Methotrexate (By mouth)
Treats bone, lung, breast, head, neck, or cancer of the blood. Also treats acute lymphoblastic leukemia in children (ALL). Also treats rheumatoid arthritis and psoriasis (a skin disease). Also used in the management of active polyarticular juvenile idiopathic arthritis (pJIA).
Trexall, XatmepThere may be other brand names for this medicine.
When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to methotrexate, or if you are pregnant or breastfeeding.
How to Use This Medicine:
- Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
- Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
- Oral liquid: Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
- This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
- Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. If you use this medicine only once a week and you miss a dose or forget to use your medicine, skip the missed dose and use your medicine as soon as possible. Return to your regular schedule the following week. Do not use extra medicine to make up for a missed dose.
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Some medicines can affect how methotrexate works. Tell your doctor if you are using any of the following:
- Azathioprine, cisplatin, phenytoin, probenecid, sulfasalazine, theophylline, or a retinoid
- Medicines to treat infection (including penicillin, sulfamethoxazole, trimethoprim)
- NSAIDs (including aspirin, diclofenac, ibuprofen, naproxen)
- Other cancer medicines, including radiation treatment
- Steroid medicines
- Vitamin supplements that contain folic acid
- Do not drink alcohol while you are using this medicine.
- This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.
Warnings While Using This Medicine:
- This medicine may cause birth defects if either partner is using it during conception or pregnancy. Tell your doctor right away if you or your partner becomes pregnant. Men should continue birth control for at least 3 months after the last dose. Women should continue birth control for at least 6 months after the last dose.
- This medicine could cause infertility. Talk with your doctor before using this medicine if you plan to have children.
- Tell your doctor if you have kidney disease, liver disease, bone marrow problems (such as anemia), diabetes, a weak immune system, any type of infection, stomach ulcers, or a history of alcohol abuse.
- This medicine may cause the following problems:
- Stomach or bowel problems, including ulcer or perforation
- Liver problems
- Lung or breathing problems
- Serious skin reactions
- Increased risk of other cancers
- This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
- This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
- Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
- Keep all medicine out of the reach of children. Never share your medicine with anyone.
Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Blistering, peeling, red skin rash
- Change in how much or how often you urinate, lower back or side pain
- Chest pain, trouble breathing, blue lips or fingers
- Dark urine or pale stools, nausea, vomiting, diarrhea, loss of appetite, stomach pain, yellow skin or eyes
- Fever, chills, cough, sore throat, and body aches
- Seizures, confusion, tingling or numbness in your hands, feet, or lips, trouble seeing, headache
- Unusual bleeding, bruising, or weakness
If you notice these less serious side effects, talk with your doctor:
- Mild diarrhea, nausea, vomiting, stomach pain
- Sores or white patches on your lips, mouth, or throat
If you notice other side effects that you think are caused by this medicine, tell your doctor
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088
Last Updated: 3/4/2018
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