Methotrexate (Oral Route, Injection Route)

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Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Newborns and other infants may be more sensitive to the effects of methotrexate. However, in other children it is not expected to cause different side effects or problems than it does in adults.

Geriatric

Side effects may be more likely to occur in the elderly, who are usually more sensitive to the effects of methotrexate.

Pregnancy

Breastfeeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Rotavirus Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Adenovirus Vaccine Type 4, Live
• Adenovirus Vaccine Type 7, Live
• Alclofenac
• Amoxicillin
• Apazone
• Asparaginase
• Aspirin
• Bacillus of Calmette and Guerin Vaccine, Live
• Benoxaprofen
• Bentiromide
• Bismuth Subsalicylate
• Carprofen
• Dantrolene
• Dexlansoprazole
• Diclofenac
• Diflunisal
• Dipyrone
• Doxycycline
• Droxicam
• Esomeprazole
• Etodolac
• Fenbufen
• Fenoprofen
• Flurbiprofen
• Hydrochlorothiazide
• Ibuprofen
• Indomethacin
• Indoprofen
• Influenza Virus Vaccine, Live
• Isoxicam
• Ketoprofen
• Ketorolac
• Leflunomide
• Measles Virus Vaccine, Live
• Meclofenamate
• Mefenamic Acid
• Mezlocillin
• Mumps Virus Vaccine, Live
• Nabumetone
• Naproxen
• Nimesulide
• Omeprazole
• Oxaprozin
• Pantoprazole
• Penicillin G
• Penicillin V
• Phenylbutazone
• Phenytoin
• Piperacillin
• Pirazolac
• Piroxicam
• Pirprofen
• Pristinamycin
• Probenecid
• Proquazone
• Pyrimethamine
• Rabeprazole
• Rotavirus Vaccine, Live
• Rubella Virus Vaccine, Live
• Salsalate
• Smallpox Vaccine
• Sulfamethizole
• Sulfamethoxazole
• Sulfapyridine
• Sulfisoxazole
• Sulindac
• Suprofen
• Tamoxifen
• Tenidap
• Tenoxicam
• Tiaprofenic Acid
• Tolmetin
• Triamterene
• Trimethoprim
• Typhoid Vaccine
• Varicella Virus Vaccine
• Warfarin
• Yellow Fever Vaccine
• Zomepirac

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Amiodarone
• Cyclosporine
• Eltrombopag
• Mercaptopurine
• Procarbazine
• Rofecoxib
• Theophylline

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse (or history of)—Increased risk of unwanted effects on the liver

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Colitis

• Disease of the immune system

• Gout (history of) or
• Kidney stones (or history of)—Methotrexate may increase levels of a chemical called uric acid in the body, which can cause gout or kidney stones

• Infection—Methotrexate can reduce immunity to infection

• Intestine blockage or
• Kidney disease or
• Liver disease—Effects may be increased because of slower removal of methotrexate from the body

• Mouth sores or inflammation or
• Stomach ulcer—May be worsened

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