Methotrexate

How do I say this name?

meth-o-TREX-ate

What is this medicine used for?

Methotrexate kills cancer cells. It also has other uses. It is used to prevent graft-versus-host disease after a bone marrow transplant. It is also used to treat severe arthritis.

This medicine may be called by the brand names, Mexate® or Folex®.

How do I take this medicine?

Methotrexate is taken by mouth, injected into the muscle or veins, or injected near the spinal cord (called intrathecal administration).

Methotrexate that is taken by mouth should be taken on an empty stomach, 1 hour before or 2 hours after a meal.

How do I store this medicine?

Store methotrexate tablets and injection at room temperature and protect from heat, moisture, and light.

Are there any special things I should do while on this medicine?

Methotrexate can decrease the number of white blood cells in your body, cells that usually help you fight infections. It can also decrease the number of cells in your blood that help your blood clot (platelets) and the number of red blood cells, cells that carry oxygen to your tissues. Without enough red blood cells, the tissues get less oxygen and you could become fatigued. Ask your doctor, nurse, or pharmacist how to reduce your risk of infection, bleeding, or fatigue.

Tell your doctor, nurse, or pharmacist if you have ever had liver problems, including cirrhosis, hepatitis, or jaundice. Methotrexate causes liver damage in a small number of patients and should be used very carefully in patients who have had liver disease.

Do not drink alcohol (i.e., beer, wine, hard liquor) or drink less alcohol while you take methotrexate. Alcohol increases the effects of methotrexate on the liver.

Avoid getting sunburned for several days before starting therapy with methotrexate. If you get sunburned during this time, the sunburn may return or worsen when you start this medicine.

Avoid getting sunburned while taking methotrexate. Your skin may be more sensitive to sunlight and you may sunburn more easily.

Check with your doctor, nurse, or pharmacist before taking any other medicine. Methotrexate causes serious side effects when combined with many medications. Prescription, nonprescription, or over-the-counter medicines which may cause problems include medicines for fever, pain, headache, or arthritis.

Tell your doctor, nurse, or pharmacist right away if you vomit within one hour after taking methotrexate by mouth.

What if I miss a dose?

Do not take the missed dose if you skip or forget to take methotrexate by mouth. Return to your regular schedule and do not increase your dose to make up for a missed dose.

What side effects are common with this medicine?

When should I call my doctor?

Call your doctor if you are worried about a side effect or have questions about your medical care.

Call the doctor at once if you have any of these side effects:

Call the doctor as soon as you can if you have any of these side effects:

Are there side effects from this medicine after I finish my chemotherapy?

Methotrexate may cause side effects that do not occur for months or years after you finish chemotherapy, including decreased ability to have children. Discuss long-term effects with your doctor if you are concerned.

These written patient information materials should be used in conjunction with verbal counseling. They are not intended as the sole source of information patients receive about their chemotherapy and other medications. The adverse effects listed are important and common ones that patients might experience; every possible adverse effect is not included. Long-term adverse effects, like secondary malignancy and infertility, are discussed for those drugs whose risk is well defined.