{"id":33494,"date":"2021-06-02T09:57:43","date_gmt":"2021-06-02T13:57:43","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=33494"},"modified":"2021-06-02T09:57:43","modified_gmt":"2021-06-02T13:57:43","slug":"methotrexate-side-effects","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/methotrexate-side-effects\/","title":{"rendered":"Methotrexate side effects and how to avoid them"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><a href=\"#methotrexate-side-effects\">Methotrexate side effects<\/a> | <a href=\"#serious-side-effects\">Serious side effects<\/a> | <a href=\"#how-long-do-side-effects-last\">How long do side effects last?<\/a> | <a href=\"#warnings\">Warnings<\/a> | <a href=\"#interactions\">Interactions<\/a> | <a href=\"#how-to-avoid-side-effects\">How to avoid side effects<\/a><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Methotrexate, available generically or under the brand names Trexall, Otrexup, and Rasuvo, is a prescription drug used in chemotherapy for various types of cancer such as lymphoma and leukemia. It is also prescribed as an immunosuppressant to treat conditions such as rheumatoid arthritis, <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/psoriasis-treatment-and-medications\"><span style=\"font-weight: 400;\">psoriasis<\/span><\/a><span style=\"font-weight: 400;\">, and juvenile idiopathic arthritis (JIA).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Methotrexate is an <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK556114\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">antifolate antimetabolite<\/span><\/a><span style=\"font-weight: 400;\"> that prevents the growth of fast-growing cancer cells by blocking their ability to use folic acid to grow and divide. As an immunosuppressant, methotrexate dials down the immune response during attacks of autoimmune disorders. Unfortunately, methotrexate side effects are commonly experienced even at low doses. In preparing for methotrexate treatment, it helps to fully understand side effects, restrictions, drug interactions, and how to manage possible side effects.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">RELATED: <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/methotrexate\/what-is\"><span style=\"font-weight: 400;\">Learn more about methotrexate<\/span><\/a><\/p>\n<h2 id=\"methotrexate-side-effects\"><span style=\"font-weight: 400;\">Common side effects of methotrexate<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The most common side effects of methotrexate involve digestive system problems. However, because methotrexate affects vital cellular functions, a wide range of side effects are possible. These side effects include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vomiting<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swelling and ulcers in the mouth (stomatitis)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Loss of appetite<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver dysfunction<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hair loss<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Abdominal discomfort<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diarrhea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tiredness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fever<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sore throat<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rash<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Itching<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dry cough<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low blood cell counts<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Photosensitivity (sunburn recall)<\/span><\/li>\n<\/ul>\n<h2 id=\"serious-side-effects\"><span style=\"font-weight: 400;\">Serious side effects of methotrexate<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Methotrexate prevents tissue growth because it blocks fundamental cellular functions. Severe adverse effects can affect many vital systems in the body including the bone marrow, liver, kidneys, lungs, digestive system, and lymphatic system. Additionally, by suppressing the immune system, methotrexate makes patients more vulnerable to infections.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Serious side effects of methotrexate include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Blood disorders<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver damage, cirrhosis (scarring), and fibrosis (extensive scarring)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Lung swelling (pneumonitis) and lung scarring (pulmonary fibrosis)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kidney damage and kidney failure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Intestinal bleeding and perforation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe mouth ulcers<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe diarrhea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Opportunistic infections<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tumor lysis syndrome (poisoning from extensive cancer cell death)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Uncontrolled growth of white blood cells<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Leukoencephalopathy (in people receiving radiation treatments to the head)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe allergic skin reactions<\/span><\/li>\n<\/ul>\n<h2 id=\"how-long-do-side-effects-last\"><span style=\"font-weight: 400;\">How long do methotrexate side effects last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Gastrointestinal side effects and some mild side effects such as dizziness, headache, and rash typically <\/span><a href=\"https:\/\/www.pdr.net\/drug-summary\/Methotrexate-Tablets-methotrexate-1797\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">start early<\/span><\/a><span style=\"font-weight: 400;\"> and resolve after a few hours. However, other common side effects, such as <\/span><a href=\"https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer-terms\/def\/radiation-recall\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">recall sunburn<\/span><\/a><span style=\"font-weight: 400;\">, which is an inflammatory reaction that occurs after certain anticancer drugs are taken, may take a few days to resolve. More extensive side effects, such as hair loss or low blood cell counts, usually don\u2019t improve until methotrexate therapy is stopped or the dose is reduced.