The symptoms of methotrexate toxicity vary but may include gastrointestinal upset, such as nausea, vomiting, and diarrhea. Hematological effects like leukopenia, anemia, and thrombocytopenia are common, along with mucositis or oral ulcers. Severe cases can lead to liver damage, pulmonary toxicity, and renal failure. Neurological symptoms such as headaches, dizziness, and confusion are also possible.