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methotrexate (oral)

Pronunciation: meth oh TREX ate

Brand: Trexall, Xatmep

Methotrexate Sodium

slide 1 of 15, Methotrexate Sodium,

2.5 mg, round, yellow, imprinted with 54 323

Image of Methotrexate Sodium
slide 1 of 15
    

Methotrexate Sodium

slide 2 of 15, Methotrexate Sodium,

2.5 mg, round, orange, imprinted with M 14

Image of Methotrexate Sodium
slide 2 of 15
    

Methotrexate Sodium

slide 3 of 15, Methotrexate Sodium,

2.5 mg, oval, yellow, imprinted with b 572

Image of Methotrexate Sodium
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Trexall

slide 4 of 15, Trexall,

5 mg, oval, green, imprinted with b, 927 5

Image of Trexall
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Trexall

slide 5 of 15, Trexall,

7.5 mg, oval, blue, imprinted with b, 928 7 1/2

Image of Trexall
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Trexall

slide 6 of 15, Trexall,

10 mg, oval, pink, imprinted with b, 929 10

Image of Trexall
slide 6 of 15
    

Trexall

slide 7 of 15, Trexall,

15 mg, oval, purple, imprinted with b, 945 15

Image of Trexall
slide 7 of 15
    

Methotrexate Sodium

slide 8 of 15, Methotrexate Sodium,

2.5 mg, round, yellow, imprinted with M 1

Image of Methotrexate Sodium
slide 8 of 15
    

Methotrexate Sodium

slide 9 of 15, Methotrexate Sodium,

2.5 mg, elliptical, yellow, imprinted with b 572

Image of Methotrexate Sodium
slide 9 of 15
    

Methotrexate Sodium

slide 10 of 15, Methotrexate Sodium,

2.5 mg, round, orange, imprinted with M 14

Image of Methotrexate Sodium
slide 10 of 15
    

Methotrexate Sodium

slide 11 of 15, Methotrexate Sodium,

2.5 mg, round, yellow, imprinted with 54 323

Image of Methotrexate Sodium
slide 11 of 15
    

Trexall

slide 12 of 15, Trexall,

10 mg, oval, pink, imprinted with b, 929 10

Image of Trexall
slide 12 of 15
    

Trexall

slide 13 of 15, Trexall,

15 mg, oval, lavender, imprinted with b, 945 15

Image of Trexall
slide 13 of 15
    

Trexall

slide 14 of 15, Trexall,

5 mg, oval, green, imprinted with b, 927 5

Image of Trexall
slide 14 of 15
    

Trexall

slide 15 of 15, Trexall,

7.5 mg, oval, blue, imprinted with b, 928 7 1/2

Image of Trexall
slide 15 of 15
    

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

YOU MAY NOT NEED TO TAKE METHOTREXATE EVERY DAY. Some people have died after incorrectly taking methotrexate every day. You must use the correct dose for your condition.

Do not use methotrexate to treat psoriasis or rheumatoid arthritis if you have low blood cell counts, a bone marrow disorder, liver disease (especially if caused by alcoholism), or if you are pregnant or breast-feeding.

Methotrexate can cause serious or life-threatening side effects. Call your doctor if you have diarrhea, mouth sores, cough, shortness of breath, upper stomach pain, dark urine, numbness or tingling, muscle weakness, confusion, seizure, or skin rash that spreads and causes blistering and peeling.

What is methotrexate?

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

Methotrexate is usually given after other treatments have failed.

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

What should I discuss with my healthcare provider before taking methotrexate?

You should not use methotrexate if you are allergic to it. You may not be able to take methotrexate if you have:

  • alcoholism, cirrhosis, or chronic liver disease;
  • low blood cell counts;
  • a weak immune system or bone marrow disorder; or
  • if you are pregnant or breastfeeding.

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

Tell your doctor if you have ever had:

  • liver problems, especially fluid in your stomach (ascites);
  • kidney disease;
  • lung problems, especially fluid in the lungs (pleural effusion);
  • radiation treatments; or
  • a stomach ulcer or ulcerative colitis.

Methotrexate can harm an unborn baby or cause birth defects if the mother or the father is using this medicine.

  • If you are a woman, do not use methotrexate to treat psoriasis or rheumatoid arthritis if you are pregnant. You may need to have a negative pregnancy test before starting this treatment. Use an effective form of birth control while you are taking methotrexate, and for 6 months after your last dose.
  • If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 3 months after your last dose.
  • Tell your doctor right away if a pregnancy occurs while either the mother or the father is using methotrexate.

This medicine may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because methotrexate can harm an unborn baby.

Do not breastfeed while using this medicine.

Do not give this medicine to a child without the advice of a doctor.

How should I take methotrexate?

YOU MAY NOT NEED TO TAKE METHOTREXATE EVERY DAY. This medicine is sometimes taken only 1 or 2 times per week, or once every 12 hours for only 3 doses. Some conditions are treated daily for just a few days followed by a rest period of 1 week or longer before taking the medicine again.

You must use the correct dose. Some people have died after incorrectly taking methotrexate every day.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. Ask your doctor or pharmacist if you have questions about how often to take methotrexate.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Methotrexate can be toxic to your organs, and may lower your blood cell counts. You will need frequent medical tests, and your next dose may be delayed based on the results.

If you need to be sedated for dental work, tell your dentist you currently use methotrexate.

Store tablets at room temperature away from moisture, heat, and light.

Store the liquid medicine in the refrigerator, do not freeze.

You may also store the liquid at room temperature for up to 60 days.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of methotrexate.

What happens if I overdose?

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

Overdose symptoms may include bruising or unusual bleeding, mouth sores, vomiting, little or no urination, bloody or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

What should I avoid while taking methotrexate?

Avoid drinking alcohol. It may increase your risk of liver damage.

Do not receive a "live" vaccine while using methotrexate, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Methotrexate could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

What are the possible side effects of methotrexate?

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Call your doctor at once if you have:

  • severe ongoing vomiting or diarrhea;
  • dry cough, chest pain, shortness of breath or rapid breathing;
  • kidney problems --little or no urination, swelling in your feet or ankles;
  • liver problems --stomach pain (upper right side), dark urine, jaundice (yellowing of the skin or eyes);
  • low blood cell counts --fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath;
  • nerve problems --weakness, coordination problems, loss of movement in any part of your body;
  • signs of stomach bleeding --bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; or
  • signs of tumor cell breakdown --confusion, weakness, muscle cramps, fast or slow heart rate, decreased urination, tingling in your hands and feet or around your mouth.

Common side effects may include:

  • low blood cell counts, infections (fever, chills, tiredness, bruising, not feeling well);
  • dizziness;
  • mouth sores;
  • nausea, upset stomach, vomiting, diarrhea;
  • hair loss; or
  • abnormal liver function tests.

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?

Methotrexate can harm your liver, especially if you also use certain medicines for infections, tuberculosis, depression, birth control, hormone replacement, high cholesterol, heart problems, high blood pressure, seizures, pain, or arthritis (including Tylenol, Advil, Motrin, or Aleve).

Many drugs can affect methotrexate. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your pharmacist can provide more information about methotrexate.

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 1996-2020 Cerner Multum, Inc. Version: 15.01. Revision date: 12/20/2019.

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