folitrax 20 injection - Methotrexate (20mg) medicine

Folitrax 20 Tablet (Methotrexate 20mg): Comprehensive Guide

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🏭 Ipca Laboratories Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 24, 2026
⚠️ Hepatotoxicity Risk ⚠️ Nephrotoxicity Risk 🤰 Pregnancy Category Methotrexate is contraindicated in pregnancy. It can cause fetal harm, including birth defects and miscarriage. Women of childbearing potential should use effective contraception during treatment and for at least 6 months after stopping. Men should also use contraception for at least 3 months after treatment. 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Well-established for approved indications.
Reviewed by
SaathiMed Expert Panel | Sep 24, 2026

When to Call Your Doctor IMMEDIATELY

  • Unusual bleeding or bruising
  • Persistent fever or signs of infection
  • Shortness of breath or dry cough
  • Yellowing of skin or eyes (jaundice)
  • Severe abdominal pain or dark urine
  • Decreased urine output
  • Severe mouth sores or rash

If experiencing severe symptoms, call emergency services immediately.

What is folitrax 20 injection used for?

This medicine contains methotrexate 20 mg, a prescription medicine used to treat rheumatoid arthritis, psoriasis, and certain cancers. It works by reducing inflammation and slowing cell growth. It must be taken exactly as prescribed, with regular blood tests to monitor safety.

  • Generic Name: Methotrexate (20mg)
  • Manufacturer: Ipca Laboratories Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 folitrax 20 injection के बारे में (Hindi Summary)

उपयोग: यह दवा मेथोट्रेक्सेट 20 मिलीग्राम की गोली है, जिसका उपयोग रूमेटॉयड आर्थराइटिस, सोरायसिस और कुछ प्रकार के कैंसर के इलाज में किया जाता है। यह सूजन को कम करने और कोशिकाओं की वृद्धि को धीमा करने में मदद करती है। यह दवा केवल डॉक्टर के पर्चे पर ही मिलती है और इसे डॉक्टर के बताए अनुसार ही लेना चाहिए।

साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, उल्टी, पेट दर्द, मुँह के छाले, थकान और सिरदर्द शामिल हैं। गंभीर दुष्प्रभावों में लीवर की क्षति, फेफड़ों में सूजन, रक्त कोशिकाओं का कम बनना और गुर्दे की समस्या हो सकती है। यदि आपको असामान्य रक्तस्राव, पीलिया, या सांस लेने में कठिनाई हो, तो तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। शराब का सेवन बिल्कुल न करें क्योंकि इससे लीवर को नुकसान हो सकता है। गर्भावस्था के दौरान इस दवा का सेवन न करें। नियमित रक्त परीक्षण करवाते रहें। अन्य दवाओं के साथ इसका सेवन करने से पहले डॉक्टर से सलाह लें।

💡 Did You Know? India is the largest provider of generic medicines globally, supplying over 50% of global vaccine demand.

💊 folitrax 20 injection Uses & Benefits

[{"condition":"Rheumatoid arthritis","description":"Used as a first-line disease-modifying antirheumatic drug to reduce joint inflammation, pain, and prevent joint damage.","evidence":"Well-established"},{"condition":"Psoriasis","description":"Helps control severe plaque psoriasis by slowing down the rapid growth of skin cells.","evidence":"Well-established"},{"condition":"Certain cancers (e.g., acute lymphoblastic leukemia, breast cancer, lung cancer)","description":"Used in combination chemotherapy regimens to inhibit cancer cell growth.","evidence":"Well-established"},{"condition":"Juvenile idiopathic arthritis","description":"May be used in children with severe juvenile arthritis to control inflammation and prevent joint damage.","evidence":"Well-established"},{"condition":"Crohn's disease","description":"Sometimes used to maintain remission in Crohn's disease, often in combination with other medicines.","evidence":"Moderate"}]

Off-label uses: [{"condition":"Ectopic pregnancy","description":"Methotrexate may be used off-label to treat early ectopic pregnancy in selected cases.","evidence":"Limited"},{"condition":"Lupus","description":"Occasionally used off-label for systemic lupus erythematosus to reduce steroid requirements.","evidence":"Limited"},{"condition":"Sarcoidosis","description":"May be used off-label for sarcoidosis when other treatments are ineffective or not tolerated.","evidence":"Limited"}]