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Serious side effects typically take days to weeks to resolve. Many of these side effects, such as organ damage, intestinal damage, blood problems, tumor lysis syndrome, or severe allergic reactions, will require treatment or even hospitalization. Some side effects, such as fibrosis, are lifelong, chronic conditions.<\/span><\/p>\n<h2 id=\"warnings\"><span style=\"font-weight: 400;\">Methotrexate contraindications &amp; warnings<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Methotrexate is a very powerful and potentially toxic drug that disrupts human cell growth and partly shuts down the immune system. Many may experience problems or get very sick while taking methotrexate. All people undergoing methotrexate treatment will be monitored closely for side effects and other problems. The good news is that most serious adverse reactions, if detected early, can be reversed by lowering the dosage, discontinuing the drug, or treating the side effect.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Abuse and dependence<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Methotrexate does not cause dependence, withdrawal, or abuse.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Overdose<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Methotrexate overdose is a serious and potentially fatal medical emergency that will require immediate medical attention. There is an antidote for methotrexate called leucovorin that can help counteract the effects of methotrexate poisoning, but treatment may require intensive medical care.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Because methotrexate injections are administered by healthcare professionals, methotrexate overdose occurs primarily in those taking methotrexate tablets. In most cases, the overdose is not due to taking too many pills at once, but rather taking the weekly dose of methotrexate every day instead.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The symptoms of an oral overdose are the same as the side effects of a normal dose. Some people who have overdosed on methotrexate, however, may experience no overdose symptoms.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Contraindications and Restrictions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">People with some medical conditions will never be given methotrexate because of the risk of severe adverse reactions.<\/span><\/p>\n<ul>\n<li><b>Pregnant or breastfeeding women:<\/b><span style=\"font-weight: 400;\"> Methotrexate can cause birth defects and kill a fetus. Women of childbearing age will undergo a pregnancy test before methotrexate is administered. Contraception should be used while taking methotrexate and after discontinuing it for up to <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=e942f8db-510f-44d6-acb5-b822196f5e8c\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">three months<\/span><\/a><span style=\"font-weight: 400;\"> in men and up to six months in women. Methotrexate should also be avoided while nursing because it is present in breast milk and could harm a baby.\u00a0<\/span><\/li>\n<li><b>Kidney disease:<\/b><span style=\"font-weight: 400;\"> Because methotrexate can damage the kidneys, people with significant kidney dysfunction will not be given methotrexate for any condition.<\/span><\/li>\n<li><b>Alcoholism, alcohol-related liver disease, and chronic liver disease:<\/b><span style=\"font-weight: 400;\"> Because methotrexate affects liver function, methotrexate will not be used to treat diseases other than cancer in people who drink or have chronic liver problems.<\/span><\/li>\n<li><b>Immune system problems:<\/b><span style=\"font-weight: 400;\"> People with a suppressed immune system will not be given methotrexate treatment for diseases other than cancer. Extra caution is required in anyone with an <\/span><b>active infection<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li><b>Blood problems:<\/b><span style=\"font-weight: 400;\"> Methotrexate suppresses bone marrow, the tissue that generates blood cells. Anyone with pre-existing blood problems, such as anemia, will not receive methotrexate for diseases other than cancer.<\/span><\/li>\n<li><b>People older than 65<\/b><span style=\"font-weight: 400;\"> are at a higher risk of serious side effects and will be monitored carefully. Methotrexate should be used with extreme caution in <\/span><b>debilitated<\/b><span style=\"font-weight: 400;\"> patients.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Because of the risk of bleeding or perforation in the digestive system, methotrexate requires careful monitoring in people with <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/ulcer-treatment-and-medications\"><b>peptic ulcer disease<\/b><\/a><span style=\"font-weight: 400;\"> or <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/ulcerative-colitis-treatment-and-medications\"><b>ulcerative colitis<\/b><\/a><b>.<\/b><\/li>\n<li><span style=\"font-weight: 400;\">People receiving <\/span><b>cranial radiation therapy<\/b><span style=\"font-weight: 400;\"> will need to be watched carefully for leukoencephalopathy, a progressive loss of white matter in the brain.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">People with significant <\/span><a href=\"https:\/\/www.nursingcenter.com\/journalarticle?Article_ID=859815&amp;Journal_ID=606913&amp;Issue_ID=859810\" target=\"_blank\" rel=\"noopener\"><b>third-space accumulations<\/b><\/a><span style=\"font-weight: 400;\">, such as pleuritis, ascites, or other conditions in which fluid builds up between tissues, will need to have excess fluid in these spaces corrected before receiving methotrexate.<\/span><\/li>\n<\/ul>\n<h2 id=\"interactions\"><span style=\"font-weight: 400;\">Methotrexate interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Methotrexate cannot be taken with a wide range of prescription and over-the-counter drugs and supplements. Other drugs should only be combined with methotrexate cautiously.