Methotrexate injection

July 17, 2018

Methotrexate injection

What is this medicine?

METHOTREXATE (METH oh TREX ate) is a chemotherapy drug used to treat cancer including breast cancer, leukemia, and lymphoma. This medicine can also be used to treat psoriasis and certain kinds of arthritis.

How should I use this medicine?

This medicine is for infusion into a vein or for injection into muscle or into the spinal fluid (whichever applies). It is usually given by a health care professional in a hospital or clinic setting.

In rare cases, you might get this medicine at home. You will be taught how to give this medicine. Use exactly as directed. Take your medicine at regular intervals. Do not take your medicine more often than directed.

If this medicine is used for arthritis or psoriasis, it should be taken weekly, NOT daily.

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 healthcare provider to get one.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 2 years for selected conditions, precautions do apply.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

  • back pain

  • breathing problems or shortness of breath

  • confusion

  • diarrhea

  • dry, nonproductive cough

  • low blood counts - this medicine may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk of infections and bleeding

  • mouth sores

  • redness, blistering, peeling or loosening of the skin, including inside the mouth

  • seizures

  • severe headaches

  • signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine

  • signs and symptoms of bleeding such as bloody or black, tarry stools; red or dark-brown urine; spitting up blood or brown material that looks like coffee grounds; red spots on the skin; unusual bruising or bleeding from the eye, gums, or nose

  • signs and symptoms of kidney injury like trouble passing urine or change in the amount of urine

  • signs and symptoms of liver injury like dark yellow or brown urine; general ill feeling or flu-like

symptoms; light-colored stools; loss of appetite; nausea; right upper belly pain; unusually weak or tired; yellowing of the eyes or skin

  • stiff neck

  • vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • dizziness

  • hair loss

  • headache

  • stomach pain

  • upset stomach

What may interact with this medicine?

This medicine may interact with the following medications:

  • acitretin

  • aspirin or aspirin-like medicines including salicylates

  • azathioprine

  • certain antibiotics like chloramphenicol, penicillin, tetracycline

  • certain medicines for stomach problems like esomeprazole, omeprazole, pantoprazole

  • cyclosporine

  • gold

  • hydroxychloroquine

  • live virus vaccines

  • mercaptopurine

  • NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen

  • other cytotoxic agents

  • penicillamine

  • phenylbutazone

  • phenytoin

  • probenacid

  • retinoids such as isotretinoin and tretinoin

  • steroid medicines like prednisone or cortisone

  • sulfonamides like sulfasalazine and trimethoprim/sulfamethoxazole

  • theophylline

What if I miss a dose?

It is important not to miss your dose. Call your doctor or health care professional if you are unable to keep an appointment. If you give yourself the medicine and you miss a dose, talk with your doctor or health care professional. Do not take double or extra doses.

Where should I keep my medicine?

If you are using this medicine at home, you will be instructed on how to store this medicine. Throw away any unused medicine after the expiration date on the label.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • fluid in the stomach area or lungs

  • if you often drink alcohol

  • infection or immune system problems

  • kidney disease

  • liver disease

  • low blood counts, like low white cell, platelet, or red cell counts

  • lung disease

  • radiation therapy

  • stomach ulcers

  • ulcerative colitis

  • an unusual or allergic reaction to methotrexate, other medicines, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

What should I watch for while using this medicine?

Avoid alcoholic drinks.

In some cases, you may be given additional medicines to help with side effects. Follow all directions for their use.

This medicine 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 use sunscreen. Do not use sun lamps or tanning beds/booths.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

You may need blood work done while you are taking this medicine.

Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.

This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding.

Check with your doctor or health care professional if you get an attack of severe diarrhea, nausea and vomiting, or if you sweat a lot. The loss of too much body fluid can make it dangerous for you to take this medicine.

Talk to your doctor about your risk of cancer. You may be more at risk for certain types of cancers if you take this medicine.

Both men and women must use effective birth control with this medicine. Do not become pregnant while taking this medicine or until at least 1 normal menstrual cycle has occurred after stopping it. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. Men should not father a child while taking this medicine and for 3 months after stopping it. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.

Updated:  

July 17, 2018