Trexall (methotrexate) is a prescription oral tablet that’s used to treat certain types of cancer, rheumatoid arthritis, and psoriasis. How often you take Trexall depends on the condition it’s being used to treat.

Trexall is used to treat:

The active ingredient in Trexall is methotrexate. (An active ingredient is what makes a drug work.) Trexall belongs to a group of drugs called disease-modifying anti-rheumatic drugs (DMARDs).

This article describes the dosages of Trexall, as well as its strengths and how to take it. To learn more about Trexall, see this in-depth article.

This section describes the usual dosages of Trexall. Keep reading to learn more.

What is Trexall’s form?

Trexall comes as an oral tablet.

What strengths does Trexall come in?

Trexall comes in four strengths:

  • 5 milligrams (mg)
  • 7.5 mg
  • 10 mg
  • 15 mg

What are the usual dosages of Trexall?

Your doctor will start you on the recommended dosage of Trexall based on the condition it’s being used to treat, your age, and other factors. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Dosage for cancer

The dosage of Trexall prescribed to treat cancer depends on the type of cancer and its severity, your body weight and height, and other medications you may be taking. See below for more details.

Dosage for acute lymphoblastic leukemia: The typical starting dose of Trexall for adults with acute lymphoblastic leukemia (ALL) is based on your body surface area, which is measured in meters squared (m2). The Trexall starting dosage is 20 mg per m2 taken once per week. Your doctor will calculate the right dosage for you.

Trexall is taken with other chemotherapy medications to treat cancer. Your doctor will do regular blood tests to check your blood cell counts while you’re taking Trexall. If needed, your doctor will adjust your dose based on your body’s response to the drug. For example, your dose may be changed if your blood cell counts fall too low, including if you develop myelosuppression. Or you may need a dosage adjustment if you have bothersome side effects during treatment.

Dosage for mycosis fungoides: The typical starting dosage of Trexall for mycosis fungoides when taken on its own is 25–75 mg taken once per week. Your doctor will likely start you on a low dose and increase your dose slowly until you reach the right amount to treat your condition. Ultimately, they’ll prescribe the lowest dose that provides the desired effect.

If Trexall is taken with other chemotherapy medications, the dosage is based on your body surface area. The dosage is 10 mg/m2 taken twice per week. Your doctor will calculate the right dosage for you.

Dosage for advanced non-Hodgkin’s lymphoma: The typical dosage of Trexall for advanced non-Hodgkin’s lymphoma is 2.5 mg taken two to four times per week, with a maximum dosage of 10 mg per week. For this use, Trexall is taken with other chemotherapy drugs.

Dosage for rheumatoid arthritis

For adults with rheumatoid arthritis, the typical starting dosage of Trexall is 7.5 mg taken once per week. Your doctor may slowly increase your dose until you reach the right dosage to manage your condition.

Taking a dosage greater than 20 mg once per week increases your risk of serious side effects, including myelosuppression.

Your doctor may suggest taking a folic acid supplement to lower your risk of side effects from Trexall. This is because having low folate levels can raise your risk of side effects from the drug.

Dosage for psoriasis

For adults with psoriasis, the typical dosage of Trexall is 10–25 mg taken once per week. Your doctor will likely start you on a low dose and slowly increase your dose until you reach the right amount to manage your condition. They’ll ultimately prescribe the lowest dose to treat your condition. For psoriasis, doses greater than 30 mg per week are not recommended, as it raises your risk of serious side effects.

Your doctor may recommend a folic acid supplement during your Trexall treatment to lower your risk of side effects.

What’s the dosage of Trexall for children?

Trexall is used to help treat ALL in children. The dosage for this use in children is based on the severity of their condition and their body weight and height. Your child’s doctor will calculate their dosage.

Trexall is also used to treat polyarticular juvenile idiopathic arthritis (JIA) in children ages 2 years and older. See below for details.

Dosage for polyarticular JIA

The Trexall dosage for polyarticular JIA is based on your child’s body surface area, which is measured in meters squared (m2). The starting dosage is 10 mg/m2 taken once per week. Your child’s doctor will calculate their dosage.

Your child’s doctor will likely start them on a low dose and slowly increase the dose until they reach the right amount to manage their condition. Doses higher than 30 mg/m2 are not recommended for polyarticular JIA, as this increases the risk of serious side effects, including myelosuppression.

Your child’s doctor may recommend a folic acid supplement to lower the risk of side effects from Trexall.

For more information about Trexall’s dosage for children, talk with your child’s doctor or a pharmacist.

Is Trexall used long term?

It’s possible. Trexall may be used as a long-term treatment for rheumatoid arthritis or psoriasis if the medication is working effectively for your condition. Your doctor will discuss the benefits and possible risks of long-term use of Trexall for these conditions.

