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methotrexate (injection)

methotrexate (injection)

Pronunciation: meth oh TREX ate

Brand: Methotrexate Sodium, Preservative Free

What is the most important information I should know about methotrexate injection?

Multum nopreg

Methotrexate can harm an unborn baby or cause birth defects. Do not use if you are pregnant. Use birth control to prevent pregnancy while you are receiving methotrexate injection, whether you are a man or a woman. Methotrexate injection use by either parent may cause birth defects.

Multum emt

Methotrexate injection can cause serious or life-threatening side effects on your liver, lungs, kidneys, and bone marrow (immune system). To check for harmful effects, your blood will need to be tested often. Your kidney or liver function may also need to be tested, and you may need an occasional liver biopsy or chest x-ray. Visit your doctor regularly.

Multum donot

You may not be able to receive methotrexate injection if you have liver disease (especially if caused by alcoholism), a blood cell or bone marrow disorder, or if you are breast-feeding a baby. Your doctor will decide if this treatment is right for you.

There are many other drugs that can interact with methotrexate. Tell your doctor about all medications you use.

What is methotrexate injection?

Methotrexate interferes with the growth of certain cells of the body, especially cells that reproduce quickly, such as cancer cells, bone marrow cells, and skin cells.

Methotrexate injection is used to treat leukemia and certain types of cancer of the breast, skin, head and neck, or lung. Methotrexate injection is also used to treat severe psoriasis and rheumatoid arthritis.

Methotrexate injection is usually given after other medications have been tried without successful treatment of symptoms.

Methotrexate injection may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before receiving methotrexate injection?

Multum donot

You should not use this medication if you are allergic to methotrexate (Rheumatrex, Trexall). Do not use methotrexate injection to treat psoriasis or rheumatoid arthritis if you have:

  • chronic liver disease;
  • alcoholism or cirrhosis of the liver;
  • a blood cell disorder such as anemia (lack of red blood cells) or leukopenia (lack of white blood cells);
  • a weak immune system or bone marrow disorder; or
  • if you are pregnant or breast-feeding.

Methotrexate injection is sometimes used to treat cancer even when patients do have one of the conditions listed above. Your doctor will decide if this treatment is right for you.

To make sure you can safely use methotrexate, tell your doctor if you have any of these other conditions:

  • kidney disease;
  • liver problems;
  • lung disease or pneumonia;
  • stomach ulcer, ulcerative colitis;
  • any type of infection; or
  • if you are receiving phototherapy or radiation treatments.
Multum nopreg

FDA pregnancy category X. This medication can harm an unborn baby or cause birth defects. Do not use methotrexate if you are pregnant. Tell your doctor right away if you become pregnant during treatment.

Use birth control to prevent pregnancy while you are receiving methotrexate injection, whether you are a man or a woman. Methotrexate injection use by either parent may cause birth defects.

If you are a man, use a condom to keep from causing a pregnancy while you are receiving methotrexate injection. Continue using condoms for at least 90 days after your treatment ends.

If you are a woman, use an effective form of birth control while you are receiving methotrexate injection, and for at least one cycle of ovulation after your treatment ends.

Multum nobrfeed

Methotrexate can pass into breast milk and may harm a nursing baby. Do not breast-feed while you are using methotrexate.

How is methotrexate injection given?

Methotrexate is injected into a muscle, or into a vein through an IV. Methotrexate may also be injected directly into a joint, or into the area around your spinal cord. You will receive this injection in a clinic or hospital setting.

To be sure this medication is not causing harmful effects, your blood will need to be tested often. Your kidney or liver function may also need to be tested, and you may need an occasional liver biopsy or chest x-ray. Visit your doctor regularly.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your methotrexate injection.

What happens if I overdose?

Multum emt

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of methotrexate injection can be fatal.

Overdose symptoms may include headache, confusion, nausea, vomiting, or seizure (convulsions).

What should I avoid while receiving methotrexate injection?

Multum dizzy

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Multum nosun

Avoid exposure to sunlight or artificial UV rays (sunlamps, tanning beds, or PUVA treatment), especially if you have psoriasis. Methotrexate injection can make your skin more sensitive to sunlight and your psoriasis may worsen.

What are the possible side effects of methotrexate injection?

Multum emt

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Multum donot

Call your doctor at once if you have a serious side effect such as:

  • diarrhea, vomiting, white patches or sores inside your mouth or on your lips;
  • feeling like you might pass out;
  • weight loss, night sweats, swollen glands;
  • fever, chills, flu symptoms, cough with yellow or green mucus;
  • dry cough without mucus;
  • stabbing chest pain, feeling short of breath;
  • pale skin, rapid heart rate, trouble concentrating;
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
  • sudden numbness or weakness on one side of the body, confusion, neck stiffness, severe headache, back pain, seizure (convulsions);
  • pain, swelling, warmth, or redness in one or both legs;
  • black, bloody, or tarry stools;
  • urinating less than usual or not at all;
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • dry mouth, increased thirst, drowsiness, restless feeling, vomiting, increased urination, muscle pain or weakness, feeling light-headed; or
  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

  • headache, blurred vision;
  • upset stomach, loss of appetite;
  • dizziness; or
  • tired feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect methotrexate injection?

Many drugs can interact with methotrexate injection. Below is just a partial list. Tell your doctor if you are using:

  • any other cancer medications, especially cisplatin (Platinol);
  • phenytoin (Dilantin);
  • diabetes medication you take by mouth;
  • retinol, tretinoin (Vesanoid, Retin-A), isotretinoin (Accutane, Amnesteem, Claravis, Sotret);
  • theophylline (Elixophyllin, Slo-Bid, Theobid, Theo-Dur);
  • vitamin or mineral supplements containing folic acid;
  • aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others;
  • medicines that reduce stomach acid, such as esomeprazole (Nexium, Vimovo), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), or rabeprazole (Aciphex);
  • salicylates such as aspirin, Backache Relief Extra Strength, Novasal, Nuprin Backache Caplet, Doan's Pills Extra Strength, Pepto-Bismol, Tricosal, and others;
  • sulfa drugs (Bactrim, Septra, Sulfatrim, SMX-TMP, and others);
  • an antibiotic such as chloramphenicol (Chloromycetin), tetracycline, penicillin, ampicillin (Principen), amoxicillin (Amoxil, Trimox), or an antibiotic given by injection;
  • medicines used to treat ulcerative colitis, such as mesalamine (Pentasa) or sulfasalazine (Azulfidine);
  • medicines used to prevent organ transplant rejection, such as azathioprine (Imuran), sirolimus (Rapamune) or tacrolimus (Prograf); or
  • antiviral medicines such as adefovir (Hepsera), cidofovir (Vistide), or foscarnet (Foscavir).

This list is not complete and there are many other drugs that can interact with methotrexate. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information?

Your doctor or pharmacist can provide more information about methotrexate injection.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2013 Cerner Multum, Inc. Version: 3.01. Revision date: 12/30/2011.

Your use of the content provided in this service indicates that you have read, understood and agree to the End-User License Agreement, which can be accessed by clicking on this link.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Last modified on: 2 April 2014


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