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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.

General medical information 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 you should find out 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.

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 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.

If you miss a dose:

Contact your doctor if you miss a dose of Methotrexate.

What happens if you 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.

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.

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);
- 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, including vitamins, minerals, and herbal products.

All prescription drugs:

A
abilify accupril accutane acetaminophen aciphex actifed actonel actos acyclovir adalat adderall adipex advair advil albuterol alesse aleve allegra allopurinol amaryl ambien amiodarone amitriptyline amoxicillin amoxil amphetamine anacin aprazolam aricept asacol aspirin atenolol ativan atorvastatin atrovent augmentin avandia avapro avastin avelox azmacort
B
baclofen
bactrim bactroban baycol benadryl bextra biaxin boniva bontril buspar buspirone
C
caduet campral camptosar capoten captopril cardizem cardura carisoprodol casodex catapress cefzil celebrex celexa cellcept cephalexin cialis cipro ciprodex clarinex claritin climara clindamycin clonazepam clonidine codeine codeprex combivent combivir concerta copaxone coreg coricidin cotrim coumadin cozaar crestor cubicin cyclobenzaprine cymbalta
D
darvocet demerol depakote desogen detrol dextromethorphan diazepam diclofenac didrex diflucan digoxin dilantin diltiazem dimetapp diovan diprivan ditropan doxazosin doxycycline drixoral duragesic dyazide
E
effexor elavil elocon eloxatin emend enalapril enbrel endocet engerix-b entex epogen epzicom erbitux ertaczo ery-tab erythromycin estradiol evista 
F
fabrazyme famotidine fazaclo fenofibrate fioricet fiorinal flexeril flomax flonase flovent fluoxetine fosamax fosrenol furosemide  
G
gabapentin gamimune gemfibrozil gemzar glipizide glucophage glucotrol glucovance glyburide glyburide guaifenesin guaifenex 
H
herceptin humalog humira hydroxyzine hyzaar  
I
ibuprofen imdur imitrex imodium inderal insulin integrilin iressa 
K
kaletra keflex kenalog keppra ketek klonopin kytril  
L
lamictal lamisil lanoxin lantus lasix lescol levaquin levitra levothyroxine levoxyl lexapro lidoderm lipitor lisinopril lithium lorazepam lortab lotensin lotrel lotrisone lovenox lupron luveris  
M
macrobid magnevist meclizine medroxyprogesterone meridia metformin methadone methamphetamine methotrexate methylphenidate methylprednisolone metoclopramide metoprolol metronidazole miacalcin minocycline mobic monopril morphine motrin myfortic  
N
naproxen nasacort nasonex natrecor neulasta neupogen neurontin nexium nifedipine nitrofurantoin norco nortriptyline norvasc  
O
omeprazole omnicef orthovisc oxybutynin oxycodone oxycontin oxytrol  
P
paraplatin patanol paxil pegasys penicillin pepcid percocet percodan percogesic phendimetrazine phenergan phentermine phenytoin plavix plendil potassium pravachol prednisone premarin prempro prevacid prilosec prinivil procrit promethazine propecia propofol propoxyphene propranolol protonix proventil provigil prozac pseudoephedrine pulmicort  
R
ranitidine rebetol reglan relafen relpax remeron remicade renagel renova rhinocort riomet risperdal risperidone ritalin rituxan rocephin rogaine roxicet  
S
sanctura seasonale sensipar serevent seroquel serzone singulair skelaxin soma somavert sonata spiriva spironolactone strattera striant sustiva synagis synthroid 
T
tamoxifen tavist taxol taxotere tegretol temazepam tenormin tenuate tequin terazosin tetracycline tiazac tindamax titralac tobradex topamax toprol tramadol trazodone triamcinolone triaminic triamterene tricor trileptal trimox triphasil trizivir truvada tylenol 
U
ultane ultracet ultram uroxatral
V
valium valtrex vaniqa vasotec velcade verapamil viagra vicodin vicoprofen vidaza viracept viread vytorin  
W
warfarin wellbutrin  
X
xalatan xanax xenical xifaxan xolair xopenex xyrem  
Y
yasmin 
Z
zanaflex zantac zavesca zelnorm zemplar zerit zestoretic zestril zetia ziac zithromax zocor zofran zoladex zoloft zometa zorbtive zosyn zovirax zyrtec zyvox