Methotrexate
Methotrexate Pronunciation: meth oh TREX ate
Brand Names: Rheumatrex Dose Pack, Trexall
Important Information Description
Who should not take it?
How should I take it?
What happens if I miss a dose?
What happens if I overdose?
What should I avoid while taking it?
What are the side effects?
What other drugs will affect it?
Where can I get more information?
Brand Names
What is the most important information I should know about methotrexate?
• Do not take more of this medication than is prescribed for you. Too much methotrexate can lead to death. For the treatment of psoriasis and rheumatoid arthritis, one dose of methotrexate is usually taken once a week. Alternatively, the dose is divided into three parts, which are taken at 12-hour intervals each week. Follow your doctor's instructions very closely.
• Notify your doctor immediately if you develop fever; chills; a sore throat; unusual bruising or bleeding; unexplained shortness of breath, coughing, or wheezing; diarrhea; abdominal pain; black, tarry stools; sores in or around the mouth; yellow skin or eyes; blood in the urine; darkened urine; swelling of the feet or legs; or joint pain. These symptoms could be early signs of dangerous side effects.
• Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, Nuprin, others), ketoprofen (Orudis KT, Orudis, Oruvail), or naproxen (Aleve, Naprosyn, Anaprox) without first talking to your doctor. A dangerous drug interaction could result, possibly leading to death.
• Do not drink alcohol while taking methotrexate.
What is methotrexate?
• Methotrexate interferes with the production and maintenance of DNA, which is the genetic material in the cells of your body. Methotrexate has a greater effect on cells that reproduce often such as cancer cells, bone marrow cells, fetal cells, skin cells, the cells lining the mouth and intestines, and cells of the bladder. It is not known exactly how methotrexate works in the treatment of rheumatoid arthritis.
• Methotrexate is used to treat certain types of cancer, psoriasis, and rheumatoid arthritis.
• Methotrexate may also be used for purposes other than those listed in this medication guide.
What should I discuss with my healthcare provider before taking methotrexate?
• Before taking methotrexate, tell your doctor if you have
· liver disease or a history of liver problems;
· kidney disease;
· alcoholism or alcoholic liver disease;
· an immune system disorder;
· an infection;
· a stomach ulcer;
· ulcerative colitis;
· diabetes;
· fluid around your lungs or in your abdomen;
· blood problems; or
· asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, or any other lung disease.
• You may not be able to take methotrexate, or you may require a dosage adjustment or special monitoring during therapy if you have any of the conditions listed above.
• Do not take this medication if you are pregnant. Methotrexate is in the FDA pregnancy category X. This means that it will cause birth defects in an unborn baby. Methotrexate can affect a baby both when a woman is treated and when a man is treated. If the woman is being treated with methotrexate, pregnancy must be avoided during treatment and for one ovulatory cycle following treatment. If the man is being treated with methotrexate, pregnancy must be avoided during treatment and for 3 months following treatment.
• Since methotrexate may harm a nursing infant, breast-feeding is not recommended during treatment with methotrexate.
How should I take methotrexate?
• Take methotrexate exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Do not take more of this medication than is prescribed for you. Too much methotrexate can lead to death. For the treatment of psoriasis and rheumatoid arthritis, one dose of methotrexate is usually taken once a week. Alternatively, the dose is divided into three parts, which are taken at 12-hour intervals each week. Follow your doctor's instructions very closely.
• Your doctor will want you to have regularly scheduled blood tests while taking methotrexate.
• Store methotrexate at room temperature away from moisture and heat.
What happens if I miss a dose?
• Contact your doctor if you miss a dose of methotrexate.
What happens if I overdose?
• Seek emergency medical attention.
• A methotrexate overdose can lead to death.
What should I avoid while taking methotrexate?
• Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, Nuprin, others), ketoprofen (Orudis KT, Orudis, Oruvail), and naproxen (Aleve, Naprosyn, Anaprox) without first talking to your doctor. A dangerous drug interaction could result, possibly leading to death.
• Do not drink alcohol while taking methotrexate.
• Avoid prolonged exposure to sunlight. Methotrexate may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.
What are the possible side effects of methotrexate?
• If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:
· an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);
· fever or chills;
· a sore throat;
· unusual bleeding or bruising;
· unexplained shortness of breath, coughing, or wheezing;
· diarrhea;
· abdominal pain;
· black, tarry stools;
· sores in or around the mouth;
· yellow skin or eyes;
· blood in the urine;
· darkened urine;
· swelling of the feet or legs;
· joint pain; or
· confusion, unusual behavior, or seizures.
• Other, less serious side effects may be more likely to occur. Continue to take methotrexate and notify your doctor if you experience
· nausea, vomiting, or decreased appetite;
· itching or a skin rash;
· hair loss;
· boils or acne;
· dizziness;
· increased sensitivity of the skin to sunlight;
· headache;
· drowsiness; or
· blurred vision.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect methotrexate?
• Do not take methotrexate without first talking to your doctor if you are taking any of the following medicines:
· aspirin; or
· a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin, Nuprin, others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox), indomethacin (Indocin), oxaprozin (Daypro), sulindac (Clinoril), tolmetin (Tolectin), ketorolac (Toradol), diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), nabumetone (Relafen), or piroxicam (Feldene).
• The medicines listed above may interact dangerously with methotrexate. Death could result. Your doctor will need to monitor your treatment if you need to take any of these medicines.
• Before taking methotrexate, tell your doctor if you are taking any of the following medicines:
· etretinate (Tegison);
· theophylline (Theo-Dur, Theolair, Theochron, Elixophyllin, Slo-Phyllin, others);
· phenytoin (Dilantin);
· probenecid (Benemid);
· procarbazine (Matulane);
· folic acid or a vitamin supplement that contains folic acid;
· a penicillin antibiotic such as ampicillin (Principen, others), amoxicillin (Amoxil, Trimox, Augmentin, others), dicloxacillin (Dynapen, others), penicillin (Pen-Vee-K, Veetids, others), and others;
· a tetracycline antibiotic such as minocycline (Minocin, Dynacin, others), doxycycline (Vibramycin, Vibra-Tabs, others), tetracycline (Sumycin, others), and others; or
· a sulfa-based medicine such as sulfamethoxazole (Bactrim, Septra, Sulfatrim, Gantanol), sulfisoxazole (Gantrisin), and others.
• You may not be able to take methotrexate, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with methotrexate. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.
Where can I get more information?
• Your pharmacist has additional information about methotrexate written for health professionals that you may read.