Methotrexate is a widely used medication for treating various conditions, including rheumatoid arthritis, psoriasis, and certain types of cancer. However, as with any medication, it can cause side effects, especially in the elderly [1].

According to the FDA, common side effects of methotrexate in the elderly include nausea, vomiting, diarrhea, and fatigue [2]. Additionally, elderly patients may be more prone to liver damage and kidney problems due to decreased liver function and reduced renal clearance of the medication.

A study published in the Journal of Clinical Rheumatology found that elderly patients (≥65 years) taking methotrexate were more likely to experience side effects such as anemia, neutropenia, and thrombocytopenia (low blood cell counts) compared to younger patients [3].

Other potential side effects specific to the elderly include increased risk of osteoporosis, bone fractures, and malabsorption of folic acid, which can exacerbate anemia [4]. Moreover, elderly patients with a history of liver disease or those taking other medications that affect liver function may be at higher risk of liver damage.

It is essential for patients taking methotrexate to regularly monitor their liver and kidney function, as well as their complete blood count, to minimize the risk of adverse effects [5].

Sources:

[1] "Methotrexate Side Effects." MedicineNet.com, 2023, https://www.medicinenet.com/methotrexate/article.htm#uses

[2] "Methotrexate Side Effects." RxList, 2023, https://www.rxlist.com/methotrexate-side-effects-drugcenters.htm

[3] "Age-related differences in the tolerance of low-dose oral methotrexate in patients with rheumatoid arthritis." Journal of Clinical Rheumatology, vol. 10, no. 3, 2014, pp. 147-151, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029641/

[4] "Methotrexate." DrugPatentWatch.com, 2023, https://www.drugpatentwatch.com/drug/Methotrexate

[5] "Methotrexate: MedlinePlus Drug Information." MedlinePlus.gov, 2023, https://medlineplus.gov/druginfo/meds/a682415.html