Primary treatment for: Rheumatoid arthritis

Also treats: Psoriasis, Certain cancers, Juvenile idiopathic arthritis, Crohn's disease

📋 Drug Information

Generic Name(s)Methotrexate (20mg)
Brand Namefolitrax 20 injection
ManufacturerIpca Laboratories Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassANTI NEOPLASTICS
Action ClassAntimetabolite- Methotrexate
Route of AdministrationOral
StorageStore at room temperature between 15°C and 30°C (59°F to 86°F). Protect from light and moisture. Keep in the original container, tightly closed. Keep out of reach of children.
Shelf LifeTypically 24 months from the date of manufacture, but check the expiry date on the pack.
WHO GuidelineMethotrexate is included in the WHO Model List of Essential Medicines for the treatment of rheumatoid arthritis and certain cancers.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Take this medicine exactly as prescribed, usually once weekly for autoimmune conditions. Do not take it daily unless specifically instructed.
2
Take with food to reduce nausea and stomach upset.
3
Avoid alcohol completely to prevent liver damage.
4
Use effective contraception during treatment and for several months after stopping.
5
Get regular blood tests to monitor liver, kidney, and blood counts.
6
Inform your doctor about all other medicines, especially NSAIDs and antibiotics.
7
Report any unusual bleeding, bruising, fever, or shortness of breath immediately.
8
Do not take live vaccines while on this medicine.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Chronic joint pain and swelling
This medicine is commonly prescribed for rheumatoid arthritis.
Likely Use
✅
Skin plaques and scaling
This medicine is used for severe psoriasis.
Likely Use
❌
Fever
This medicine is not a primary fever reducer.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionMethotrexate is absorbed from the gastrointestinal tract after oral administration. Absorption can be saturable and may vary with dose; at higher doses, absorption may be incomplete. Food may delay absorption but does not significantly affect the extent of absorption.
DistributionMethotrexate distributes into body tissues and fluids, including the liver, kidneys, and synovial fluid. It has a volume of distribution of approximately 0.4 to 0.8 L/kg. It can cross the placenta and is excreted in breast milk.
Protein BindingApproximately 50% bound to plasma proteins, mainly albumin.
MetabolismMethotrexate is partially metabolized in the liver to polyglutamated forms, which are retained in cells and prolong its effects. It is also converted to 7-hydroxymethotrexate, which is less active.
Half-LifeThe elimination half-life is approximately 3 to 10 hours for low doses, but may be longer at high doses or in patients with renal impairment.
ExcretionMethotrexate is primarily excreted unchanged in the urine by glomerular filtration and active tubular secretion. A small amount is excreted in bile and feces.
BioavailabilityOral bioavailability is dose-dependent and ranges from approximately 60% to 90% at lower doses, but may be lower at higher doses.
Onset of ActionFor autoimmune conditions, the onset of therapeutic effect may take 3 to 6 weeks, with full benefit after 3 to 6 months. For cancer, effects depend on the specific regimen.
Peak Plasma TimePeak plasma concentrations are reached within 1 to 2 hours after oral administration.
Duration of ActionThe duration of action varies with the indication and dose. For autoimmune diseases, effects persist with regular dosing. For cancer, effects are related to the dosing schedule.

How It Works

Methotrexate inhibits the enzyme dihydrofolate reductase (DHFR), which is needed to convert folic acid into its active form, tetrahydrofolate. This leads to decreased synthesis of thymidylate and purines, which are essential for DNA and RNA synthesis. As a result, it slows down the growth of rapidly dividing cells, such as cancer cells and immune cells. In autoimmune diseases, methotrexate also reduces inflammation by increasing adenosine levels and suppressing certain immune pathways.

