Before Using

Drug information provided by: Merative, Micromedex®

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of methotrexate injection for the treatment of cancer and juvenile idiopathic arthritis in children. However, safety and efficacy have not been established in children with psoriasis.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of Otrexup™ or Reditrex® for the treatment of juvenile idiopathic arthritis in children. However, safety and efficacy have not been established in children with cancer and psoriasis.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of methotrexate injection in the elderly. However, elderly patients are more likely to have bone marrow, liver, or kidney problems, which may require caution and an adjustment in the dose in patients receiving methotrexate injection.

Breastfeeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Varicella Virus Vaccine, Live
  • Zoster Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abacavir
  • Acarbose
  • Aceclofenac
  • Acemetacin
  • Acetazolamide
  • Acetohexamide
  • Adalimumab
  • Adenovirus Vaccine, Live
  • Albendazole
  • Allopurinol
  • Alprazolam
  • Ambrisentan
  • Amiodarone
  • Amoxicillin
  • Ampicillin
  • Amtolmetin Guacil
  • Anidulafungin
  • Apixaban
  • Asciminib
  • Asparaginase
  • Aspirin
  • Atomoxetine
  • Atovaquone
  • Azacitidine
  • Azanidazole
  • Azithromycin
  • Bacampicillin
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Balofloxacin
  • Balsalazide
  • Balsalazide Disodium
  • Beet Root
  • Bentiromide
  • Benznidazole
  • Bexarotene
  • Bicalutamide
  • Bortezomib
  • Bosentan
  • Bromfenac
  • Bufexamac
  • Bumetanide
  • Busulfan
  • Capecitabine
  • Capmatinib
  • Captopril
  • Carbamazepine
  • Caspofungin
  • Cefaclor
  • Cefadroxil
  • Cefatrizine
  • Cefdinir
  • Cefditoren
  • Cefetamet
  • Cefixime
  • Cefpodoxime
  • Cefprozil
  • Cefteram Pivoxil
  • Ceftibuten
  • Cefuroxime
  • Celecoxib
  • Cephalexin
  • Cephradine
  • Chenodiol
  • Chloral Hydrate
  • Chlorpropamide
  • Chlortetracycline
  • Chlorthalidone
  • Chlorzoxazone
  • Cholera Vaccine, Live
  • Choline Salicylate
  • Cinoxacin
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clindamycin
  • Clofarabine
  • Clomipramine
  • Clonixin
  • Clopidogrel
  • Cloxacillin
  • Cyclosporine
  • Cyproheptadine
  • Dabigatran Etexilate
  • Dactinomycin
  • Danazol
  • Dantrolene
  • Dapsone
  • Darolutamide
  • Darunavir
  • Deferasirox
  • Delamanid
  • Demeclocycline
  • Dengue Tetravalent Vaccine, Live
  • Dexibuprofen
  • Dexketoprofen
  • Dexlansoprazole
  • Dexmethylphenidate
  • Diclofenac
  • Dicloxacillin
  • Diflunisal
  • Dipyrone
  • Dirithromycin
  • Disulfiram
  • Divalproex Sodium
  • Doxifluridine
  • Doxycycline
  • Dronedarone
  • Droxicam
  • Duloxetine
  • Ebola Zaire Vaccine, Live
  • Edoxaban
  • Efavirenz
  • Elexacaftor
  • Eltrombopag
  • Enalapril
  • Enalaprilat
  • Encorafenib
  • Entecavir
  • Epoprostenol
  • Eravacycline
  • Erlotinib
  • Erythromycin
  • Escitalopram
  • Esomeprazole
  • Ethambutol
  • Etodolac
  • Etofenamate
  • Etravirine
  • Febuxostat
  • Felbamate
  • Felbinac
  • Fenbufen
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Flecainide
  • Floctafenine
  • Floxacillin
  • Fluconazole
  • Flufenamic Acid
  • Flumequine
  • Fluorouracil
  • Flurbiprofen
  • Flutamide
  • Folic Acid
  • Foscarnet
  • Fosfomycin
  • Fosphenytoin
  • Framycetin
  • Fulvestrant
  • Furosemide
  • Fusidic Acid
  • Ganciclovir
  • Gemcitabine
  • Gemtuzumab Ozogamicin
  • Gliclazide
  • Glimepiride
  • Glipizide
  • Gliquidone
  • Glyburide
  • Golimumab
  • Griseofulvin
  • Hydrochlorothiazide
  • Hydroxychloroquine
  • Hydroxyurea
  • Ibuprofen
  • Ibuprofen Lysine
  • Imatinib
  • Indapamide
  • Indomethacin
  • Infliximab
  • Influenza Virus Vaccine, Live
  • Interferon Beta-1a
  • Interferon Beta-1b
  • Isoniazid
  • Itraconazole
  • Ixabepilone
  • Josamycin
  • Kanamycin
