METHOTREXATE (METH oh TREX ate) is a chemotherapy drug used to treat cancer including breast cancer, leukemia, and lymphoma. This medicine can also be used to treat psoriasis and certain kinds of arthritis.
This medicine is for infusion into a vein or for injection into muscle or into the spinal fluid (whichever applies). It is usually given by a health care professional in a hospital or clinic setting.
In rare cases, you might get this medicine at home. You will be taught how to give this medicine. Use exactly as directed. Take your medicine at regular intervals. Do not take your medicine more often than directed.
If this medicine is used for arthritis or psoriasis, it should be taken weekly, NOT daily.
It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or healthcare provider to get one.
Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 2 years for selected conditions, precautions do apply.
Side effects that you should report to your doctor or health care professional as soon as possible:
allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
breathing problems or shortness of breath
dry, nonproductive cough
low blood counts - this medicine may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk of infections and bleeding
redness, blistering, peeling or loosening of the skin, including inside the mouth
signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine
signs and symptoms of bleeding such as bloody or black, tarry stools; red or dark-brown urine; spitting up blood or brown material that looks like coffee grounds; red spots on the skin; unusual bruising or bleeding from the eye, gums, or nose
signs and symptoms of kidney injury like trouble passing urine or change in the amount of urine
signs and symptoms of liver injury like dark yellow or brown urine; general ill feeling or flu-like
symptoms; light-colored stools; loss of appetite; nausea; right upper belly pain; unusually weak or tired; yellowing of the eyes or skin
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
This medicine may interact with the following medications:
aspirin or aspirin-like medicines including salicylates
certain antibiotics like chloramphenicol, penicillin, tetracycline
certain medicines for stomach problems like esomeprazole, omeprazole, pantoprazole
live virus vaccines
NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
other cytotoxic agents
retinoids such as isotretinoin and tretinoin
steroid medicines like prednisone or cortisone
sulfonamides like sulfasalazine and trimethoprim/sulfamethoxazole
It is important not to miss your dose. Call your doctor or health care professional if you are unable to keep an appointment. If you give yourself the medicine and you miss a dose, talk with your doctor or health care professional. Do not take double or extra doses.
If you are using this medicine at home, you will be instructed on how to store this medicine. Throw away any unused medicine after the expiration date on the label.
They need to know if you have any of these conditions:
fluid in the stomach area or lungs
if you often drink alcohol
infection or immune system problems
low blood counts, like low white cell, platelet, or red cell counts
an unusual or allergic reaction to methotrexate, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
Avoid alcoholic drinks.
In some cases, you may be given additional medicines to help with side effects. Follow all directions for their use.
This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.
You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.
You may need blood work done while you are taking this medicine.
Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.
This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding.
Check with your doctor or health care professional if you get an attack of severe diarrhea, nausea and vomiting, or if you sweat a lot. The loss of too much body fluid can make it dangerous for you to take this medicine.
Talk to your doctor about your risk of cancer. You may be more at risk for certain types of cancers if you take this medicine.
Both men and women must use effective birth control with this medicine. Do not become pregnant while taking this medicine or until at least 1 normal menstrual cycle has occurred after stopping it. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. Men should not father a child while taking this medicine and for 3 months after stopping it. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.