Medications and Drugs

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GENERIC NAME: METHOTREXATE - INJECTION (meth-oh-TREX-ate)

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WARNING: Methotrexate has infrequently caused serious (sometimes fatal) side effects. Therefore, this medication should be used only to treat cancer or severe cases of psoriasis or rheumatoid arthritis. Methotrexate formulations with preservatives must not be used for high-dose treatment or injected into the spine (intrathecal). Methotrexate has caused birth defects and fetal death. Women must avoid becoming pregnant while taking this medication. Pregnant women who have psoriasis or rheumatoid arthritis must not use methotrexate. (See also Precautions.) If you have kidney problems or excess body water (ascites, pleural effusion), you must be closely monitored and your dose may be adjusted or stopped by your doctor. Methotrexate (usually at high dosages) has rarely caused severe (sometimes fatal) bone marrow suppression (decreasing your body's ability to fight infections) and stomach/intestinal disease (e.g., bleeding) when used at the same time as non-steroidal anti-inflammatory drugs (NSAIDs such as indomethacin, ketoprofen). Therefore, NSAIDs should not be used with high-dose methotrexate. Caution is advised if you also take aspirin. NSAIDs/aspirin may be used with low-dose methotrexate such as for the treatment of rheumatoid arthritis if directed by your doctor. If you are using low-dose aspirin (81-325 mg per day) for heart attack or stroke prevention, continue to take it unless directed otherwise. Consult your doctor regarding safe use of these drugs (e.g., close monitoring by your doctor, maintaining stable doses of NSAIDs). This drug in rare instances may also cause liver problems when it is used for long periods of time. If you are using methotrexate long-term, a liver biopsy is usually recommended. Methotrexate use has infrequently resulted in serious (sometimes fatal) lung problems, lung infections (Pneumocystis carinii pneumonia), skin reactions, diarrhea and mouth sores (ulcerative stomatitis). (See also Side Effects.) Lumps (tumors/abnormal growths) may very infrequently appear during methotrexate use. The drug must be stopped and treatment may be needed. Consult your doctor immediately if new lumps/growths occur. When used to treat tumors, methotrexate sometimes causes side effects due to the rapid destruction of cancer cells (tumor lysis syndrome). Tell your doctor immediately if you experience symptoms such as irregular heartbeat or muscle weakness. Although rare, this medication when used with radiation treatment may increase the risk of tissue and bone damage. Discuss the risks and benefits of your treatment plan with your doctor.