Expert Q&A: How Often Do I Need Blood Tests With Methotrexate?

Question: I have been taking 15 mg of methotrexate weekly for the past seven years. I have had blood work done at least every other month during that time; however, my doctor wants me to have blood tests every month. Since none of my past blood tests have shown any problems, I am wondering why I need to have these tests so often. Wouldn't every few months suffice?

Answer: No, I wouldn't recommend having those tests any less frequently than your doctor recommends. In general, patients taking methotrexate should have the tests monthly. Just because you haven't had any problems for the past seven years doesn't mean you can't develop problems at any time in the future.

Methotrexate can cause liver or kidney problems. Frequent blood tests may detect subtle abnormalities that could alert your doctor to modify your methotrexate dose before a serious problem occurs. If you still have concerns about the frequency of your lab tests, I would recommend bringing up the subject with your doctor at your next appointment. In the meantime, I know it's a hassle to have the tests monthly, but in doing so, you may save yourself serious problems down the road.

Bernard Rubin, DO
Rheumatology Division Head (retired)
Henry Ford Hospital
Detroit, Michigan