Methotrexate is used in the treatment of many health conditions such as rheumatoid arthritis, psoriasis and cancers. This drug suppresses the immune system and slows down the growth of cancer cells. However, use of methotrexate may lead to harmful effects such as those listed below. Common side effects of methotrexate include mouth ulcers, headache, dizziness, fatigue and allergy reaction. Use of methotrexate may weaken your immune system and impair your ability to fight infections as they work by suppressing the immune system. Besides, if used together with high dose of non-steroidal anti-inflammatory drugs, it may increase your risk of developing gastrointestinal problems such as gastric ulcers, nausea, vomiting and abdominal pain. Also, this drug can cause liver fibrosis and cause liver disease in the long run. Therefore, routine liver function tests are needed to monitor the liver function. Other harmful effects of methotrexate include tumour lysis syndrome, birth defects or death of the unborn baby.