I am on plaquenil. But a friend of mine has been on methotrexate for years. It has worked for her. She has had little of side effects. Here is some info I found on it.
The most common side effect of methotrexate is nausea. The nausea from methotrexate use often disappears on its own though and may be controlled by lowering the dose or spreading the dose out.
The drug can cause hidden problems too and tests are done to monitor whether or not these problems are occurring. Complete blood counts are done since methotrexate can suppress the production of new blood cells and lead to severe forms of anemia. Liver-chemistry profiles are done to watch for possible effects on the liver. Liver damage is among the worst potential problems since once the damage is done it is irreversible. Since most serious damage to the liver is not revealed in a blood test, a liver biopsy may be recommended periodically.
Another potential threat from methotrexate use is lung disease. Dry cough accompanied by fever and shortness of breath could indicate such a problem. Some people who use methotrexate develop sores on their skin and inside their mouths. These are signs of a toxic reaction to the drug and its use may need to be discontinued.
Wish you the best,
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