Brand Names: U.S.
Otrexup; Rheumatrex; Trexall
Brand Names: Canada
Apo-Methotrexate; JAMP-Methotrexate; Methotrexate Injection USP; Methotrexate Injection, BP; Methotrexate Sodium Injection; Metoject; ratio-Methotrexate Sodium
- This drug may cause very bad and sometimes deadly side effects. This drug is only for use in people with very bad psoriasis or rheumatoid arthritis when other drugs have been used and have not worked. Some products may be used in people with life-threatening cancer. Talk with your doctor.
- You will be watched closely by your doctor.
- Have your blood work checked often. Talk with your doctor.
- Some health problems may raise the chance of side effects. Tell your doctor if you have kidney problems or extra fluid around your stomach area or lungs. Tell your doctor if you are getting radiation.
- Very bad and sometimes deadly bone marrow problems and stomach or bowel problems have happened when this drug was taken with NSAIDs like ibuprofen or naproxen. Talk with your doctor.
- This drug may cause very bad and sometimes deadly liver problems. Most of the time, this only happens after long-term use. You will need to have your liver checked while using this drug. Talk with your doctor.
- This drug may cause very bad lung problems. This can happen at any time and with any dose. Sometimes, lung problems will not go back to normal. Call your doctor right away if you have lung or breathing problems like trouble breathing, shortness of breath, chest pain, or a cough that is new or worse.
- This drug may raise your chance of lymphoma and other cancers.
- Patients with cancer who take this drug may be at greater risk of getting a bad and sometimes deadly health problem called tumor lysis syndrome (TLS). Call your doctor right away if you have a fast heartbeat or a heartbeat that does not feel normal; any passing out; trouble passing urine; muscle weakness or cramps; upset stomach, throwing up, loose stools or not able to eat; or feel sluggish.
- Tell your doctor if you have loose stools (diarrhea) or mouth or tongue sores or irritation. You may need to stop this drug. If you do not stop this drug, very bad and sometimes deadly bowel problems may happen. Talk with your doctor.
- A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.
- Very bad and sometimes deadly infections can happen with this drug. Talk with your doctor.
- This drug may cause harm to the unborn baby if you take it while you are pregnant. If you get pregnant while taking this drug, call your doctor right away.
Psoriasis or rheumatoid arthritis:
- Do not take if you are pregnant.
What is this drug used for?
- It is used to treat rheumatoid arthritis.
- It is used to treat cancer.
- It is used to treat psoriasis.
- It may be given to you for other reasons. Talk with the doctor.
What do I need to tell my doctor BEFORE I take this drug?
- If you have an allergy to methotrexate or any other part of this drug.
- If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
- If you are breast-feeding. Do not breast-feed while you take this drug.
Psoriasis or rheumatoid arthritis:
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
- If you have any of these health problems: Bone marrow disease (like low white blood cell count, low platelet count, or anemia), drinking problem, liver disease, or a weak immune system.
What are some things I need to know or do while I take this drug?
- Tell dentists, surgeons, and other doctors that you use this drug.
- Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
- Talk with your doctor before getting any vaccines. Use with this drug may either raise the chance of an infection or make the vaccine not work as well.
- You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.
- You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
- Avoid beer, wine, or mixed drinks.
- Take good care of your teeth. See a dentist often.
- You may get sunburned more easily. Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun. Keep protecting yourself from sunburn for as long as you were told by your doctor.
- Tell your doctor if you have too much sweat, fluid loss, throwing up, loose stools (diarrhea), not hungry, or more thirst.
- Do not switch between different forms of this drug without first talking with the doctor.
- If you are 65 or older, use this drug with care. You could have more side effects.
- This drug may affect sperm in men. This may affect being able to father a child. Talk with the doctor.
- If you are a man and have sex with a female who could get pregnant, protect her from pregnancy during care and for 3 months after care ends. Use birth control that you can trust.
- This drug may cause you to not be able to get pregnant. Talk with the doctor.
- A pregnancy test will be done to show that you are NOT pregnant before starting this drug. If you get pregnant while taking this drug, call your doctor right away.
- If you are able to get pregnant, use birth control that you can trust to stop pregnancy while taking this drug and for at least 1 monthly period (menstrual) cycle after stopping this drug.
- If you are a woman and you miss a period, have unprotected sex, or think that your birth control has not worked, call your doctor right away.
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of infection. These include a fever of 100.5°F (38°C) or higher, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, wound that will not heal, or anal itching or pain.
- Signs of bleeding like throwing up blood or throw up that looks like coffee grounds; coughing up blood; blood in the urine; black, red, or tarry stools; bleeding from the gums; vaginal bleeding that is not normal; bruises without a reason or that get bigger; or any bleeding that is very bad or that you cannot stop.
- Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.
- Signs of kidney problems like unable to pass urine, change in the amount of urine passed, blood in the urine, or a big weight gain.
- Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
- Pinpoint red spots on your skin.
- Throwing up.
- Very bad belly pain.
- Very bad dizziness or passing out.
- Change in thinking clearly and with logic.
- Change in eyesight.
- Bone pain.
- Swelling, warmth, numbness, change of color, or pain in a leg or arm.
- Change in strength on 1 side is greater than the other, trouble speaking or thinking, change in balance, or blurred eyesight.
- Neck stiffness.
- Not able to move.
What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.
- Upset stomach.
- Hair loss.
- Feeling tired or weak.
- Belly pain.
How is this drug best taken?
Use this drug as ordered by your doctor. Read and follow the dosing on the label closely.
- Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.
- Take as you have been told by your doctor. This drug is not to be used every day. Be sure you know how to use this drug.
- To gain the most benefit, do not miss doses.
- How this drug is taken may change based on blood work results, side effects, and how well the drug is working.
Shot (if given under the skin):
- It is given as a shot into the fatty part of the skin on the top of your thigh or the belly area.
- Your doctor may teach you how to give the shot.
- Follow how to use carefully.
- Do not use if the solution is cloudy, leaking, or has particles.
- Do not give into red or irritated skin.
- Throw away needles in a needle/sharp disposal box. When the box is full, follow all local rules for getting rid of it. Talk with a doctor or pharmacist if you have any questions.
Shot (if given in the muscle or vein):
- It is given as a shot into a muscle or vein.
- A shot may be given into the spinal fluid.
- This drug will be given to you by a doctor.
What do I do if I miss a dose?
- Call the doctor to find out what to do.
How do I store and/or throw out this drug?
Shot (if given in the muscle or vein):
- This drug will be given to you in a hospital or doctor’s office. You will not store it at home.
All other products:
- Store at room temperature.
- Store in a dry place. Do not store in a bathroom.
- Protect from light.
Shot (if given under the skin):
- Keep all drugs out of the reach of children and pets.
- Check with your pharmacist about how to throw out unused drugs.
General drug facts
- If your symptoms or health problems do not get better or if they become worse, call your doctor.
- Do not share your drugs with others and do not take anyone else’s drugs.
- Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
- Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
- Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, pharmacist, or other health care provider.
- If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
Consumer Information Use and Disclaimer
This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.
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