Methotrexate medication does not usually cause nosebleeds. If patients taking methotrexate have nosebleeds, they should be alert to the fact that overdose of methotrexate can lead to adverse drug reactions, leukemia, and dryness of the nasal mucosa. 1. Adverse drug reactions: normal consumption of methotrexate does not usually lead to nosebleeds. However, severe bone marrow suppression can occur after overdose of methotrexate, which may also lead to nosebleeds. 2. Leukemia: one of the indications for methotrexate is leukemia, so nosebleeds in leukemia patients treated with methotrexate may also be caused by leukemia itself. 3. Dry nasal mucosa: when the nasal mucosa is cracked and dry, the patient’s picking action may cause the mucosa to be broken and the symptom of nosebleed occurs. There may be other reasons for nosebleeds, methotrexate has toxicity, need to be used under the guidance of a physician, strict monitoring of the relevant indications during the drug, it is recommended that the use of methotrexate symptoms of nosebleeds to the regular hospital rheumatology and immunology, oncology and other related departments for consultation.