METHOTREXATE SODIUM

METHOTREXATE (METH oh TREX ate) treats inflammatory conditions such as arthritis or psoriasis. It works by decreasing inflammation, which can reduce pain and prevent long-term injury to the joints and skin.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

This medication is injected under the skin. You will be taught how to prepare and give it. Take it as directed on the prescription label. Keep taking it unless your care team tells you to stop.
This medication should be taken weekly, NOT daily.
This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.
Handling this medication may be harmful. Talk to your care team about how to handle this medication. Special instructions may apply.
It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or care team to get one.
Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 2 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

Do not take this medication with any of the following:
-Acitretin
-Probenecid
This medication may also interact with the following:
-Alcohol
-Aspirin or aspirin-like medications
-Azathioprine
-Dapsone
-Hydroxychloroquine
-Live virus vaccines
-Medications for viral infections, such as acyclovir, cidofovir, foscarnet, ganciclovir
-Mercaptopurine
-NSAIDs, medications for pain and inflammation, such as ibuprofen or naproxen
-Phenytoin
-Pyrimethamine
-Retinoids, such as isotretinoin or tretinoin
-Some antibiotics, such as gentamicin, penicillin, tetracycline, vancomycin
-Some medications that treat or prevent blood clots, such as warfarin, apixaban, dabigatran, rivaroxaban
-Some medications for stomach problems, such as esomeprazole, omeprazole, pantoprazole
-Sulfonamides, such as sulfasalazine or trimethoprim; sulfamethoxazole
-Theophylline

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse.
You may need blood work done while you are taking this medication.
This medication can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and sunscreen. Do not use sun lamps, tanning beds, or tanning booths.
This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.
This medication may increase your risk of getting an infection. Call your care team for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.
Be careful brushing or flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this medication.
Make sure you stay hydrated while taking this medication. Drink water often. Eat fruits and veggies that have a high water content. Drink more water when it is hot or you are active. Talk to your care team right away if you have fever, infection, vomiting, diarrhea, or if you sweat a lot while taking this medication. The loss of too much body fluid may make it dangerous for you to take this medication.
Talk to your care team about your risk of cancer. You may be more at risk for certain types of cancer if you take this medication.
Talk to your care team if you or your partner may be pregnant. Serious fetal side effects can occur if you take this medication during pregnancy and for 6 months after the last dose. You will need a negative pregnancy test before starting this medication. Contraception is recommended while taking this medication and for 6 months after the last dose. Your care team can help you find the option that works for you.
If your partner can get pregnant, use a condom during sex while taking this medication and for 3 months after the last dose.
Do not breastfeed while taking this medication and for 1 week after the last dose.
This medication may cause infertility. Talk to your care team if you are concerned about your fertility.

If you are not sure if this medication was injected or if you have a hard time giving the injection, do not inject another dose. Talk with your care team.

Side effects that you should report to your care team as soon as possible:
-Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
-Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
-Dry cough, shortness of breath or trouble breathing
-Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
-Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
-Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing of the skin or eyes, unusual weakness or fatigue
-Low red blood cell count—unusual weakness or fatigue, dizziness, headache, trouble breathing
-Redness, blistering, peeling, or loosening of the skin, including inside the mouth
-Seizures
-Unusual bruising or bleeding
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
-Diarrhea
-Dizziness
-Hair loss
-Nausea
-Pain, redness, or swelling with sores inside the mouth or throat
-Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Keep out of the reach of children and pets.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep this medication in the original packaging. Protect from light. Get rid of any unused medication after the expiration date.
To get rid of medications that are no longer needed or have expired:
-Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
-If you cannot return the medication, ask your pharmacist or care team how to get rid of it safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.