What is Methotrexate Sodium: Uses, Warnings & Interactions

How to take Methotrexate Sodium

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.

• Do not change the dose.

• Do not take methotrexate more frequently than prescribed. You may be taking methotrexate once per day or once per week. Make sure you understand the dosing schedule.

• If you are being treated for an autoimmune disorder, the healthcare provider may prescribe a folic acid or folinic acid supplement to be taken daily.

  • If you are being treated for cancer, do not take a folic acid or folinic acid supplement unless instructed to by the healthcare provider.

• How to take methotrexate tablets:

  • Swallow the tablet whole with water.

  • Store methotrexate tablets at room temperature away from light.

• How to take or administer methotrexate oral solution: 

  • Always wear disposable gloves when giving methotrexate doses.

  • Shake the bottle before measuring a dose.

  • Always use the calibrated oral syringe that comes with this medicine to measure a dose. Do not use kitchen or table utensils.

  • The person taking the dose should be sitting up or standing up.

  • Always thoroughly wash the oral syringe with soap and water after administering a dose.

  • Store the oral solution at room temperature in its original bottle. Make sure the bottle is tightly closed. Store the oral syringe in a clean, dry place. Do not use it to administer other medications.

  • When the bottle is empty, throw away both the bottle and the oral syringe.

  • Dispose of any unused medicine 3 months after the bottle is opened. Do not put the medicine in household trash or flush it down a drain. Ask a pharmacist what to do. 

• How to administer methotrexate injections: 

  • You can inject methotrexate beneath the skin with single-dose methotrexate pen injectors (Otrexup or Rasuvo).

  • Read the Instructions for Use that come with the injector. 

  • The instructions will vary depending on the brand.

  • Always check the dose on the package, the expiration date, the integrity of the injector, and the medicine visible in the viewing window of the injector. 

  • Administer injections only into the skin on the abdomen or thigh.

  • Do not administer injections into skin that is damaged, bruised, tender, hard, or scarred.

  • Wipe the injection area with an alcohol swab.

  • Follow the Instructions for Use when administering an injection.

  • Dispose of the injector in a sharps container.

What to do if you miss a dose of Methotrexate Sodium

• Ask the healthcare provider what you should do if a dose is missed or forgotten.

• For methotrexate injections, if the injector does not deliver a full dose, do not take another dose. Contact your healthcare provider.

Methotrexate Sodium contraindications

• This medicine is not right for everyone. 

• Do not use it if you have had an allergic reaction to methotrexate.

• Methotrexate can never be used to treat anything other than cancer in women who are pregnant. Methotrexate can harm or kill a fetus.

  • If you are a woman of childbearing age, your healthcare provider may give you a pregnancy test before you start using this medicine to make sure you are not pregnant. 

  • Female patients should use an effective form of birth control during treatment and for at least 6 months after the last dose.

  • Female patients should use an effective form of birth control during treatment and for at least 6 months after the last dose.

Methotrexate Sodium warnings

• Tell any healthcare provider who treats you that you are using this medicine.

• Your healthcare provider may need to perform regular lab tests to check on the effects of this medicine and the progress of your treatment. Keep all appointments.

• Methotrexate is very powerful and can have many serious side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your healthcare provider during your treatment and to keep the healthcare provider informed about any side effects or problems you are having while taking this medicine.

• Understand the dosing schedule. Methotrexate can be prescribed once per week or once daily. Taking weekly doses every day could cause serious side effects.

• Before taking methotrexate, tell the prescribing healthcare provider if you have:

  • Kidney disease

  • Liver problems

  • Fluid buildup in the abdomen (ascites)

  • Fluid buildup in the lungs

  • Lung disease

  • Stomach ulcers

  • Ulcerative colitis

  • Any upcoming surgery that requires anesthesia

  • Any recent radiation treatment

• Tell your healthcare provider if you drink alcohol and how much.

• This medicine may cause birth defects if either partner is using it during conception or pregnancy.

  • Tell your healthcare provider right away if you or your partner becomes pregnant. 

  • Female patients should use an effective form of birth control during treatment and for at least 6 months after the last dose.

  • Male patients who have female partners should use an effective form of birth control during treatment and for at least 3 months after the last dose.

• Do not breastfeed during treatment and for at least 1 week after the last dose.

• Tell your healthcare provider if you have used methotrexate for any reason.

• This medicine may cause the following problems:

  • Serious and possibly life-threatening infections

  • Kidney damage

  • Severe digestive system problems, including bleeding and perforation

  • Kidney dysfunction or kidney failure

  • Severe and possibly irreversible lung damage

  • Secondary cancers, including skin cancer and lymphoma

  • Severe nerve damage

  • Tumor lysis syndrome, a potentially life-threatening effect of cancer treatment

  • Anemia

  • Eye damage or sight loss

• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often. Avoid people with infectious diseases.

• This medicine could cause infertility. Talk with your healthcare provider before using this medicine if you plan to have children.

• This medicine may make your skin more sensitive to sunlight. It can also bring back any sunburn or radiation burns that have already cleared up. Wear sunscreen. Do not use sunlamps or tanning beds.

Methotrexate Sodium interactions

• To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medications, and supplements you are using before taking methotrexate, especially:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen

  • Heartburn and ulcer medications called proton pump inhibitors (PPIs)

  • Antibiotics, particularly penicillins, sulfa drugs, aminoglycosides, and tetracyclines

  • Cancer drugs

  • Immune suppressants

  • Diabetes drugs called sulfonylureas

  • Salicylates

  • Blood thinners

  • Retinoids

  • Malaria or cancer drugs called antifolates

  • Phenytoin, probenecid, sulfasalzine, valproate

• Flu shots or other vaccines may not work well in people taking methotrexate. 

• Healthcare providers usually avoid giving live vaccines to people taking methotrexate. There’s a chance the vaccine will cause a serious infection.

• Do not drink alcohol while you are using this medicine.

• People taking methotrexate for cancer should not take folic acid (vitamin B9) supplements.

• People taking methotrexate for autoimmune diseases will probably be advised to supplement their diet with folic acid (vitamin B9). This will help prevent some of the liver problems associated with methotrexate.

• Tell other healthcare providers you are using this medicine before they prescribe new medications.

Find more detailed information about methotrexate interactions to avoid here.