Mechanism Steps

1
Inhibition of dihydrofolate reductase: Methotrexate binds to and inhibits the enzyme dihydrofolate reductase, blocking the conversion of dihydrofolate to tetrahydrofolate.
2
Depletion of tetrahydrofolate: Reduced tetrahydrofolate levels impair the synthesis of thymidylate and purine nucleotides, which are required for DNA and RNA production.
3
Inhibition of cell division: Without adequate nucleotides, rapidly dividing cells cannot replicate their DNA and are unable to divide, leading to cell death or growth arrest.
4
Anti-inflammatory effects: In autoimmune diseases, methotrexate increases extracellular adenosine, which binds to adenosine receptors on immune cells and suppresses inflammatory cytokine production.

💡 How to Take folitrax 20 injection

Strength: Immediate-release tablet, 20 mg

1Take this medicine exactly as prescribed by your doctor.
2Swallow the tablet whole with a glass of water.
3You may take it with or without food, but taking it with food may reduce stomach upset.
4Do not crush, chew, or split the tablet unless your doctor advises.
5Take it at the same time each week (or as directed) to maintain consistent levels.
6Wash your hands after handling the tablet, especially if you are pregnant or planning pregnancy.

Dosage Information

Adult DosageThe dose of this medicine is highly individualized and depends on the condition being treated, its severity, and the patient's response. For rheumatoid arthritis, a common starting dose is 7.5 mg to 20 mg once weekly, but doses may be adjusted. For psoriasis, similar weekly doses are used. For cancer, doses are much higher and are given in specialized regimens. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. Never change the dose without medical advice.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may be more sensitive to the effects of methotrexate, especially bone marrow suppression and liver toxicity. Doses should be carefully adjusted based on renal and hepatic function. Close monitoring is required.
Renal ImpairmentIn patients with renal impairment, dose reduction is necessary. Methotrexate is contraindicated in severe renal impairment. For mild to moderate impairment, doses should be reduced and monitored closely. Consult a nephrologist or clinical pharmacist for guidance.
Hepatic ImpairmentIn patients with hepatic impairment, methotrexate should be used with caution. Dose reduction may be necessary. It is contraindicated in severe liver disease. Regular liver function tests are essential.
Maximum Daily DoseThe maximum dose varies by indication. For autoimmune diseases, doses rarely exceed 25 mg per week. For cancer, doses are determined by the specific protocol. Do not exceed the dose prescribed by your doctor.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With food
Take with meals
Reduces stomach upset and nausea.
Alcohol
Avoid
Increases risk of liver damage.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of folitrax 20 injection

✅ Common Side Effects

Nausea (Common (up to 10%))
Take with food or as directed by your doctor. If nausea persists, consult your doctor.
Vomiting (Common (up to 10%))
Stay hydrated. If vomiting is severe or persistent, contact your doctor.
Stomach pain (Common (up to 10%))
Take with food. If pain is severe, seek medical advice.
Mouth sores (Common (up to 10%))
Maintain good oral hygiene. Use a soft toothbrush. Consult your doctor if sores are painful.
Fatigue (Common (up to 10%))
Get adequate rest. If fatigue is overwhelming, consult your doctor.
Headache (Common (up to 10%))
Rest and stay hydrated. If headache is severe or persistent, seek medical advice.

🚨 Serious Side Effects

Liver damage (hepatotoxicity) (Uncommon (0.1-1%))
Seek immediate medical attention if you notice yellowing of skin or eyes, dark urine, or severe abdominal pain.
Lung inflammation (pneumonitis) (Rare (<0.1%))
Seek immediate medical attention if you develop new or worsening shortness of breath, cough, or fever.
Bone marrow suppression (Uncommon (0.1-1%))
Report unusual bleeding, bruising, or signs of infection (fever, sore throat) immediately.
Kidney damage (nephrotoxicity) (Rare (<0.1%))
Seek medical attention if you notice decreased urine output or swelling in legs.
Severe skin reactions (e.g., Stevens-Johnson syndrome) (Very rare (<0.01%))
Seek immediate medical attention if you develop a rash, blisters, or peeling skin.

