Brand Name(s): Rheumatrex, Trexall
Generic Name Methotrexate

What are methotrexate tablets?

METHOTREXATE (Rheumatrex®) is a chemotherapy agent that is used to treat
certain kinds of cancer and other diseases. Methotrexate tablets are
commonly used to treat inflammatory conditions such as rheumatoid arthritis
and psoriasis. Methotrexate affects cells that are rapidly growing such as
cancer cells, cells of psoriasis, and cells in your mouth and stomach.
Methotrexate is used in treating a number of cancers including leukemias,
lymphoma, breast cancer, and others. Generic methotrexate tablets are
available.

What should my health care professional know before I take methotrexate
tablets?
They need to know if you have any of these conditions:
*If you are HIV-positive or have acquired immunodeficiency syndrome (AIDS)
*If you frequently drink alcohol-containing beverages
*bleeding or blood disorders
*cold sores or previous chickenpox or shingles infection
*gout
*an active infection
*kidney disease, including a history of kidney stones
*liver disease
*lung disease
*recent radiation therapy or sunburn
*stomach or intestinal disease or obstruction
*ulcerative colitis
*an unusual or allergic reaction to methotrexate, other chemotherapy, other
medicines, foods, dyes, or preservatives
*pregnant or trying to get pregnant
*breast-feeding

How should I take this medicine?
Take methotrexate tablets by mouth. Follow the directions on the
prescription label. Swallow the tablets with a drink of water. Do not take
your medicine more often than directed. Finish the full course prescribed by
your doctor or health care professional, even if the tablets make you feel
unwell. Do not stop taking except on your prescriber's advice.

The dose of methotrexate and how often it will be given may be different
depending upon your disease and other medicines you are taking. If you have
questions about the proper dose of your medicine, ask your prescriber or
other health care professional.

What if I miss a dose?
If you miss a dose, skip that dose unless you remember within an hour or
two, or your prescriber or health care professional tells you otherwise. Do
not take double or extra doses. If you vomit after taking a dose, call your
prescriber or health care professional for advice.

What drug(s) may interact with methotrexate?
*antiinflammatory drugs (NSAIDs, such as ibuprofen)
*antibiotics and other medicines for infections
*aspirin and aspirin-like medicines
*leucovorin
*vaccines
*medicines for diabetes
*phenytoin
*probenecid
*pyrimethamine

Tell your prescriber or health care professional about all other medicines
that you are taking, including nonprescription medicines, nutritional
supplements, or herbal products. Also tell your prescriber or health care
professional if you are a frequent user of drinks with caffeine or alcohol,
if you smoke, or if you use illegal drugs. These may affect the way your
medicine works. Check with your health care professional before stopping or
starting any of your medicines.

What side effects may I notice from taking methotrexate tablets?
Side effects will vary depending on the condition for which you are being
treated, the dose, and the length of time you are taking methotrexate. If
you want more information on possible side effects, ask your prescriber or
health care professional to discuss this with you.

Side effects that you should report to your prescriber or health care
professional as soon as possible:
*symptoms of infection - fever or chills, cough, sore throat, pain or
difficulty passing urine
*symptoms of decreased platelets or bleeding - bruising, pinpoint red spots
on the skin, black, tarry stools, blood in the urine
*symptoms of decreased red blood cells (anemia) - unusual weakness or
tiredness, fainting spells, lightheadedness
*diarrhea
*difficulty breathing, a non-productive cough
*mouth and throat ulcers
*redness, blistering, peeling or loosening of the skin, including inside the
mouth
*skin rash, hives, or itching
*changes in vision
*vomiting
*yellow coloring of skin or eyes

Side effects that usually do not require medical attention (report to your
prescriber or health care professional if they continue or are bothersome):
*hair loss
*increased sensitivity to sun and ultraviolet light
*loss of appetite
*nausea

What should I watch for while taking methotrexate tablets?
Visit your prescriber or health care professional for checks on your
progress. You will need to have regular blood checks. The side effects of
methotrexate can continue after you finish your treatment; report side
effects promptly. It may take several weeks before you see an improvement in
your rheumatoid arthritis or psoriasis.

Avoid alcohol-containing beverages while taking methotrexate. Methotrexate
therapy for rheumatoid arthritis and psoriasis may cause damage to your
liver. Your prescriber or health care professional will closely monitor your
liver function while you are taking methotrexate. You may need to have a
liver sample (a biopsy) taken before you receive methotrexate and during
your therapy for rheumatoid arthritis or psoriasis.

Methotrexate may make you feel generally unwell. This is because
methotrexate affects good cells as well as the disease cells. Report any
side effects as above, but continue your course of medicine even though you
feel ill, unless your prescriber or health care professional tells you to
stop.

Methotrexate may decrease your body's ability to fight infections. Call your
prescriber or health care professional if you have a fever, chills, sore
throat or other symptoms of a cold or flu. Do not treat these symptoms
yourself. Try to avoid being around people who are sick.

Methotrexate may harm your unborn baby. You should contact your prescriber
immediately if you believe or suspect you or your partner have become
pregnant while you are taking methotrexate. Both men and women must use
effective birth control continuously while taking methotrexate. It is
recommended that you use 2 reliable forms of contraception together. Men
should continue to use contraception for at least 3 months after stopping
methotrexate therapy. Women should continue to use contraception until after
their first normal menstrual cycle after stopping methotrexate therapy.

If you are going to have surgery or dental work, tell your surgeon, dentist,
or health care professional that you are taking methotrexate.

Methotrexate may cause you to more sensitive to the sun. Also methotrexate
may cause a previous sunburn or radiation therapy reaction to reappear. Keep
out of the sun, or wear protective clothing outdoors and use a sunscreen. Do
not use sun lamps or sun tanning beds or booths.

Where can I keep my medicine?
Keep out of the reach of children in a container that small children cannot
open.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F).
Protect from light. Throw away any unused medicine after the expiration
date.