Rheumatrex (Methotrexate Sodium)

They need to know if you have any of these conditions: -fluid in the stomach area or lungs -if you often drink alcohol -infection or immune system problems -kidney disease or on hemodialysis -liver disease -low blood counts, like low white cell, platelet, or red cell counts -lung disease -radiation therapy -stomach ulcers -ulcerative colitis -an unusual or allergic reaction to methotrexate, other medicines, foods, dyes, or preservatives -pregnant or trying to get pregnant -breast-feeding

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor's advice. Make sure you know why you are taking this medicine and how often you should take it. If this medicine is used for a condition that is not cancer, like arthritis or psoriasis, it should be taken weekly, NOT daily. Taking this medicine more often than directed can cause serious side effects, even death. Talk to your healthcare provider about safe handling and disposal of this medicine. You may need to take special precautions. Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others.

If you miss a dose, talk with your doctor or health care professional. Do not take double or extra doses.

This medicine may interact with the following medication: -acitretin -aspirin and aspirin-like medicines including salicylates -azathioprine -certain antibiotics like penicillins, tetracycline, and chloramphenicol -cyclosporine -gold -hydroxychloroquine -live virus vaccines -NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen -other cytotoxic agents -penicillamine -phenylbutazone -phenytoin -probenecid -retinoids such as isotretinoin and tretinoin -steroid medicines like prednisone or cortisone -sulfonamides like sulfasalazine and trimethoprim/sulfamethoxazole -theophylline

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Avoid alcoholic drinks. This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths. You may need blood work done while you are taking this medicine. Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick. This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding. Check with your doctor or health care professional if you get an attack of severe diarrhea, nausea and vomiting, or if you sweat a lot. The loss of too much body fluid can make it dangerous for you to take this medicine. Talk to your doctor about your risk of cancer. You may be more at risk for certain types of cancers if you take this medicine. Both men and women must use effective birth control with this medicine. Do not become pregnant while taking this medicine or until at least 1 normal menstrual cycle has occurred after stopping it. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. Men should not father a child while taking this medicine and for 3 months after stopping it. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.

Side effects that you should report to your doctor or health care professional as soon as possible: -allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue -breathing problems or shortness of breath -diarrhea -dry, nonproductive cough -low blood counts - this medicine may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding. -mouth sores -redness, blistering, peeling or loosening of the skin, including inside the mouth -signs of infection - fever or chills, cough, sore throat, pain or trouble passing urine -signs and symptoms of bleeding such as bloody or black, tarry stools; red or dark-brown urine; spitting up blood or brown material that looks like coffee grounds; red spots on the skin; unusual bruising or bleeding from the eye, gums, or nose -signs and symptoms of kidney injury like trouble passing urine or change in the amount of urine -signs and symptoms of liver injury like dark yellow or brown urine; general ill feeling or flu-like symptoms; light-colored stools; loss of appetite; nausea; right upper belly pain; unusually weak or tired; yellowing of the eyes or skin Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome): -dizziness -hair loss -tiredness -upset stomach -vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Keep out of the reach of children. Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Protect from light. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.