methotrexate Drug information
Generic Name: methotrexate (meth oh TREX ate)
Brand Names: Rheumatrex Dose Pack, Trexall


What is the most important information I should know about methotrexate?
� Methotrexate should only be administered under the supervision of a qualified healthcare provider experienced in the use of this medication.
� Methotrexate may cause side effects that could be dangerous or life-threatening. Discuss with your doctor the risks and benefits of using methotrexate before starting treatment. Methotrexate has been reported to cause blood and bone marrow problems (fever, chills, sore throat, unusual bruising or bleeding, black, bloody or tarry stools,); lung problems (unexplained shortness of breath, coughing, or wheezing); stomach problems (diarrhea, abdominal pain, sores in or around the mouth); liver problems (yellow skin or eyes, unusual fatigue); kidney problems (blood in the urine; darkened urine, swelling of the feet or legs); and others. Notify your doctor immediately if you develop any of these symptoms.
� Do not take methotrexate if you are pregnant or could become pregnant during treatment. Methotrexate is in the FDA pregnancy category X. This means that it is known to 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.
� Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, Nuprin, others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox), and others except under the direction of your doctor. Although these medications may be prescribed together to treat certain conditions, methotrexate may interact with aspirin and NSAIDs, and possibly cause serious side effects. Discuss the use of aspirin and NSAIDs with your doctor.
� 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 the body. Methotrexate has a greater effect on cells that reproduce often such as cancer cells, bone marrow cells, skin cells, and others. This is how methotrexate works in the treatment of cancer and psoriasis. 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;
� blood or bone marrow problems;
� an infection;
� a stomach ulcer;
� ulcerative colitis;
� diabetes;
� fluid around the lungs or in the abdomen; 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.
� It is important for anyone receiving methotrexate to follow a medical doctor`s advice on the use of folic acid supplements.
� Do not take methotrexate if you are pregnant or could become pregnant during treatment. Methotrexate is in the FDA pregnancy category X. This means that it is known to 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.
� Methotrexate may be harmful to a nursing infant. Breast-feeding is not recommended during treatment with methotrexate.


How should I take methotrexate?
� Methotrexate should only be administered under the supervision of a qualified healthcare provider experienced in the use of this medication.
� Take oral 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 oral dose with a full glass of water.
� Methotrexate is also available as an injection. If you are using injectable methotrexate at home, your doctor will give you detailed instructions regarding preparation, administration, and storage of the medication.
� Do not take more of this medication than is prescribed. Too much methotrexate can be dangerous, possibly resulting in death. Methotrexate is used to treat different medical conditions, each with a different dosing regimen. Follow your doctor's instructions.
� It is important to take methotrexate regularly to get the most benefit.
� Your doctor may want you to have blood tests or other medical evaluations during treatment with methotrexate to monitor progress and side effects.
� 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 if an overdose is suspected.
� Symptoms of a methotrexate overdose may include nausea, vomiting, bleeding in the stomach, sores in the mouth, blood and bone marrow problems, and possibly 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), naproxen (Aleve, Naprosyn, Anaprox), and others except under the direction of your doctor. Although these medications may be prescribed together to treat certain conditions, methotrexate may interact with aspirin and NSAIDs, and possibly cause serious side effects. Discuss the use of aspirin and NSAIDs with your doctor.
� Do not drink alcohol while taking methotrexate.
� Avoid prolonged exposure to sunlight. Methotrexate may increase the sensitivity of the 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?
� Methotrexate may cause side effects that could be dangerous or life-threatening. Discuss with your doctor the risks and benefits of using methotrexate before starting treatment. Methotrexate has been reported to cause blood and bone marrow problems (fever, chills, sore throat, unusual bruising or bleeding, black, bloody or tarry stools,); lung problems (unexplained shortness of breath, coughing, or wheezing); stomach problems (diarrhea, abdominal pain); sores in or around the mouth; liver problems (yellow skin or eyes, unusual fatigue); kidney problems (blood in the urine; darkened urine, swelling of the feet or legs); and others. Notify your doctor immediately if you develop any of these symptoms.
� 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 the throat; difficulty breathing; swelling of the lips, face, or tongue; or hives);
� 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 aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, Nuprin, others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox), and others except under the direction of your doctor. Although these medications may be prescribed together to treat certain conditions, methotrexate may interact with aspirin and NSAIDs, and possibly cause serious side effects.
� Before taking methotrexate, tell your doctor if you are taking any of the following medicines:
� etretinate (Tegison);
� acitretin (Soriatane);
� theophylline (Theo-Dur, Theolair, Theochron, Elixophyllin, Slo-Phyllin, others);
� phenytoin (Dilantin);
� probenecid (Benemid);
� procarbazine (Matulane);
� 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, including vitamins, minerals, and herbal products.