Methotrexate

Methotrexate may cause very serious side effects. Some side effects of methotrexate may cause death. You should only use methotrexate to treat life-threatening cancer, or certain other conditions that are very severe and that cannot be treated with other medications. Talk to your doctor about the risks of taking methotrexate for your condition.

Tell your doctor if you have or have ever had excess fluid in your stomach area or in the space around your lungs and if you have or have ever had kidney disease. Also tell your doctor if you are taking aspirin or other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) or are being treated with radiation therapy. These conditions and treatments may increase the risk that you will develop serious side effects of methotrexate. Your doctor will monitor you more carefully and may need to change the doses of your medications.

Methotrexate may cause liver damage. Tell your doctor if you are taking any of the following medications: acitretin (Soriatane), azathioprine (Imuran), isotretinoin (Accutane), sulfasalazine (Azulfidine), or tretinoin (Vesanoid), Tell your doctor if you drink or have ever drunk large amounts of alcohol and if you have or have ever had liver disease, Your doctor may tell you that you should not take methotrexate unless you have a life-threatening cancer. Also tell your doctor if you have diabetes. Do not drink alcohol while you are taking methotrexate. Call your doctor immediately if you experience any of the following symptoms: nausea, extreme tiredness, lack of energy, loss of appetite, pain in the upper right part of the stomach, yellowing of the skin or eyes, or flu-like symptoms.

Methotrexate may cause lung damage. Tell your doctor if you have or have ever had lung disease. Call your doctor immediately if you experience any of the following symptoms: dry cough, fever, or shortness of breath.

Methotrexate may cause kidney damage. Be sure to drink plenty of fluids during your treatment with methotrexate, especially if you exercise or are physically active. Call your doctor if you think you might be dehydrated (do not have enough fluid in your body). You may become dehydrated if you sweat excessively or if you vomit, have diarrhea, or have a fever.

Methotrexate may cause a decrease in the number of blood cells made by your bone marrow. Tell your doctor if you have or have ever had a low blood count (decrease in the number of blood cells in your body), anemia (red blood cells do not bring enough oxygen to all parts of the body), or any other problem with your blood cells. Your doctor may tell you not to take methotrexate unless you have a life-threatening cancer. Call your doctor immediately if you experience any of the following symptoms: sore throat, chills, fever, or other signs of infection; unusual bruising or bleeding; excessive tiredness; weakness; pale skin; dizziness; confusion; fast heartbeat; shortness of breath; or difficulty falling asleep or staying asleep.

Methotrexate may cause damage to your intestines. Tell your doctor if you have or have ever had stomach ulcers or ulcerative colitis (condition in which part or all of the lining of the intestine is swollen or worn away). If you develop sores in your mouth or diarrhea, stop taking methotrexate and call your doctor immediately.

Methotrexate may cause a severe rash that may be life-threatening. If you develop a rash, blisters, or a fever, call your doctor immediately.

Methotrexate may decrease the activity of your immune system, and you may develop serious infections. Tell your doctor if you have any type of infection and if you have or have ever had any condition that affects your immune system such as human immunodeficiency syndrome (HIV) or acquired immunodeficiency syndrome (AIDS). Your doctor may tell you that you should not take methotrexate unless you have a life-threatening cancer. If you experience signs of infection such as a sore throat, cough, fever, or chills, call your doctor immediately.

Taking methotrexate may increase the risk that you will develop lymphoma (cancer that begins in the cells of the immune system). If you do develop lymphoma, it might go away without treatment when you stop taking methotrexate, or it might need to be treated with chemotherapy.

If you are taking methotrexate to treat cancer, you may develop certain complications as methotrexate works to destroy the cancer cells. Your doctor will monitor you carefully and treat these complications if they occur.

Keep all appointments with your doctor and the laboratory. Your doctor will order lab tests before, during, and after your treatment to check your body's response to methotrexate and to treat side effects before they become severe.

Women who are taking methotrexate, or whose male partners are taking methotrexate are less likely to become pregnant than women who are not taking methotrexate or whose partners are not taking the medication. However, you should not assume that you or your partner cannot become pregnant while you are taking methotrexate. Tell your doctor if you or your partner is pregnant or plan to become pregnant. If you are female, you will need to take a pregnancy test before you begin taking methotrexate. Use a reliable method of birth control so that you or your partner will not become pregnant during or shortly after your treatment. If you are male, you and your female partner should continue to use birth control for 3 months after you stop taking methotrexate. If you are female, you should continue to use birth control until you have had one menstrual period that began after you stopped taking methotrexate. If you or your partner become pregnant, call your doctor immediately. Methotrexate may harm the fetus.