METHOTREXATE-ORAL (cont.)
PRECAUTIONS: Before taking methotrexate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: liver disease, severe kidney disease, severe lung disease (e.g., pulmonary fibrosis), alcohol use, suppressed immune system, blood cell/bone marrow disorders. Before using this medication, tell your doctor or pharmacist your medical history, especially of: stomach/intestinal diseases (e.g., peptic ulcer, ulcerative colitis), kidney disease, any active infection (including chickenpox or recent exposure to it), folic acid deficiency. This drug may make you dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery. Avoid alcoholic beverages. This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths or sunlamps. Use a sunscreen and wear protective clothing when outdoors. Do not have immunizations/vaccinations without the consent of your doctor and avoid contact with people who have recently received oral polio vaccine. Use caution with sharp objects like safety razors or nail cutters and avoid activities such as contact sports to lower the chance of getting cut, bruised, or injured. Wash your hands well to prevent the spread of infections. Methotrexate must not be used during pregnancy. It may cause fetal harm. If you become pregnant or think you may be pregnant, inform your doctor immediately. Pregnancy must be avoided, therefore males and females must use reliable form(s) of birth control during and for at least 3 months following the end of methotrexate treatment. Methotrexate passes into breast milk. Do not breast-feed while using this drug due to the risk for fetal harm.
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.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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