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Because of potentially severe drug interactions, methotrexate is never used with certain drugs or vaccines:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Live vaccines<\/b><span style=\"font-weight: 400;\"> could cause a serious infection.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Imlygic (talimogene laherparepvec)<\/b><span style=\"font-weight: 400;\">, a genetically modified live herpes virus, can cause a serious or life-threatening herpes infection <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=64ffb680-ea8c-42fc-9649-9e8c0eb77ddb#_4_1_Immunocompromised_Patients\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">in anyone<\/span><\/a><span style=\"font-weight: 400;\"> taking an immune-suppressing drug like methotrexate.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Acitretin<\/b><span style=\"font-weight: 400;\">, a retinoid used to treat psoriasis, <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=889783be-45c4-4b74-807f-a61a9f660d3b\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">raises the risk of liver damage<\/span><\/a><span style=\"font-weight: 400;\"> when combined with methotrexate.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Cidofovir<\/b><span style=\"font-weight: 400;\">, an antiviral drug, is highly toxic to the kidneys and is never prescribed with any other drug, like methotrexate, that also can <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=44966a7e-d777-40fb-956f-d0f31f737848\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">damage the kidneys<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Other drug interactions will require caution and careful monitoring. If there are problems, dosing or therapies may need to be adjusted. These drugs include:<\/span><\/p>\n<ul>\n<li><b>Nonsteroidal anti-inflammatory drugs (NSAIDs) and antifolates<\/b><\/li>\n<li><b>Antibiotics:<\/b><span style=\"font-weight: 400;\"> Aminoglycosides like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/streptomycin-sulfate\"><span style=\"font-weight: 400;\">streptomycin<\/span><\/a><span style=\"font-weight: 400;\"> are toxic to the kidneys, so doctors will avoid prescribing them with methotrexate. Penicillins interfere with the body\u2019s ability to clear methotrexate from the body, raising the risk of side effects. Some antibiotics are toxic to the liver and others reduce the body\u2019s ability to absorb methotrexate. They might require dose adjustments or sometimes should be avoided.<\/span><\/li>\n<li><b>Immunosuppressants:<\/b><span style=\"font-weight: 400;\"> Because methotrexate suppresses the immune system, taking it with other immune-suppressing drugs can seriously compromise immune function.<\/span><\/li>\n<li><b>Retinoids and alcohol: <\/b><span style=\"font-weight: 400;\">Taking methotrexate with oral retinoids or alcohol increases the risk of liver damage.<\/span><\/li>\n<li><b>Proton-pump inhibitors (PPIs):<\/b><span style=\"font-weight: 400;\"> PPIs increase methotrexate levels in the blood, making side effects more likely.<\/span><\/li>\n<li><b>Sulfonylureas and seizure medications: <\/b><span style=\"font-weight: 400;\">Sulfonylureas are drugs commonly used to treat Type 2 diabetes. Hydantoins, such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/phenytoin-sodium\"><span style=\"font-weight: 400;\">phenytoin<\/span><\/a><span style=\"font-weight: 400;\">, are used to prevent and control seizures. Both types of drugs increase the amount of methotrexate in the blood, increasing its toxicity.<\/span><\/li>\n<li><b>Theophyllines:<\/b> <a href=\"https:\/\/www.singlecare.com\/drug-classes\/bronchodilators\"><span style=\"font-weight: 400;\">Theophyllines<\/span><\/a><span style=\"font-weight: 400;\"> are more likely to produce serious side effects when combined with methotrexate. Healthcare providers are advised to avoid using them with methotrexate.<\/span><\/li>\n<li><b>Colony-stimulating factors:<\/b><span style=\"font-weight: 400;\"> Generally used after<\/span> <span style=\"font-weight: 400;\">cancer chemotherapy, drugs like filgrastim stimulate bone marrow cells to grow.\u00a0<\/span><\/li>\n<li><b>Photosensitizing agents:<\/b><span style=\"font-weight: 400;\"> Over <\/span><a href=\"https:\/\/www.dhs.wisconsin.gov\/radiation\/medications.htm\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">100<\/span><\/a><span style=\"font-weight: 400;\"> different drugs, vitamins, and herbal supplements make tissues more sensitive to light damage. Methotrexate reactivates tissue damage due to light or radiation. Many other drugs, including diuretics, tricyclic antidepressants, antihistamines, and a host of others, <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK431072\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">make skin and tissues more vulnerable to sunlight damage<\/span><\/a><span style=\"font-weight: 400;\">. Using them with methotrexate will require extra caution with sun exposure.<\/span><\/li>\n<li><b>Vaccines:<\/b><span style=\"font-weight: 400;\"> Because methotrexate suppresses the immune system, vaccination may not be effective. Vaccines should be delayed until methotrexate treatment is ended.<\/span><\/li>\n<\/ul>\n<h2 id=\"how-to-avoid-side-effects\"><span style=\"font-weight: 400;\">How to avoid methotrexate side effects<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Unfortunately, side effects are a common experience among people taking methotrexate. There are ways, however, to manage side effects.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">1. Tell the doctor about all medical conditions and medications<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The doctor prescribing methotrexate will perform a complete history and workup including blood tests. Even so, the best way to prevent side effects is to inform the doctor about all existing medical conditions and medications being taken. Once started on methotrexate, do not start or change any medications currently being taken until a doctor has been consulted.