If you take Trexall for cancer, your doctor will discuss your treatment plan and how long you’ll likely take Trexall.

Talk with your doctor if you have questions about how long you’ll likely take Trexall.

Dosage adjustments

In some cases, your doctor may need to adjust your dosage of Trexall. This depends on your condition, Trexall’s dosage, other medications you may be taking, your response to treatment, and side effects you may experience.

Trexall can cause serious side effects. Your doctor will typically prescribe the lowest dose to manage your condition. They’ll monitor you carefully during treatment and may adjust your dose if needed. They may also have you stop taking the drug temporarily or permanently if you experience serious side effects.

If you have questions about your dosage and any dosage adjustments you may need, talk with your doctor.

The dosage of Trexall you’re prescribed may depend on several factors. These include:

  • the type and severity of the condition you’re using the drug to treat
  • age (for children taking the drug)
  • body weight and height
  • other medications you may be taking
  • other conditions you may have (see the “Dosage adjustments” section above)

Trexall comes as an oral tablet. How often you take the drug depends on the condition it’s being used to treat. Trexall is typically not taken every day. It’s important to follow your doctor’s directions on how to take the medication, because the drug can cause serious side effects. Taking too much Trexall can be fatal.

You should not crush, cut, or chew Trexall tablets. Swallow them whole. You can take the medication with or without food.

If your doctor prescribes a once-weekly dose of Trexall, take the medication on the same day and around the same time of day each week.

If you have trouble swallowing tablets, see this article for tips on how to take this form of medication.

For information on the expiration, storage, and disposal of Trexall, talk with your doctor or pharmacist.

Accessible drug containers and labels

Some pharmacies provide medication labels that:

  • have large print
  • use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

Let your pharmacist know if you have trouble opening medication bottles. They may have tips to help, or they may be able to supply Trexall in an easy-open container. Trexall has serious side effects. It’s important to store the medication in a secure location away from children and pets.

If you miss a dose of Trexall, call your doctor’s office. They can advise you on what to do about a missed dose. You should not take two doses of Trexall at once to make up for a missed dose. This can cause serious side effects.

If you need help remembering to take your dose of Trexall on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

Do not take more Trexall than your doctor prescribes, as this can lead to harmful effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

  • drop in blood cell counts, which can lead to fever, bruising or bleeding easily, and fatigue
  • nausea and vomiting
  • diarrhea
  • stomatitis (painful mouth sores)
  • ulcers (sores) or bleeding in your digestive system

What to do in case you take too much Trexall

Call your doctor right away if you think you’ve taken too much Trexall. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Below are answers to some commonly asked questions about Trexall’s dosage.

Is Trexall’s dosage similar to the dosages of Humira?

No. Although the drugs are used to treat some of the same conditions, the forms, dosages, and how often you take each drug are different. Trexall and adalimumab (Humira) are both used to treat rheumatoid arthritis, psoriasis, and juvenile idiopathic arthritis, but they also have other uses.

Humira is a biologic drug made from living cells. Trexall belongs to a group of drugs called disease-modifying anti-rheumatic drugs (DMARDs), and it’s not a biologic.

Trexall comes as an oral tablet. The dosage depends on the condition the drug is being used to treat and other factors.

Humira comes as a liquid solution that’s injected under your skin. Humira’s dosage depends on the condition it’s being used to treat and other factors.

Your doctor will prescribe the drug and the dosage that’s right for you. To learn more about how these drugs compare, talk with your doctor. (And to learn more about Humira’s dosage, see this article.)

How long does it take for Trexall to start working?

Trexall starts to work after your first dose. But how long it takes to ease your symptoms can vary based on several factors. These include how your body responds to the drug, the condition you’re using it to treat, and the severity of your condition.

For example, most people taking Trexall for rheumatoid arthritis, psoriasis, or juvenile idiopathic arthritis see their symptoms begin to ease within 3–6 weeks after starting treatment. But it may take up to 12 weeks for some people with these conditions to notice the effects of the drug.

How long it takes Trexall to work in people with cancer is not known. This depends on the type of cancer and its severity. If you take Trexall for cancer, you likely won’t notice the drug working in your body.

If you have other questions about what to expect from your Trexall treatment, talk with your doctor.

The sections above describe the usual dosages provided by Trexall’s manufacturer. If your doctor recommends this drug, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Trexall without your doctor’s recommendation. Only take Trexall exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • Will you lower my dosage if I lose weight while taking Trexall?
  • How does the dosage of Trexall compare with that of etanercept (Enbrel)?
  • Will I need a dosage adjustment for Trexall if I’m also taking an antacid?

To learn more about Trexall, see this article.

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.