each medication is listed below.
More on Rasuvo (methotrexate) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Varicella Virus Vaccine, Live
- Zoster Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aceclofenac
- Acemetacin
- Acetazolamide
- Adenovirus Vaccine
- Amoxicillin
- Amtolmetin Guacil
- Asparaginase
- Aspirin
- Bacillus of Calmette and Guerin Vaccine, Live
- Beet Root
- Bentiromide
- Bromfenac
- Bufexamac
- Capecitabine
- Capmatinib
- Celecoxib
- Chloral Hydrate
- Cholera Vaccine, Live
- Choline Salicylate
- Clonixin
- Dantrolene
- Darolutamide
- Dengue Tetravalent Vaccine, Live
- Dexibuprofen
- Dexketoprofen
- Dexlansoprazole
- Diclofenac
- Dicloxacillin
- Diflunisal
- Dipyrone
- Doxifluridine
- Doxycycline
- Droxicam
- Enasidenib
- Esomeprazole
- Etodolac
- Etofenamate
- Felbinac
- Fenbufen
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Floxacillin
- Flufenamic Acid
- Fluorouracil
- Flurbiprofen
- Foscarnet
- Fosphenytoin
- Hydrochlorothiazide
- Ibuprofen
- Ibuprofen Lysine
- Indomethacin
- Influenza Virus Vaccine, Live
- Ketoprofen
- Ketorolac
- Lasmiditan
- Leflunomide
- Levetiracetam
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Mezlocillin
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Nitrous Oxide
- Omeprazole
- Oxaprozin
- Oxyphenbutazone
- Pantoprazole
- Parecoxib
- Penicillin G
- Penicillin V
- Pexidartinib
- Phenylbutazone
- Phenytoin
- Piketoprofen
- Piperacillin
- Piroxicam
- Pirprofen
- Poliovirus Vaccine, Live
- Pristinamycin
- Probenecid
- Proglumetacin
- Proguanil
- Propionic Acid
- Propyphenazone
- Proquazone
- Pyrimethamine
- Rabeprazole
- Salicylic Acid
- Salsalate
- Sapropterin
- Silver Sulfadiazine
- Simeprevir
- Smallpox Vaccine
- Sodium Salicylate
- Sulfacetamide
- Sulfacytine
- Sulfadiazine
- Sulfamethizole
- Sulfamethoxazole
- Sulfapyridine
- Sulfisoxazole
- Sulindac
- Tamoxifen
- Tegafur
- Tenoxicam
- Teriflunomide
- Tiaprofenic Acid
- Ticarcillin
- Tolfenamic Acid
- Tolmetin
- Triamterene
- Trimethoprim
- Typhoid Vaccine, Live
- Valdecoxib
- Warfarin
- Yellow Fever Vaccine
- Zonisamide
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amiodarone
- Cyclosporine
- Eltrombopag
- Etoricoxib
- Mercaptopurine
- Procarbazine
- Rofecoxib
- Theophylline
How much does Rasuvo (methotrexate) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Rasuvo (brand)
$76.35
Rasuvo (methotrexate) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Rasuvo (methotrexate) will not be safe for you to take.
- Currently pregnant
- Alcohol use disorder
- Liver problems
- Weak immune system
- Blood problems (e.g., low platelets, low white blood cells, anemia)
What are alternatives to Rasuvo (methotrexate)?
There are a number of medications that your doctor can prescribe in place of Rasuvo (methotrexate). Compare a few possible alternatives below.
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