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2. Take methotrexate as directed<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Follow all the directions on the prescription label or provided by a healthcare professional. Do not take more or less than prescribed until you\u2019ve consulted with a doctor or healthcare professional.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">3. Take methotrexate as scheduled<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Adverse reactions and overdose are often due to people taking their methotrexate more often than scheduled. For people taking methotrexate for a disease other than cancer, methotrexate is taken only <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/24901\/methotrexate\/Adult-Dosing\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">once per week<\/span><\/a><span style=\"font-weight: 400;\">, not once per day. For cancer treatment, take the dose as scheduled, which could be <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/24901\/methotrexate\/Adult-Dosing\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">once a week to four times a week<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">4. Take folic acid supplements as directed<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">People taking methotrexate to treat cancer may be instructed by their doctor not to take folic acid (vitamin B9), folinic acid, or any multivitamin containing folic acid. Folic acid supplements reduce methotrexate\u2019s ability to fight off cancer. On the other hand, people taking methotrexate to treat diseases other than cancer may be instructed by their doctor to take folic acid supplements to prevent side effects. Folic acid does not reduce methotrexate\u2019s ability to treat autoimmune diseases. In all cases, follow the doctor\u2019s instructions to the letter.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">5. Split the dose<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">For people taking methotrexate for diseases other than cancer, the weekly dose can be split to minimize digestive system side effects. Take half the dose in the morning and the other half in the evening.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">6. Take methotrexate after a meal<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Another way to minimize gastrointestinal side effects is to take the methotrexate dose after a meal.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">7. Use a saltwater rinse for mouth sores<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A saltwater rinse or mouthwash containing a topical anesthetic can help relieve mouth irritation and sores.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Resources:<\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=889783be-45c4-4b74-807f-a61a9f660d3b\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Acitretin prescribing information<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=44966a7e-d777-40fb-956f-d0f31f737848\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Cidofovir prescribing information<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=64ffb680-ea8c-42fc-9649-9e8c0eb77ddb\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Imlygic (talimogene laherparepvec) prescribing information<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.dhs.wisconsin.gov\/radiation\/medications.htm\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Medications and other agents that increase sensitivity to light<\/span><\/a><span style=\"font-weight: 400;\">, Wisconsin Department of Health<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/online.epocrates.com\/drugs\/24901\/methotrexate\/Adult-Dosing\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Methotrexate<\/span><\/a><span style=\"font-weight: 400;\">, Epocrates<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK556114\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Methotrexate<\/span><\/a><span style=\"font-weight: 400;\">, StatPearls<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=dd39255b-81d1-4c08-aecf-acc4f2cdc04a\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Methotrexate tablet prescribing information<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=57b2face-9edd-4aea-bbc4-938249aa2267\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Methotrexate injection prescribing information<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560686\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Photodynamic Therapy<\/span><\/a><span style=\"font-weight: 400;\">, StatPearls<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK431072\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Photosensitivity<\/span><\/a><span style=\"font-weight: 400;\">, StatPearls<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.nursingcenter.com\/journalarticle?Article_ID=859815&amp;Journal_ID=606913&amp;Issue_ID=859810\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Topics in progressive care: Third-spacing: when fluid shifts<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Nursing Critical Care<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=e942f8db-510f-44d6-acb5-b822196f5e8c\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Trexall methotrexate tablet prescribing information<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Methotrexate side effects | Serious side effects | How long do side effects last? | Warnings | Interactions | How to avoid side effects Methotrexate, available generically or under the brand names Trexall, Otrexup, and Rasuvo, is a prescription drug used in chemotherapy for various types of cancer such as lymphoma and leukemia. It is [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":33536,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[12164,794,790,12752],"coauthors":[8861],"class_list":["post-33494","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-arthritis","tag-cancer","tag-chronic-disease","tag-medication-side-effects","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Methotrexate side effects, interactions and warnings | SingleCare<\/title>\n<meta name=\"description\" content=\"Nausea, vomiting, and stomatitis are common methotrexate side effects. 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