Methotrexate (Non-Cancer)

​You may experience the following side effects while on Methotrexate. Tell your doctor if you encounter any of them so that adjustments to your therapy may be made to reduce the occurrence of these side effects where possible. These include:

• Abdominal pain, nausea and vomiting
• Skin dryness, increased sensitivity to sun (Apply sunscreen when out in the sun)

Please inform your doctor if you experience any other side effects or if the side effects become severe and bothersome.

There are some potentially serious but rare side effects that may be experienced when you are using Methotrexate. These include:

• Breathing difficulties, persistent cough
• Bone marrow suppression, manifested as sore throats, mouth ulcers, unexplained bruising/bleeding, unusual tiredness, infection or persistent fever
• Yellowing of skins and/or eye(s), dark-coloured urine
• Bloody or black tarry stools and/or coffee-ground vomitus

Stop using Methotrexate and inform your doctor immediately if you experience any of the potentially serious side effects.

Do not give your child or yourself any other medications or herbal products without consulting your doctor or pharmacist. Some medication or food may reduce its efficacy, or increase incidence of side effects where close monitoring is required. These include:

• Live vaccines such as BCG, MMR and some forms of polio or influenza vaccines
• Certain antibiotic such as co-trimoxazole (Bactrim®)

Drugs commonly co-administered
1. Biologic agents such as Adalimumab, Etanercept or Infliximab
2. Folic acid (Usually taken on different days of the week)
3. Other DMARDs such as Hydroxychloroquine, Sulphasalazine
4. Non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, Indomethacin or Naproxen
5. Corticosteroids such as Prednisolone

Disclaimer: The list is not exhaustive, if in doubt, do inform your doctor or pharmacist especially if you are on any other medication or supplements when you are prescribed Methotrexate

 

​Methotrexate is available in tablet or injection form.

To maximise the absorption of Methotrexate, it is best taken orally at night once or twice WEEKLY on empty stomach, i.e an hour before food or 2 hours after food. However, if you experience stomach discomfort while on Methotrexate, you may take it with food. Please inform your pharmacist or doctor if you are doing so.

Do not stop taking Methotrexate unless you are told to do so by your doctor. Do not take more or less than required unless instructed.

Methotrexate should be taken orally or injected at the same day(s) of the week. It is advisable that you note down the day and timing of methotrexate administration on your calendar to avoid missing a dose or overdosing.

 

​If you forget a dose, take it as soon as you remember. If it is nearer to the time of your next dose, skip the missed dose. Do not take two doses at the same time.

​To minimise drug exposure to other members of the family, the following methods of administration are recommended:

• Place tablets onto a spoon dedicated for use with Methotrexate and administer directly to the mouth. Avoid contact with fingers if possible and wash hands and the spoon thoroughly after taking Methotrexate.
• Pregnant or breastfeeding women are advised to wear gloves as extra precaution where possible.
• For patients who are unable to swallow tablets whole, it is advised to soak the tablets in water for a few minutes before grinding them to minimise the inhalation of medication powder.

Keep away from children;#Keep in a cool, dry place, away from direct sunlight;#Store at room temperature;#

​Store below 25°C

Compliance to follow up visits

While taking Methotrexate, you should be seeing your specialist doctor regularly to ensure that your treatment is optimized and to address any concerns relating to your treatment.Regular laboratory tests may be conducted as directed by your doctor.

Supply of Drugs

You are advised not to purchase more Methotrexate than required before your next visit in case of dose changes or discontinuation of therapy.

Proper Disposal

You are advised to bring Methotrexate to the pharmacy for proper disposal if you are to stop the drug permanently.

Caregiver advice

If you are pregnant or breastfeeding, extra precaution should be taken when handling Methotrexate as it may cause harm to the developing foetus or baby. Do not give Methotrexate to anyone else. It has been prescribed for a specific condition, may not be the correct treatment for another person, and would be dangerous if the other person is pregnant or breastfeeding.