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  • Generic Name: (methotrexate)
    Other Brands: N/A
  • Last Revised: 04/2014
    • What is this medication and its most common uses?

      Methotrexate injection is a medicine used to treat certain cancers. It is also used to treat severe psoriasis (an immune disorder that affects the skin) and severe rheumatoid arthritis (a type of arthritis that involves inflammation of the joints) (including juvenile rheumatoid arthritis). Methotrexate injection is administered as intramuscular (into your muscle), intravenous (into your vein), intra-arterial (into your artery), or intrathecal (into your spinal fluid) injections.

    • What should I know when beginning and continuing on this medication?

      How does this medication work?

      Methotrexate injection works by slowing the growth of cancer cells when used in the treatment of cancer. Methotrexate injection is thought to decrease the activity of the immune system in the treatment of rheumatoid arthritis and slow the growth of skin cells to stop the formation of scales in psoriasis.

      What are the beneficial effects of this medication and when should I begin to have results?

      What: Methotrexate injection has been shown to improve symptoms associated with arthritis, such as joint swelling and tenderness.

      When: Methotrexate injection may start working to reduce symptoms associated with rheumatoid and juvenile rheumatoid arthritis within 3 to 6 weeks, and may continue to improve symptoms for another 12 weeks or more.

      How do I know it is working?

      Your healthcare provider may order tests regularly to check how well this medication is working.

    • What are the possible side effects of this medication?

      The following is not a full list of side effects. Side effects cannot be anticipated. If any develop or change in intensity, tell your healthcare provider as soon as possible. Only your healthcare provider can determine if it is safe for you to continue taking this medication.

      Methotrexate injection can harm your unborn baby. If you are pregnant or your sexual partner is pregnant, or plans to become pregnant, do not receive methotrexate injection. Neither you nor your partner should become pregnant while receiving methotrexate injection. Women should wait at least 1 menstrual cycle after stopping treatment with methotrexate injection before getting pregnant. Men should wait at least 3 months after stopping treatment with methotrexate injection before getting their partner pregnant. Women who can become pregnant should have a pregnancy test before receiving methotrexate injection.

      Methotrexate injection can cause serious anemia (low red blood cell counts), low white blood cell, and low platelet (a type of blood cells that form clots to help stop bleeding) counts in your blood. Call your healthcare provider right away if you develop any signs of an infection or unusual bleeding or bruising.

      Methotrexate injection can cause liver damage (including cirrhosis [scarring of the liver]), kidney damage, or lung disease. Your healthcare provider may perform certain tests to monitor your condition. If you experience symptoms such as a dry, hacking cough, call your healthcare provider right away.

      Methotrexate injection can cause lymphoma (a type of cancer involving cells of the immune system, called lymphocytes), severe skin reactions and rashes, or certain infections.

      Methotrexate injection can also cause soft tissue and bone damage if you are getting radiation therapy at the same time you are receiving methotrexate injection.

      Common side effects may include: mouth sores, nausea, low white blood cell counts, upset stomach.

    • Who should not take this medication?

      Your healthcare provider will not administer methotrexate injection to you if you are allergic to it or any of its ingredients.

      Your healthcare provider will not administer methotrexate injection to you if you are pregnant, plan to become pregnant, or are breastfeeding.

      Your healthcare provider will not administer methotrexate injection to you if you have any condition that weakens your immune system.

      Your healthcare provider will not administer methotrexate injection to you if your bone marrow does not make enough blood cells; or if you have low white blood cell counts, low platelet counts, or serious anemia.

      Your healthcare provider will not administer methotrexate injection to you if you drink alcohol, have liver problems from alcohol abuse, or if you have long-term liver disease.

    • What should I tell my healthcare provider before I take the first dose of this medication?

      Tell your healthcare provider about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with methotrexate injection. Also, talk to your healthcare provider about your complete medical history, especially if you have liver or kidney problems, or if you are pregnant, plan to become pregnant, or are breastfeeding.

    • What is the usual dosage?

      The information below is based on the dosage guidelines your healthcare provider uses. Depending on your condition and medical history, your healthcare provider may prescribe a different regimen. Do not change the dosage or stop taking your medication without your healthcare provider's approval.

      Cancer

      Adults and children: Your healthcare provider will prescribe the appropriate dose for you or your child, based on the type of cancer being treated.

