Methotrexate is an anti-metabolite medicine (medicine which affects how the body’s cells grow) and immunosuppressant (medicine which reduces the activity of the immune system). Methotrexate is used in large doses (on its own or in combination with other medicines) to treat certain types of cancer such as breast cancer. In smaller doses it can be used to treat severe psoriasis (a skin disease with thickened patches of inflamed red skin, often covered by silvery scales), when it has not responded to other treatments.
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||• Are allergic (hypersensitive) to Methotrexate or any of the ingredients of Methotrexate
• have significant kidney or liver problems
• have been told you have (or think you have) a blood disorder such as low levels of white blood cells, red blood cells (anaemia) or platelets
Tell your doctor if any of the above applies to you before this medicine is used.
|Drug Special Care
||• have a stomach ulcer of ulcerative colitis (inflammation and ulceration of the gut)
• have an infection
• have mild kidney problems
• have a medical condition which causes a build up of fluid in the lining of your lungs or in your abdomen (the fluid will need to be drained before methotrexate treatment is started)
• are to have radiotherapy (risk of tissue and bone damage may be increased)
• are to have any vaccinations
Tell your doctor if any of the above applies to you before this medicine is used. Special care will also be taken in children, the elderly and in those who are in poor physical condition.
|Drug Drug Interactions
||Special care is needed if you are taking/using other medicines as some could interact with methotrexate, for example:
• non-steroidal anti-inflammatory medicines e.g. ibuprofen (medicines taken for pain relief)
• aspirin or similar medicines (known as salicylates)
• diuretics (water tablets)
• medicines taken for diabetes (including insulin and tablets)
• antibiotics such as penicillins, sulphonamides, co-trimoxazole, trimethoprim, tetracycline, chloramphenicol and para-aminobenzoic acid
• phenytoin (medicine often used to treat epilepsy)
• vitamin supplements containing folic acid
• probenecid (medicine used to treat gout)
• nitrous oxide (used for general anaesthesia and pain relief)
• retinoids, such as acitretin (a medicine used to treat psoriasis) or isotretinoin (used to treat severe acne)
• other drugs that may cause damage to your kidneys
• other drugs that may case damage to your liver
Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
|Drug Pregnancy Interaction
||Tell your doctor if you are pregnant, trying to become pregnant or breast-feeding before this medicine is used. This medicine must not be used during pregnancy.
|Drug Breast feeding Interaction
||Mothers should not breast-feed whilst treatment with methotrexate in ongoing. Due to the risk of birth defects, conception should be avoided during methotrexate treatment and for at least 6 months after treatment is stopped. Ask your doctor or pharmacist for advice before taking any medicine.
|Drug Machinery Interaction
||Do not drive or use machines if you experience any side effect (e.g. dizziness, drowsiness
or blurred vision) which may lessen your ability to do so.
|Drug More Information
||Do not drink alcohol whilst being treated with Methotrexate as alcohol increases the risk
of liver damage.
|How to take the
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||Your doctor will work out the correct dose of Methotrexate for you and how often it must be given. The dose of medicine given to you will depend on the disease being treated, your medical condition, your age, your size and how well your kidneys are working. Before treatment is started your doctor may carry out blood tests to check the levels of cells in your blood, and also to check how well your kidneys and liver are working. You may also have a chest X-ray. Further tests may also be done during and after treatment.
||This medicine may be given by (using a syringe) into a vein (intravenously), into muscle (intramuscularly) or into an artery (intraarterially). It may also be given by infusion (drip) into a vein. It may be diluted before it is given.
|Excess Drug Consumption
||This medicine will be given to you in a hospital, under the supervision of a doctor. It is unlikely that you will be given too much or too little, however, tell your doctor or nurse if you have any concerns.
|Forgot Drug Consumption
||Contact Your doctor
|Stop Drug Consumption
||Do not stop the drug untill your doctor says you to do so.
||• severe allergic reaction - you may experience a sudden itchy rash (hives), swelling of the hands, feet, ankles, face, lips, mouth or throat (which may cause difficulty in swallowing or breathing), and you may feel you are going to faint
• inflammation of the lung with breathlessness – you may develop a persistent cough, experience pain or difficulty breathing, or become breathless. This may be associated with changes in a particular type of white cell in your blood
• symptoms of an infection e.g. fever, chills, achiness, sore throat
• unexpected bleeding e.g. bleeding gums, blood in the urine or in vomit, or the appearance of unexpected bruises or broken blood vessels (broken veins)
• black tarry stools
• a sore mouth, particularly if you have a number of ulcers or blisters inside of the mouth or on the tongue
• skin rashes or blistering to the surfaces of the eyes, nose, vagina or anus (back passage)
• stroke/weakness on one side of the body
• weakness in the legs that spreads to the upper limbs and the face, which may result in paralysis
These are serious side effects. You may need urgent medical attention.
|Common Drug Side Effects
• blurred vision
• difficulty/inability to talk
• muscle weakness
• you may feel the need to drink more than usual (diabetes)
• abnormally easily broken bones (osteoporosis)
• pain or redness of the blood vessels (vasculitis)
• itching or the appearance of lightened patches on the skin, bruises, boils
• increased sensitivity to sunlight
• yellowing of the skin and whites of the eyes (jaundice)
• pain in the stomach, loins or abdomen
• you may need to pass urine more often than usual, which may be painful (cystitis)
• generally feeling tired or unwell
• reduced appetite, feeling or being sick
• irregular periods in women (periods may stop completely)
• hair loss
Some different side effects may occur following into the spine. These are
• back or shoulder pain
• difficulty with bending your head down
• temporary paralysis or weakness
• problems with a particular part of your brain, leading to shaking, abnormal balance or staggering.
• Irritability and confusion
• Confusion and loss of memory
Methotrexate may lead to problems with your blood, liver and kidneys. Your doctor will take blood samples to check for these problems and may ask you to have an operation to have a small sample of you liver removed.
Treatment with methotrexate may reduce fertility in men and women. Fertility is thought
to go back to normal after methotrexate treatment is stopped. Tell your doctor if you have
|Rare Drug Side Effects
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|Very Rare Drug Side Effects
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|Drug Side Effects Symptoms
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|How to Store the
|How to Store the Medicine
||Keep out of the reach and sight of children
This medicine must not be used after the expiry date which is stated on the vial label and
carton after 'EXP'. Where only a month and year is stated, the expiry date refers to the last
day of that month.
The vials should be kept in the outer carton, in order to protect from light, and stored at or
below 25°C. The vials should not be frozen. Unused portions of opened vials must not be stored for later use. Prepared infusions should be used immediately, however, if this is not possible they can, in certain circumstances, be stored for up to 30 days in a refrigerator provided they have been prepared in a way to exclude microbial contamination.