DRUG INTERACTIONS: See also Warnings about non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin use. This drug should not be used with the following medications because very serious interactions may occur: acitretin, asparaginase, live vaccines, pyrimethamine. If you are currently using any of these medications, tell your doctor or pharmacist before starting methotrexate. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of: other cancer treatments potentially toxic to the kidney (e.g., cisplatin), digoxin, leflunomide, other drugs potentially toxic to the liver (e.g., azathioprine, sulfasalazine, retinoids such as isotretinoin), penicillins, phenytoin, probenecid, procarbazine, sulfa medications, theophylline. Certain antibiotics (e.g., chloramphenicol, sulfa, tetracyclines) may interfere with methotrexate blood tests (increase methotrexate blood levels due to protein-binding displacement). Make sure laboratory personnel and your doctors know you are using any of these types of antibiotics. Do not start or stop any medicine without doctor or pharmacist approval.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include severe nausea and vomiting, and bloody stools.

NOTES: Do not share this medication with others. Laboratory and/or medical tests (e.g., CBC, liver and kidney function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

MISSED DOSE: It is important to use each dose at the scheduled time. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule. Do not double the dose to catch up.

STORAGE: Store this medication at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).