Trade name

Methotrexat^®

What Methotrexate is and what it is used for?

• Methotrexate is classified as anticancer antimetabolites. This medicine inhibits DNA and RNA synthesis, thereby stopping cell replication and eventually causing cell death. This cell damage slows or stops the growth of cancer cells in the body.
• Methotrexate can be used alone or in combination with other medicines to treat a number of cancers, rheumatoid arthritis (RA) and other autoimmune diseases, as determined by your doctor.

How Methotrexate is given?

• Methotrexate can be as tablet to take by mouth.
• Methotrexate can be as an injection solution given into a muscle, under the skin, or as an infusion into a vein. This drug may also be injected into the area around the spinal cord. How you receive this medicine depends on your treatment plan.

What should I know while receiving Methotrexate?

• Do not receive this drug when you are pregnant or breastfeeding.
• Men and women should use effective contraception during treatment and for at least 3 months after the treatment ends.
• Methotrexate may affect fertility. You can talk to your doctor about methods of preserving fertility before treatment starts.
• Do not receive any kind of vaccination without doctor's approval.
• You will have regular blood tests to check that you have enough blood cells and have adequate organ functions to receive this drug. The timing and dosing of your treatment may be changed based on the test results or other side effects.
• The existing health problems may affect the use of methotrexate. You should let your doctor know if you have any other medical problems, especially if you have kidney and liver problems, or any type of infection.
• There are many drugs may affect how methotrexate works. Tell your doctor about all the medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Common side effects

• Low white blood cell count

You may have a higher risk of getting infections. Try to stay away from crowds and wash hands often. Tell your doctor right away if you have repeated fevers, coughing, stuffy nose, a painful urination or wound that becomes red and swollen.

• Low red blood cell count

You may look pale and get tired more easily. Let your doctor know if you experience any difficulty breathing or dizziness when changing positions.

• Low platelet count

You may have a higher risk of bleeding. Let your doctor know if you find red or purple dots on the skin, bleeding from the nose or gums, or any bruising or bleeding that you cannot explain.

• Mouth sores

Medicines may be given to help you feel better. Good mouth care will help prevent mouth sores.

• Loss of appetite

Try to eat in small quantities and have frequent meals. If your appetite doesn't get any better after a few days, talk to the doctor.

Less common side effects

• Nausea and vomiting

Medicines may be given before the treatment to prevent it happening. Eating and drinking often in small amounts may reduce the discomfort.

• Skin rash

A rash can be itchy, red, or painful. Tell your doctor about any skin changes that you have, they can give you medicines and advices that help you feel better.

• Weakness and fatigue

Try to pace yourself and rest as much as you need to. Speak to your doctors if you are feeling very tired. They can help you to manage it and might give you treatment.

• Diarrhea

Talk to your doctor and ask for advice. Drinking plenty of water and dietary changes can improve diarrhea.

• Hair loss

It may begin 2-3 weeks after your first treatment. Hair growth should return after treatment has finished.

• Elevated liver enzymes

This is usually mild and may return to normal after treatment has ended. Seek medical help right away if you have yellowing of the skin or eyes, dark or brown urine, or pain in abdomen, as these can be signs of liver toxicity.

• Kidney damage

This is more common in patient receiving high dose therapy. You will receive a large amount of IV fluids with sodium bicarbonate before and after the treatment to prevent kidney damage.

Rare but serious side effects

• Tumor lysis syndrome (TLS)

TLS is a life-threatening condition that happens when the large amount of cancer cells die too quickly and their wastes release into the blood stream. Symptoms of TLS include general fatigue, muscle cramps, abnormal heartbeat, decreased urination, throwing up, or confusion. Your doctor will monitor you closely and prescribe medicines to prevent its development.

More Information

• Your doctor may ask you to drink at least 6 to 8 cups of water every day. This can help to prevent kidney damage.
• Alcohol and cigarettes may interfere with certain medicines or worsen side effects from chemotherapy treatment. It is wise to avoid alcohol and cigarettes during cancer treatment. If you have any problem about drinking alcohol and smoking, you should check with your doctor.
• Your skin may more sensitive to sunlight and may burn more easily during treatment. You should stay out of the sun. If you must go out in the sun, wear protective clothing and use sunscreen.