Generic Methotrexate

Methotrexate is used to treat certain types of cancer or to control severe psoriasis or rheumatoid arthritis. This medication works by interfering with cell growth and by suppressing the immune system. Early treatment of rheumatoid arthritis with more aggressive therapy such as methotrexate helps to reduce further joint damage and to preserve joint function.

This medication is given by injection as directed by your doctor. The dose, method of injection, and how often you receive this medication are based on your medical condition and response to treatment. For some conditions (such as rheumatoid arthritis), you may be taught to give yourself injections at home. In this case, read and learn all preparation and usage instructions from your health care professional. If you have any questions, ask your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard needles and medical supplies safely.

Before using methotrexate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: liver disease, severe kidney disease, severe lung disease (e.g., pulmonary fibrosis), alcohol use, suppressed immune system, blood cell/bone marrow disorders. Before using this medication, tell your doctor or pharmacist your medical history, especially of: stomach/intestinal diseases (e.g., peptic ulcer, ulcerative colitis), kidney disease, any active infection (including chickenpox or recent exposure to it), folic acid deficiency. This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages. This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths or sunlamps. Use a sunscreen and wear protective clothing when outdoors. Do not have immunizations/vaccinations without the consent of your doctor and avoid contact with people who have recently received oral polio vaccine. Use caution with sharp objects like safety razors or nail cutters and avoid activities such as contact sports to lower the chance of getting cut, bruised, or injured. Wash your hands well to prevent the spread of infections. Caution is advised when using this drug in children because they may be more sensitive to the side effects of the drug, especially seizures. Methotrexate must not be used during pregnancy. It may cause harm to an unborn baby. If you become pregnant or think you may be pregnant, inform your doctor immediately. Pregnancy must be avoided, therefore males and females must use reliable form(s) of birth control during and for at least 3 months following the end of methotrexate treatment. Methotrexate passes into breast milk and may harm a nursing infant. Do not breast-feed while using this drug.

For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule. Do not double the dose to catch up.

See also Warning section. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: acitretin, asparaginase, ciprofloxacin, digoxin, leflunomide, live vaccines, natalizumab, other cancer treatments potentially toxic to the kidney (e.g., cisplatin), other drugs potentially toxic to the liver (e.g., azathioprine, sulfasalazine, retinoids such as isotretinoin), penicillins, phenytoin, probenecid, procarbazine, pyrimethamine, sulfa medications, theophylline. Certain drugs that reduce stomach acid (proton pump inhibitors-PPIs such as esomeprazole, omeprazole, pantoprazole) may increase the blood level of methotrexate. This may lead to a higher chance of side effects, especially with high-dose methotrexate treatment. Ask your doctor or pharmacist for details and ways to lessen the risk of side effects. Certain antibiotics (e.g., chloramphenicol, sulfa, tetracyclines) may interfere with methotrexate blood tests (increase methotrexate blood levels due to protein-binding displacement). Make sure laboratory personnel and your doctors know you are using any of these types of antibiotics.

See also Warning section. Nausea, vomiting, stomach pain, drowsiness or dizziness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: mouth sores, diarrhea, fever, fatigue, persistent sore throat, unusual bleeding or bruising, black stools, skin rash, enlarged glands/lymph nodes, dark urine, bone pain, unusual pain and discoloration of the skin, yellowing eyes/skin, change in the amount of urine, chest pain, dry cough, trouble breathing, calf pain/swelling, vision changes, irregular heartbeat, muscle weakness, severe headache, neck stiffness, mental/mood changes, seizures. Temporary hair loss may occur. Normal hair growth should return after treatment has ended. A serious allergic reaction to this drug is unlikely, but get medical help right away if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.