METHOTREXATE (Rheumatrex®) is a chemotherapy agent that is used to treat certain kinds of cancer and other diseases. Methotrexate tablets are commonly used to treat inflammatory conditions such as rheumatoid arthritis and psoriasis. Methotrexate affects cells that are rapidly growing such as cancer cells, cells of psoriasis, and cells in your mouth and stomach. Methotrexate is used in treating a number of cancers including leukemias, lymphoma, breast cancer, and others. Generic methotrexate tablets are available.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions: • If you are HIV-positive or have acquired immunodeficiency syndrome (AIDS) • If you frequently drink alcohol-containing beverages • bleeding or blood disorders • cold sores or previous chickenpox or shingles infection • gout • an active infection • kidney disease, including a history of kidney stones • liver disease • lung disease • recent radiation therapy or sunburn • stomach or intestinal disease or obstruction • ulcerative colitis • an unusual or allergic reaction to methotrexate, other chemotherapy, other medicines, foods, dyes, or preservatives • pregnant or trying to get pregnant • breast-feeding
How should I take this medicine?
Take methotrexate tablets by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. Do not take your medicine more often than directed. Finish the full course prescribed by your doctor or health care professional, even if the tablets make you feel unwell. Do not stop taking except on your prescriber's advice.
The dose of methotrexate and how often it will be given may be different depending upon your disease and other medicines you are taking. If you have questions about the proper dose of your medicine, ask your prescriber or other health care professional.
What if I miss a dose?
If you miss a dose, skip that dose unless you remember within an hour or two, or your prescriber or health care professional tells you otherwise. Do not take double or extra doses. If you vomit after taking a dose, call your prescriber or health care professional for advice.
What drug(s) may interact with methotrexate?
• anti-inflammatory drugs (NSAIDs, such as ibuprofen) • antibiotics and other medicines for infections • aspirin and aspirin-like medicines including bismuth subsalicylate (e.g. Pepto-Bismol®) • cholestyramine • dapsone • leucovorin • medicines for diabetes • pemetrexed • phenytoin or fosphenytoin • probenecid • pyrimethamine • trimetrexate • vaccines
Tell your prescriber or health care professional about all other medicines that you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What side effects may I notice from taking methotrexate tablets?
Side effects will vary depending on the condition for which you are being treated, the dose, and the length of time you are taking methotrexate. If you want more information on possible side effects, ask your prescriber or health care professional to discuss this with you.
Side effects that you should report to your prescriber or health care professional as soon as possible: • symptoms of infection - fever or chills, cough, sore throat, pain or difficulty passing urine • symptoms of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine • symptoms of decreased red blood cells (anemia) - unusual weakness or tiredness, fainting spells, lightheadedness • diarrhea • difficulty breathing, a non-productive cough • mouth and throat ulcers • redness, blistering, peeling or loosening of the skin, including inside the mouth • skin rash, hives, or itching • changes in vision • vomiting • yellow coloring of skin or eyes
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome): • hair loss • increased sensitivity to sun and ultraviolet light • loss of appetite • nausea
What should I watch for while taking methotrexate tablets?
Visit your prescriber or health care professional for checks on your progress. You will need to have regular blood checks. The side effects of methotrexate can continue after you finish your treatment; report side effects promptly. It may take several weeks before you see an improvement in your rheumatoid arthritis or psoriasis.
Avoid alcohol-containing beverages while taking methotrexate. Methotrexate therapy for rheumatoid arthritis and psoriasis may cause damage to your liver. Your prescriber or health care professional will closely monitor your liver function while you are taking methotrexate. You may need to have a liver sample (a biopsy) taken before you receive methotrexate and during your therapy for rheumatoid arthritis or psoriasis.
Methotrexate may make you feel generally unwell. This is because methotrexate affects good cells as well as the disease cells. Report any side effects as above, but continue your course of medicine even though you feel ill, unless your prescriber or health care professional tells you to stop.
Methotrexate may decrease your body's ability to fight infections. Call your prescriber or health care professional if you have a fever, chills, sore throat or other symptoms of a cold or flu. Do not treat these symptoms yourself. Try to avoid being around people who are sick.
Methotrexate may harm your unborn baby. You should contact your prescriber immediately if you believe or suspect you or your partner have become pregnant while you are taking methotrexate. Both men and women must use effective birth control continuously while taking methotrexate. It is recommended that you use 2 reliable forms of contraception together. Men should continue to use contraception for at least 3 months after stopping methotrexate therapy. Women should continue to use contraception until after their first normal menstrual cycle after stopping methotrexate therapy.
If you are going to have surgery or dental work, tell your surgeon, dentist, or health care professional that you are taking methotrexate.
Methotrexate may cause you to more sensitive to the sun. Also methotrexate may cause a previous sunburn or radiation therapy reaction to reappear. Keep out of the sun, or wear protective clothing outdoors and use a sunscreen. Do not use sun lamps or sun tanning beds or booths.
Where can I keep my medicine?
Keep out of the reach of children in a container that small children cannot open.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Throw away any unused medicine after the expiration date.