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|Methotrexate

Methotrexate

Methotrexate is used for:

Treating certain types of cancer. It is also used to control severe psoriasis and severe rheumatoid arthritis.

Methotrexate is an antimetabolite that blocks an enzyme important in DNA synthesis. This slows the rate of cell production and development in tissues, which are growing at an abnormally fast rate. How Methotrexate works in rheumatoid arthritis is not completely understood. It may suppress the immune system, which produces chemicals causing inflammation (eg, swelling, pain, stiffness, warmth) of rheumatoid arthritis.

Do NOT use Methotrexate if:

• you are allergic to any ingredient in Methotrexate
• you have anemia or another blood disease, low white cell count or low platelet count in your blood, bone marrow depression, or a suppressed immune system
• you have alcoholism, alcoholic liver disease, or chronic liver disease
• you have severe kidney disease
• you are pregnant or are breast-feeding
• you are taking acitretin

Contact your doctor or health care provider right away if any of these apply to you.

Before using Methotrexate :

Some medical conditions may interact with Methotrexate . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are planning to become pregnant
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have fluid in your stomach; excess fluid around your lungs; an obstruction of your intestines or colon; liver disease; an infection; a swelling, irritation, or ulceration of your digestive tract; kidney disease; nausea or vomiting; a folic acid deficiency; a peptic ulcer; chickenpox; shingles; or ulcerative colitis
• if you are receiving chemotherapy or radiation, abuse alcohol, or are debilitated or dehydrated

Some MEDICINES MAY INTERACT with Methotrexate . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, naproxen) because the risk of side effects, some possibly fatal, may be increased
• Certain medicines that can cause liver problems (eg, acitretin, azathioprine, etretinate, sulfasalazine) because they may increase the risk for liver problems with Methotrexate
• Cisplatin, corticosteroids (eg, prednisone), cyclosporine, hydantoins (eg, phenytoin), many antibiotics (eg, chloramphenicol, ciprofloxacin, neomycin, penicillin, tetracycline, trimethoprim/sulfamethoxazole, vancomycin), phenylbutazone, pristinamycin, probenecid, or salicylates (eg, aspirin) because they may increase the risk of side effects
• Vitamins containing folic acid because they may decrease Methotrexate "s effectiveness
• Cyclosporine, oral anticoagulants (eg, warfarin), or theophylline because side effects may be increased by Methotrexate
• Digoxin because effectiveness may be decreased by Methotrexate

This may not be a complete list of all interactions that may occur. Ask your health care provider if Methotrexate may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Methotrexate :

Use Methotrexate as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Methotrexate is usually given as an injection at your doctor"s office, hospital, or clinic. If you will be using Methotrexate at home, a health care provider will teach you how to use it. Be sure you understand how to use Methotrexate . Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
• If Methotrexate contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
• Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
• Drinking extra fluids while you are taking Methotrexate is recommended. Check with your doctor for instructions.
• This is a potent medicine. The dose and how often you use it are based on your medical condition and response to therapy. There are many different dosing schedules for Methotrexate (especially for cancer treatment). Therefore, it is very important that you follow your doctor"s instructions carefully.
• It may take several months of continued use for the full benefit of Methotrexate to be seen in the management of psoriasis or rheumatoid arthritis. Do not stop using Methotrexate without checking with your doctor.
• It is important to use each dose at the scheduled time. If you miss a dose of Methotrexate , contact your doctor or pharmacist. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Methotrexate .

Important safety information:

• Methotrexate may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Methotrexate with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• If nausea, vomiting, or loss of appetite occurs, ask your doctor or pharmacist for ways to lessen these effects.
• Do not drink alcohol while you are using Methotrexate .
• Methotrexate may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Methotrexate . Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
• Methotrexate may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
• Methotrexate may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
• Do not receive a live vaccine (eg, measles, mumps) while you are taking Methotrexate . Talk with your doctor before you receive any vaccine.
• Certain side effects (eg, mouth sores) may be reduced by taking a folic acid supplement. Talk with your doctor or pharmacist about the use of folic acid supplements to determine if one is right for you.
• Certain antibiotics (eg, chloramphenicol, sulfa, tetracyclines) may interfere with methotrexate blood tests. Be sure your doctor and lab personnel know you are using any of these types of antibiotics.
• Use an effective form of birth control during therapy and for up to 3 months after Methotrexate is stopped. Fetal harm can occur if conception occurs while a male or female is taking Methotrexate .
• Lab tests, including, liver function, kidney function, and complete blood cell counts, may be performed while you use Methotrexate . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Methotrexate may have benzyl alcohol in it. Do not use it in NEWBORNS or INFANTS. It may cause serious and sometimes fatal nervous system problems and other side effects.
• Use Methotrexate with caution in the ELDERLY; they may be more sensitive to its effects.
• Methotrexate should not be used in CHILDREN younger than 6 months old; safety and effectiveness in these children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: Methotrexate may cause birth defects or fetal death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. Methotrexate is found in breast milk. Do not breast-feed while taking Methotrexate .

Possible side effects of Methotrexate :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Acne; chills and fever; dizziness; flushing; general body discomfort; hair loss; headache; infertility; irregular periods; itching; loss of appetite; lowered resistance to infection; miscarriage; nausea; sensitivity to sunlight; sore throat; speech impairment; stomach pain; swelling of the breast; unusual tiredness; vaginal discharge; vomiting.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black or bloody stools; blood in the urine; bone pain; calf pain/swelling; change in amount of urine; chest pain; confusion; dark urine; diarrhea; dry cough; enlarged glands; fatigue; fever or chills; inflammation of the pancreas (stomach tenderness, nausea, vomiting, fever, increased pulse rate); irregular heartbeat; mental changes; mouth sores; muscle weakness; persistent sore throat; red, swollen, or blistered skin; seizures; serious infection (herpes, hepatitis, blood infection); trouble breathing; unusual bleeding or bruising; unusual pain and discoloration of the skin; vision changes; vomit that looks like coffee grounds; yellowing of skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include bloody stools; seizures; severe nausea; vomiting.

Store Methotrexate at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Methotrexate out of the reach of children and away from pets.

General information:

• If you have any questions about Methotrexate , please talk with your doctor, pharmacist, or other health care provider.
• Methotrexate is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Methotrexate . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.