      Severe Psoriasis

      Adults: Your healthcare provider will prescribe the appropriate dose for you.

      Rheumatoid Arthritis

      Adults: Your healthcare provider may prescribe a different way to take this medicine at the start of treatment, if your dose does not match the available methotrexate injection doses. Your healthcare provider may adjust your dose, and will prescribe the appropriate dose of methotrexate injection for you as needed.

      Juvenile Rheumatoid Arthritis

      Children 2-16 years: Your healthcare provider will prescribe the appropriate dose for your child, based on his/her height and weight.

      Your healthcare provider may adjust your or your child's dose as needed, until the desired effect is achieved.

    • How should I take this medication?

      Your healthcare provider will administer methotrexate injection to you.

      Your dose of methotrexate injection and when you receive it will depend on the condition that is being treated. If you are receiving methotrexate injection for severe psoriasis or severe rheumatoid arthritis (including juvenile rheumatoid arthritis), remember to receive your dose weekly and not every day.

    • What should I avoid while taking this medication?

      Do not become pregnant while receiving methotrexate injection. Women should wait at least 1 menstrual cycle after stopping treatment with methotrexate injection before getting pregnant. Men should wait at least 3 months after stopping treatment with methotrexate injection before getting their partner pregnant.

      Do not breastfeed while you are receiving methotrexate injection.

      Do not drive, operate heavy machinery, or do other dangerous activities until you know how methotrexate injection affects you.

      Do not miss any scheduled follow-up appointments with your healthcare provider. Methotrexate injection may cause serious and life-threatening effects. It is important that you are always under your healthcare provider's supervision during treatment.

    • What are the possible food and drug interactions associated with this medication?

      If methotrexate injection is used with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your healthcare provider before combining methotrexate injection with the following: aspirin, azathioprine, certain antibiotics (such as chloramphenicol, penicillin, sulfamethoxazole/trimethoprim, or tetracycline), certain cancer medicines (such as cisplatin or mercaptopurine), folic acid supplementation, medicines that reduce acid in your stomach (such as omeprazole or pantoprazole), nonsteroidal anti-inflammatory drugs (NSAIDs) (such as ibuprofen or naproxen), phenytoin, probenecid, retinoids (such as isotretinoin), sulfasalazine, or theophylline.

    • May I receive this medication if I am pregnant or breastfeeding?

      Do not receive methotrexate injection during pregnancy or breastfeeding. Tell your healthcare provider immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

    • What should I do if I miss a dose of this medication?

      Methotrexate injection should be given under special circumstances determined by your healthcare provider. If you miss your scheduled dose, contact your healthcare provider or pharmacist for advice.

    • How should I store this medication?

      Your healthcare provider will store this medication for you.

    • Who should I contact in case of emergency or overdose?
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      In the event of a medical emergency call your doctor or 9-1-1 immediately. In the event of overdose, call your doctor or poison control for further instructions.
      National Poison Control#: Call 1-800-222-1222

      This PDR+ drug information has been developed by the Physicians’ Desk Reference Network (PDRN), a source of medication information trusted by doctors for over 65 years.

      This monograph summarizes the most important information about your medication and does not cover all the information you may need. If you have any questions or concerns or want to learn more about your medication, ask your healthcare provider; he/she will be able to provide answers to your questions. This medication should only be used by the patient for whom it was prescribed and should not be shared with other people.
    • Additional patient resources.
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    This discount plan is NOT insurance or a Medicare prescription drug plan. The plan is not intended as a substitute for insurance and does not meet creditable coverage requirements under state or federal law. The plan provides discounts at participating pharmacies on certain pharmaceutical supplies, prescription drugs, or medical equipment and supplies. The range of discounts will vary depending on the products received. Members are obligated to pay the pharmacy the entire amount of the discounted rate for such products at the point of sale. The plan does not pay pharmacies for products provided to members. No enrollment or periodic fees apply. The pharmacy may pay the plan a fee from amounts the pharmacy collects from the member. The discount plan organization is ProCare Pharmacy Benefit Manager, Inc.,1267 Professional Parkway, ProCare Office Park, Gainesville, GA 30507, 1-888-299-5383. Customer service is provided by PDR, LLC., 5 Paragon Drive, Montvale, NJ, 07645, 1-800-232-7379, www.pdr.net/DiscountCard, customerservice@pdr.net.