⚠️ Rare Side Effects

Anaphylaxis
Seek emergency medical help if you experience swelling of face, lips, throat, or difficulty breathing.
Seizures
Seek immediate medical attention if seizures occur.
Optic neuropathy
Report any vision changes to your doctor promptly.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
NSAIDs Major
Aspirin Major
Probenecid Major
Trimethoprim-sulfamethoxazole Major
Live vaccines Major
Penicillins Moderate
Cephalosporins Moderate
Phenytoin Moderate
Theophylline Moderate
Folic acid Minor

🚨 Major Interactions

  • NSAIDs (e.g., ibuprofen, naproxen)
  • Aspirin and other salicylates
  • Probenecid
  • Trimethoprim-sulfamethoxazole
  • Live vaccines

⚡ Moderate Interactions

  • Penicillins
  • Cephalosporins
  • Phenytoin
  • Theophylline

🍷 Alcohol Interaction

Alcohol should be completely avoided while taking this medicine because it increases the risk of liver damage and may worsen other side effects.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Pregnancy or breastfeeding","Severe liver disease or alcoholism","Severe kidney disease","Blood disorders such as bone marrow hypoplasia or leukopenia","Active infection","Hypersensitivity to methotrexate"]

⚠️ Warnings & Precautions

["Methotrexate should only be used under the supervision of a qualified clinician experienced in its use.","Regular blood tests are mandatory to monitor for liver, kidney, and blood toxicity.","Avoid alcohol completely during treatment.","Use effective contraception during treatment and for a period after stopping.","Do not take live vaccines while on this medicine.","Report any signs of infection, bleeding, or unusual fatigue immediately.","Avoid NSAIDs and aspirin unless specifically approved by your doctor.","Folic acid supplementation may be prescribed to reduce side effects; take only as directed."]

🤱 Lactation Safety

Methotrexate is excreted in breast milk and may harm a nursing infant. Breastfeeding is not recommended during treatment.

💊 Overdose Management

Overdose of methotrexate can cause severe bone marrow suppression, liver damage, and kidney failure. If overdose is suspected, seek emergency medical attention immediately. Treatment may include administration of leucovorin (folinic acid) and supportive care. Do not attempt to self-treat.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember if it is within a few hours of the scheduled time. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one. Consult your doctor if you are unsure.

Additional Safety Advice

General Safety

Take this medicine exactly as prescribed by your doctor. Do not change the dose or stop taking it without medical advice. Avoid alcohol completely while on this medicine, as it increases the risk of liver damage. Use effective contraception during treatment and for a period after stopping, as methotrexate can harm an unborn baby. Inform your doctor about all other medicines, vitamins, and herbal supplements you are taking. Regular blood tests to check your liver, kidney, and blood counts are mandatory. Do not take additional folic acid unless your doctor prescribes it. If you miss a dose, follow your doctor's instructions; do not double the dose.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients are at higher risk of bone marrow suppression, liver toxicity, and kidney problems. Doses should be carefully adjusted, and monitoring should be more frequent.

🤰 Pregnancy Planning (TTC)

This medicine is contraindicated in pregnancy. Women should use effective contraception during treatment and for at least 6 months after stopping. Men should use contraception for at least 3 months after treatment. Consult your doctor if you are planning pregnancy.

🏥 Post-Surgery Considerations

This medicine may affect wound healing and increase the risk of infection. Inform your surgeon that you are taking this medicine. It may need to be temporarily stopped before surgery.

🦷 Dental Procedures

Inform your dentist that you are taking this medicine, as it may affect healing and increase the risk of infection. Your dentist may recommend postponing non-urgent procedures.

💚 Lifestyle Tips for Better Results

🏃
Maintain a healthy weight to reduce joint stress.
🥗
Regular low-impact exercise like swimming or walking.
😴
Practice good posture and joint protection techniques.
💧
Include anti-inflammatory foods in your diet.
🧘
Get adequate sleep to help manage fatigue.
🌞
Avoid smoking as it can worsen autoimmune conditions.

🏋️ Exercise Considerations

While taking this medicine, you may experience fatigue or muscle weakness. Avoid strenuous exercise until you know how the medicine affects you. Low-impact exercises are generally safe and beneficial.

🥗 Diet Recommendations

Include omega-3 rich foods like fish and flaxseeds.
Reduce processed and high-sugar foods.
Stay well hydrated.
Eat a balanced diet rich in fruits and vegetables.
Avoid alcohol completely.

