Ratio-methotrexate

Brand Name:Methotrexate Injection USP, Methotrexate Sodium Injection USP, Methotrexate Tablets USP

Prescription needed: Yes

What is this drug used for?

Methotrexate is used to treat various types of cancer by interfering with cancer cell growth. It can decrease the body’s harmful response to diseases affecting the immune system. It is also used for severe psoriasis and in rheumatoid arthritis. Methotrexate may also be useful to treat other medical conditions as defined by your doctor. This medication is available in injection form and oral tablet form.

Is there any reason not to take this drug?

Do not take this drug if you are allergic to methotrexate. Do not take this medication if you are pregnant or breastfeeding. If you have psoriasis or rheumatoid arthritis, you should not take this medication if you have bone marrow disease, low blood cell count or other blood disorder, liver disease, alcohol addiction, or diseases of the immune system. Also, tell your doctor if you have or ever have had:

  • Chickenpox and/or Herpes zoster (shingles)
  • Gout
  • Infection or a weakened immune system
  • Seizures
  • Kidney disease
  • Liver disease
  • Stomach or intestinal problems
  • Ascites (fluid in the abdomen)
  • Mouth sores

What about possible side effects?

Common side effects include:

  • nausea
  • vomiting
  • dizziness
  • drowsiness
  • thin, brittle hair or temporary hair loss
  • mouth sores
  • sun sensitivity

Ask your health care professional for ways to lessen these side effects.

Do not stop using this medicine without first checking with your doctor. If any of these side effects continue or worsen, check with your doctor as well.

Call your doctor immediately if you experience any of these more serious side effects:

  • diarrhea or severe abdominal pain
  • unexplained shortness of breath, coughing
  • blood in the urine, darkened urine
  • black, tarry stools
  • swelling of the feet or legs
  • skin rash
  • seizures, muscle weakness, confusion
  • a condition called leukopenia - call your doctor immediately if you experience unexplained sore throat, fever, chills, or other signs of infection
  • a condition called thrombocytopenia - call your doctor immediately if you experience any increase in bruising or bleeding.
  • cases of hepatitis have been reported (usually dose related); call your doctor if you experience unexplained nausea, vomiting, stomach pain, fatigue, loss of appetite, dark urine, yellowing of the skin and/or eyes

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including herbal products and over-the-counter medications) as they may interact with another drug, increasing or decreasing effectiveness and safety of either or both. Tell your doctor specifically if you are taking any of these drugs as he/she may need to make changes or monitor you more closely:

  • amiodarone, antibiotics (penicillin type, ciprofloxacin, Septra) - may increase methotrexate blood levels and increase your chance of side effects
  • cyclosporine - may increase both methotrexate and cyclosporine blood levels
  • seizure medication (e.g. phenytoin) - may increase methotrexate blood levels and decreases phenytoin effects
  • other cancer treatments (e.g. cisplatin) - may increase chance of kidney side effects or liver side effects (such as azathioprine medication)

· pain medications such as Aspirin or nonsteroidal anti-inflammatory drugs NSAIDs (e.g. ibuprofen, diclofenac) may also increase the effects of methotrexate - check with your doctor

· live vaccines – may increase your chances of getting an infection

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

How to take this medication: There are many different dosing schedules for this medicine (especially for cancer treatment). Therefore it is very important that you follow your doctor’s instructions carefully. For managing psoriasis or rheumatoid arthritis, it may take up to several months of continued use before you see the full benefit of this medication.

Unless your doctor instructs you otherwise, drink plenty of fluids (non-caffeinated) while taking this medication. This helps your kidneys remove the drug from your body and minimize some of the side effects.

Managing side effects: Since your skin may burn more easily while taking this medication, it is recommended that you use sunscreen, and wear sunglasses and protective clothing to decrease the chances of this happening.

Your risk of getting an infection is higher when you take methotrexate because it can temporarily lower the number of white blood cells in your system. Proper hand washing is necessary to prevent infection.

Methotrexate can also lower the number of platelets, which are necessary for proper blood clotting. Discuss with your doctor before engaging in sports or other activities where injury could occur.

Because methotrexate causes birth defects, notify your doctor immediately if you think you are pregnant. Use birth control for both men and women. Talk to your doctor for further details.

Monitoring: Your doctor will likely order lab tests for kidney, liver or other blood tests periodically to monitor your progress and to check that this medication is not causing any side effects.

Children: For cancer treatment only. Reduced dose necessary.

Seniors: May require a reduced dosage. Side effects may be more likely to occur.

Pregnant women: Do not take as it can cause birth defects. Talk to your doctor.

Women who are nursing: This drug passes into breast milk and may harm your baby. Talk to your doctor.

People who drive or operate machinery: Should not do so until they know the impact this drug has on them personally.

Alcohol: Do not drink alcohol while using this medicine as it can increase the chance of liver problems.

Overdose: If you seriously exceed the recommended dosage, call your doctor or 911. Large doses of this drug can damage bone marrow and cause severe nausea, abdominal pain and bloody stools.

Stopping the drug: Do not stop taking this drug until you have discussed it with your doctor. Stopping abruptly may cause worsening of the underlying condition.

If you miss a dose: It is important to take each dose at the scheduled time. Do not take a double dose. Check with your doctor to establish a new dosing schedule.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom); always out of reach of children.

Dietary precautions: Take this medication with plenty of fluids unless otherwise directed by your doctor.