ASK THE EXPERT - RA, methotrexate, and anemia

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s Hopkins Arthritis Center

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Last updated 09 Apr 2007

Question:

Dear sir,

I want to know that what should be the minimum level of haemoglobin to

start the methotrexate ?

Answer:

There is no minimum level. The critical question is why is the

hemoglobin low (anemia). Methotrexate at the doses used for RA rarely

is the cause of anemia. However, if the reason for the anemia is bone

marrow failure, then I would be concerned about methotrexate use.

Inflammation can cause anemia and thus in those instances,

methotrexate might actually help.

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Not an MD