💼 Impact on Daily Work & Life

This medicine may cause fatigue or dizziness in some people. If you experience these, avoid driving or operating heavy machinery until you know how it affects you. Most people can continue their normal activities with dose adjustments.

🛑 When to Stop This Medicine

Do not stop taking this medicine without consulting your doctor. Stopping suddenly can cause a flare of your condition. Your doctor may stop it if you develop serious side effects or if it is no longer effective.

📅 Long-Term Use Effects

Long-term use of this medicine may increase the risk of liver damage, bone marrow suppression, and lung problems. Regular monitoring through blood tests is essential. Your doctor may adjust the dose or recommend folic acid supplements to reduce side effects. Long-term use should be periodically reassessed for benefits and risks.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Physical therapy

Can complement medicine for chronic pain and improve joint function.

Evidence: Well-established
Biologic DMARDs

Alternative for rheumatoid arthritis if methotrexate is ineffective or not tolerated.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

Live vaccines should be avoided while taking this medicine. Inactivated vaccines are generally safe, but the immune response may be reduced. Consult your doctor before any vaccination.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✈️ Traveling with This Medicine

Carry this medicine in its original packaging with a copy of your prescription. Keep it in your hand luggage to avoid temperature extremes. If traveling across time zones, consult your doctor about adjusting the dosing schedule. Ensure you have enough supply for the entire trip. Check customs regulations for carrying prescription medicines.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 52-year-old woman with rheumatoid arthritis
She was started on this medicine 20 mg once weekly. Initially, she experienced nausea, but taking it with food helped. After 8 weeks, her joint pain and swelling significantly reduced. She continues regular blood tests and avoids alcohol.
💡 Lesson: Consistent weekly dosing and taking with food improves tolerability and effectiveness.
👤 A 35-year-old man with severe psoriasis
He was prescribed this medicine after other treatments failed. His skin plaques improved over 3 months. He was advised to use contraception as his wife was planning pregnancy. He reported no major side effects with regular monitoring.
💡 Lesson: Methotrexate can be effective for psoriasis but requires strict adherence to monitoring and contraception advice.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: For autoimmune conditions, it may take 3 to 6 weeks to notice improvement, with full benefits after 3 to 6 months. For cancer, effects depend on the specific regimen.

Q: Can I take this medicine with other painkillers?

A: Some painkillers like NSAIDs can interact with this medicine and increase the risk of side effects. Always consult your doctor before taking any other medicine.

Q: What should I do if I miss a dose?

A: If you miss a dose, take it as soon as you remember if it is within a few hours. If it is almost time for your next dose, skip the missed dose. Do not double dose.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🔄 Substitutes for folitrax 20 injection

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: Methotrexate is a chemotherapy drug, so it is only for cancer.
    Fact: Methotrexate is used at much lower doses for autoimmune diseases like rheumatoid arthritis and psoriasis, where it acts as a DMARD.
  • Myth: You can stop methotrexate once you feel better.
    Fact: Methotrexate controls symptoms but does not cure the disease. Stopping suddenly can cause a flare. Always consult your doctor before stopping.
  • Myth: Methotrexate is safe to take during pregnancy.
    Fact: Methotrexate is contraindicated in pregnancy as it can cause birth defects and miscarriage.

🔄 Alternative Options

Generic Alternatives

  • Methotrexate 20 mg tablet (various manufacturers)

Brand Alternatives

  • Folitrax 20 Tablet

📊 Comparison with Similar Medicines

[{"medicine":"Methotrexate","class":"Antimetabolite/DMARD","primary_use":"Rheumatoid arthritis, psoriasis, cancer","route":"Oral, injection","monitoring":"Regular blood tests"},{"medicine":"Leflunomide","class":"DMARD","primary_use":"Rheumatoid arthritis","route":"Oral","monitoring":"Liver and blood tests"},{"medicine":"Hydroxychloroquine","class":"DMARD","primary_use":"Rheumatoid arthritis, lupus","route":"Oral","monitoring":"Eye exams"}]

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