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Methotrexate ( meh-tho-TREKS-ate ) (Amethopterin, MTX, Rheumatrex®, Trexall®) What is this medication used for? Methotrexate is used to treat some cancers including leukemia, solid tumors, and brain tumors.
What does it look like? • Tablet • Liquid How is it given? • By mouth (oral or po) • Into the vein (IV) or venous access device • Into the muscle (IM) • Under the skin (subcutaneous or subq) • Into spinal fluid (intrathecal) What are the common side effects? • Mouth sores • Nausea, vomiting, or loss of appetite • Diarrhea • Changes to liver function tests What are the less common side effects? • Kidney damage • Headache, drowsiness, or blurred vision • Low blood counts (white blood cells, hemoglobin, platelets, or neutrophils) • Hair loss (alopecia) • Skin sensitivity to sunlight (may cause a rash) • Darkening of the skin • Eye sensitivity to sunlight (photosensitivity) • Neurological symptoms including memory loss and seizures
Special instructions: • Fluid intake and urine output will be closely monitored when taking high doses of methotrexate. • When methotrexate is given in high doses, blood will be drawn at certain times and the methotrexate level will be monitored closely. • When receiving a high-dose methotrexate infusion, leucovorin may be prescribed and must be taken exactly on time after the methotrexate to prevent side effects. Do not stop taking leucovorin unless told by your healthcare provider. • Certain medicines will increase methotrexate side effects and may not be taken before, during, or shortly after receiving methotrexate. These drugs include aspirin, ibuprofen (Motrin®), vitamin C, vitamins that contain folic acid, Dilantin®, proton pump inhibitors (e.g., omeprazole, lansoprazole, and esomeprazole), and some antibiotics including Bactrim. • If mouth sores develop, call your healthcare provider. • In utero exposure may cause fetal harm.
Notes from Your Healthcare Team
Not all of the possible side effects of this medicine and precautions related to taking it are covered in this information sheet. For a complete list of side effects and precautions, ask your healthcare professional (doctor, nurse, pharmacist) for a manufacturer’s package insert or another reference.
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