Do not take METHOTREXATE if you are allergic to any of its contents; if you have immunodeficiency conditions, bone marrow problems, low white blood cell count, low platelet count, serious anaemia, liver problems due to alcohol abuse, chronic liver disease; if you are pregnant or breastfeeding. Talk to your doctor before taking METHOTREXATE if you have/had liver or kidney problems, ulceration in the stomach or bowels, poor general condition, received any vaccinations or if you are due to have any vaccinations, diabetes, ascites (fluid in the stomach area), lung problems or fluid in the lungs. METHOTREXATE may cause dizziness and fatigue, so drive only if you are alert. Take METHOTREXATE exactly as directed by the doctor as it may cause serious problems if not taken in the dose and duration prescribed by the doctor. Stop taking METHOTREXATE and consult your doctor immediately if you have mouth sores, diarrhoea, a fever, dehydration, cough, bleeding, shortness of breath, any signs of infection, or a skin rash.

Drug-Drug Interactions: METHOTREXATE may interact with pain killers (celecoxib, acetaminophen, hydrocodone), anti-depressant (duloxetine), immunosuppressants (etanercept), anti-rheumatoid (adalimumab), antacid (esomeprazole), and anti-malarial (hydroxychloroquine).

Drug-Food Interactions: Avoid consuming alcohol whilst on treatment with METHOTREXATE. 

Drug-Disease Interactions: Inform your doctor if you have immunodeficiency conditions, bone marrow problems, low white blood cell count, low platelet count, serious anaemia, liver problems due to alcohol abuse, or chronic liver disease.

Arthritis:

• Physical activity helps in strengthening muscles and relieves joint stiffness. Gentle exercises like 20-30minutes of walking or swimming would be helpful.
• Performing yoga may also help in improving joint flexibility and pain management.
• Maintain a healthy weight by performing regular low-strain exercises and eating healthy food.
• Get adequate sleep as resting the muscles can help reduce inflammation and swelling.
• De-stress yourself by meditating, reading books, taking a warm bubble bath or listening to soothing music.
• Acupuncture, massage and physical therapy may also be helpful.
• Eat food rich in antioxidants such as berries, spinach, kidney beans, dark chocolate, etc.
• Foods containing flavonoids help in reducing inflammation. These include soy, berries, broccoli, grapes and green tea.
• Avoid smoking and alcohol consumption.

Psoriasis:

• Include foods such as cherries, berries, leafy vegetables, salmon, sardines, and fish rich in omega-3 fatty acids.
• Consume antioxidant-rich spices and herbs like cumin, ginger, sage and thyme.
• Avoid processed foods, refined sugars, and fatty foods.
• Limit intake of food that might trigger allergies, such as dairy products, soy, eggs, and nuts.
• Include fruits, vegetables, whole grains, healthy fats and fish in your diet.
• Reducing stress and maintaining a good sleep cycle would be helpful.
• Avoiding getting in contact with harsh soaps, detergents and rough fabrics.

Cancer:

• Consume a healthy diet and exercise regularly to maintain proper weight.
• Avoid smoking and alcohol consumption.
• Include leafy vegetables, citrus fruits, fatty fish, berries, yoghurt, apples, peaches, cauliflower, cabbage, broccoli, beans, herbs, and spices in your diet.
• Avoid fast food, fried food, processed meats, refined carbs, and added sugar.
• Get optimal sleep; rest well.

• Women of child-bearing age must use effective contraception whilst on treatment with METHOTREXATE and for at least 6 months after the last dose.
• Male patients are advised to consult their doctor regarding the possibility of sperm preservation before starting the treatment as METHOTREXATE may cause infertility.
• METHOTREXATE may make you more susceptible to infections; consult your doctor if you develop any signs of infections such as fever, sore throat, breathlessness, jaundice, unexplained bleeding or bruising.
• Your doctor may advise regular blood tests, kidney and liver tests to monitor your condition.
• If you miss a dose of METHOTREXATE, call your doctor and ask if you should take the missed dose or not.