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Labetalol
  • Lamotrigine
  • Lansoprazole
  • Lapatinib
  • Leflunomide
  • Leniolisib
  • Levetiracetam
  • Levofloxacin
  • Linezolid
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Lymecycline
  • Mafenide
  • Meclocycline
  • Meclofenamate
  • Mefenamic Acid
  • Mefloquine
  • Meloxicam
  • Memantine
  • Mepartricin
  • Mercaptopurine
  • Mesalamine
  • Methacycline
  • Methazolamide
  • Methicillin
  • Methimazole
  • Metolazone
  • Metronidazole
  • Micafungin
  • Midostaurin
  • Milnacipran
  • Minocycline
  • Miokamycin
  • Momelotinib
  • Morniflumate
  • Moxifloxacin
  • Nabumetone
  • Nafcillin
  • Nalidixic Acid
  • Naproxen
  • Nefazodone
  • Neomycin
  • Nepafenac
  • Nevirapine
  • Niacin
  • Niflumic Acid
  • Nilutamide
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Nimorazole
  • Nitisinone
  • Nitrofurantoin
  • Nitrous Oxide
  • Nortriptyline
  • Oleandomycin
  • Olsalazine
  • Olsalazine Sodium
  • Omadacycline
  • Omeprazole
  • Ondansetron
  • Orlistat
  • Ornidazole
  • Oxacillin
  • Oxandrolone
  • Oxaprozin
  • Oxyphenbutazone
  • Oxytetracycline
  • Pantoprazole
  • Parecoxib
  • Paromomycin
  • Paroxetine
  • Pazopanib
  • Pazufloxacin
  • Pefloxacin
  • Peginterferon Alfa-2a
  • Pemetrexed
  • Penicillin G
  • Penicillin V
  • Pexidartinib
  • Phenylbutazone
  • Phenytoin
  • Piketoprofen
  • Pipemidic Acid
  • Piperacillin
  • Piroxicam
  • Pirprofen
  • Pivampicillin
  • Poliovirus Vaccine, Live
  • Posaconazole
  • Pristinamycin
  • Probenecid
  • Proglumetacin
  • Proguanil
  • Propionic Acid
  • Propylthiouracil
  • Propyphenazone
  • Proquazone
  • Pyrimethamine
  • Rabeprazole
  • Raltegravir
  • Ramipril
  • Ribavirin
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Riluzole
  • Ritonavir
  • Rivaroxaban
  • Rokitamycin
  • Rolitetracycline
  • Rosoxacin
  • Rufloxacin
  • Salicylic Acid
  • Salsalate
  • Sapropterin
  • Sarecycline
  • Secnidazole
  • Silver Sulfadiazine
  • Simeprevir
  • Sirolimus
  • Smallpox Monkeypox Vaccine, Live Non-Replicating
  • Smallpox Vaccine
  • Sodium Salicylate
  • Sorafenib
  • Spiramycin
  • Sulfacetamide
  • Sulfacytine
  • Sulfadiazine
  • Sulfamethizole
  • Sulfamethoxazole
  • Sulfapyridine
  • Sulfasalazine
  • Sulfisoxazole
  • Sulindac
  • Sultamicillin
  • Sunitinib
  • Tafamidis
  • Tamoxifen
  • Tedizolid Phosphate
  • Tegafur
  • Teicoplanin
  • Temocillin
  • Tenoxicam
  • Terbinafine
  • Teriflunomide
  • Testosterone
  • Tetracycline
  • Tiaprofenic Acid
  • Ticarcillin
  • Tigecycline
  • Tipranavir
  • Tizanidine
  • Tolazamide
  • Tolbutamide
  • Tolcapone
  • Tolfenamic Acid
  • Tolmetin
  • Tolvaptan
  • Torsemide
  • Tramadol
  • Triamterene
  • Trimethoprim
  • Trofinetide
  • Typhoid Vaccine, Live
  • Valdecoxib
  • Valproic Acid
  • Venlafaxine
  • Vincristine
  • Voriconazole
  • Warfarin
  • Yellow Fever Vaccine
  • Zafirlukast
  • Zidovudine
  • Zolpidem
  • Zonisamide

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Etoricoxib
  • Procarbazine
  • Rofecoxib
  • Rolapitant
  • Theophylline

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Cola

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse, or history of or
  • Anemia or
  • Leukopenia (low white blood cells) or
  • Liver disease, severe or
  • Thrombocytopenia (low platelet blood level) or
  • Weak immune system—Should not be used in patients with these conditions.
  • Ascites (extra fluid in the stomach area) or
  • Kidney disease or
  • Pleural effusion (extra fluid in the lung)—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Diabetes or
  • Liver disease or
  • Obesity or
  • Peptic ulcers or
  • Ulcerative colitis (inflammation of the colon)—Use with caution. May cause side effects to become worse.
  • Infection (bacteria, fungus, virus)—Use with caution. May decrease your ability to fight an infection.

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