Harms

Problems encountered with methotrexate in these studies included dyspepsia, a rise in transaminases (55% reported by Carneiro and Sato77) and an increased rate of infection. Three of 12 patients withdrew from Wilson and Abeles'79 study because of side-effects -thrombocytopenia and elevated liver enzymes in one, persistent nausea and elevated liver enzymes in a second and recurring mouth ulcers in a third.79 Transient malaise was also reported. A thorough discussion of methotrexate toxicity has been published by McKendry.87

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