What is Methotrexate: Uses, Warnings & Interactions

Updated Jan 13, 2021  •  Published Dec 30, 2020

Methotrexate overview

BRAND NAMES:

  • Trexall, Xatmep

Generic Names:

  • Methotrexate

Uses:

  • Treats cancer, including bone, lung, breast, head, neck, or blood cancer (including acute lymphoblastic leukemia), mycosis fungoides, or non-Hodgkin lymphoma. Also treats rheumatoid arthritis, psoriasis (a skin disease), and polyarticular juvenile idiopathic arthritis.

Therapeutic Classes:

  • Antineoplastic Agent, Antipsoriatic, Antirheumatic, Cytotoxic

Forms:

  • Tablet, Liquid

How it’s taken:

  • By mouth

What is Methotrexate used for?

Methotrexate is a medication used to treat certain types of cancers and autoimmune diseases. Methotrexate belongs to a class of medications called antifolate drugs. Methotrexate is a generic drug also sold under the trade names Trexall and Rasuvo. Methotrexate has been in use since the 1950s. In the treatment of cancers and autoimmune disease, methotrexate use is very common.

What form(s) does Methotrexate come in

  • Tablet

  • Liquid

What are common Methotrexate doses?

  • Tablet 2.5MG

Common Methotrexate prescriptions

  • Methotrexate Sodium
    36 tablets bottle

  • Methotrexate Sodium
    2.5mg tablet

How to take Methotrexate

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.

  • Oral liquid: Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.

  • Tablet: Swallow whole. Do not crush, break, or chew it. Do not take the tablet if you cannot swallow it.

  • Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

  • Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. If you use this medicine only once a week and you miss a dose or forget to use your medicine, skip the missed dose and use your medicine as soon as possible. Return to your regular schedule the following week. Do not use extra medicine to make up for a missed dose.

  • You may store this medicine in the refrigerator or at room temperature. If stored at room temperature, throw it away after 60 days. Do not freeze or expose this medicine to high temperatures.

  • Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

  • Tablet: Swallow whole. Do not crush, break, or chew it. Do not take the tablet if you cannot swallow it.

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.

  • Oral liquid: Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.

  • Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. If you use this medicine only once a week and you miss a dose or forget to use your medicine, skip the missed dose and use your medicine as soon as possible. Return to your regular schedule the following week. Do not use extra medicine to make up for a missed dose.

  • You may store this medicine in the refrigerator or at room temperature. If stored at room temperature, throw it away after 60 days. Do not freeze or expose this medicine to high temperatures.

What to do if you miss a dose of Methotrexate

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

  • If you use this medicine only once a week and you miss a dose or forget to use your medicine, skip the missed dose and use your medicine as soon as possible. Return to your regular schedule the following week. Do not use extra medicine to make up for a missed dose.

  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Methotrexate contraindications

  • This medicine is not right for everyone. Do not use it if you had an allergic reaction to methotrexate, or if you are pregnant or breastfeeding.

Methotrexate warnings

  • This medicine may cause birth defects if either partner is using it during conception or pregnancy. Tell your doctor right away if you or your partner becomes pregnant. If you are a woman who can bear children, your doctor may give you a pregnancy test before you start using this medicine to make sure you are not pregnant. Female patients should use an effective form of birth control during treatment and for at least 6 months after the last dose. Male patients who have female partners should use an effective form of birth control during treatment and for at least 3 months after the last dose.

  • Do not breastfeed during treatment and for at least 1 week after the last dose.

  • Tell your doctor if you have kidney disease, liver disease, blood or bone marrow problems (including anemia), diabetes, a weak immune system, any type of infection, stomach or bowel problem (including ulcers), lung or breathing problem, or a history of alcohol abuse.

  • This medicine may cause the following problems:Serious infections, which may be life-threateningKidney problemsStomach or bowel problems, including ulcer or perforationLiver problemsLung or breathing problems, including acute or chronic interstitial pneumonitisSerious skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome, exfoliative dermatitis, skin necrosis, or erythema multiformeIncreased risk of other cancers, including blood or skin cancerNerve problemsTumor lysis syndrome (electrolyte and metabolic problem that can be life-threatening)

  • This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.

  • This medicine could cause infertility. Talk with your doctor before using this medicine if you plan to have children.

  • Oral routeMedicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

  • This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.

  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Methotrexate interactions

  • Do not drink alcohol while you are using this medicine.

  • This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.

  • Tell your doctor if you have used methotrexate before for any reason.

  • Talk to your doctor before getting flu shots or other vaccines while you are receiving methotrexate. Vaccines may not work as well while you are using this medicine.

  • Some medicines can affect how methotrexate works. Tell your doctor if you are using any of the following:Azathioprine, cisplatin, cyclosporine, phenytoin, probenecid, sulfasalazine, theophyllineAntifolate medicine (including dapsone, pemetrexed, pyrimethamine, sulfonamides)Blood thinner (including warfarin)Diabetes medicine (including sulfonylureas)Medicine to treat an infection (including penicillin, sulfamethoxazole, trimethoprim/sulfamethoxazole, neomycin, tetracyclines)NSAIDs or pain medicine (including aspirin, diclofenac, ibuprofen, naproxen)Other cancer medicines, including radiation treatmentRetinoid medicineSalicylatesSteroid medicineStomach medicine (including esomeprazole, omeprazole, pantoprazole)Vitamin supplements containing folic acid

  • Make sure your doctor knows about any cancer treatments you are using, including cisplatin (Platinol®) or radiation.

Methotrexate side effects

Serious Side Effects

  • Change in how much or how often you urinate, lower back or side pain

  • Fever, chills, cough, sore throat, body aches

  • Chest pain, trouble breathing, blue lips or fingers

  • Rapid weight gain, swelling in your leg, ankles, or feet

  • Blistering, peeling, red skin rash

  • Dark urine or pale stools, nausea, vomiting, diarrhea, loss of appetite, stomach pain, yellow skin or eyes

  • Seizures, confusion, tingling or numbness in your hands, feet, or lips, trouble seeing, headache

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

  • Unusual bleeding, bruising, tiredness, or weakness

Less Serious Side Effects

  • Sores or white patches on your lips, mouth, or throat