Low-dose methotrexate has been used for decades in the management of autoimmune conditions including rheumatoid arthritis. While long used orally as a once weekly dose, pharmacists are increasingly seeing methotrexate used weekly as a subcutaneous injection, administered by the patient or their carer. Pharmacists should be able to counsel patients on the mode of action, as well as both the oral and subcutaneous use, of this medication.