be trained Rheumatrex Dose Pack (Oral) Generic Name: methotrexate (Oral route) meth-oh-TREX-ate Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings Breastfeeding Warnings User Reviews Support Group Q & A Oral route(Solution) Severe Toxic Reactions, Including Embryo-Fetal ToxicityMethotrexate can cause severe or fatal toxicities. Monitor closely and modify dose or discontinue for the following toxicities: bone marrow suppression, infection, renal, gastrointestinal, hepatic, pulmonary, hypersensitivity and dermatologic.Methotrexate can cause embryo-fetal toxicity and fetal death. Use in polyarticular juvenile idiopathic arthritis is contraindicated in pregnancy. Consider the benefits and risks of methotrexate and risks to the fetus when prescribing methotrexate to a pregnant patient with a neoplastic disease. Advise patients to use effective contraception during and after treatment with methotrexate . Oral route(Tablet) Only use for life-threatening neoplastic disease or severe rheumatoid arthritis and psoriasis unresponsive to other therapies. Death, fetal death and/or congenital anomalies, lung disease, tumor lysis syndrome, fatal skin reactions, and Pneumocystis carinii pneumonia have been reported. Monitor for bone marrow, liver, lung, and kidney toxicities. Unexpectedly severe (sometimes fatal) bone marrow suppression, aplastic anemia, and gastrointestinal toxicity have been reported with concomitant administration of methotrexate (usually in high dosage) along with some nonsteroidal anti-inflammatory drugs (NSAIDs). Hepatotoxicity, fibrosis, and cirrhosis occur with prolonged use. Diarrhea and ulcerative stomatitis require interruption of therapy. Methotrexate elimination is reduced in patients with impaired renal function, ascites, or pleural effusions. Increased risk of soft tissue necrosis and osteonecrosis with concomitant radiotherapy. Malignant lymphoma may occur . Commonly used brand name(s) In the U.S. Rheumatrex Dose Pack Trexall Xatmep Available Dosage Forms: Solution Tablet Therapeutic Class: Antineoplastic Agent Pharmacologic Class: Antimetabolite Slideshow What Are Biosimilars? Top Facts You May Not Know Uses For Rheumatrex Dose Pack Methotrexate tablets are used alone or together with other medicines to treat several types of cancer such as breast, head and neck, lung, blood, bone, lymph node, uterus cancers, and severe rheumatoid arthritis. It is also used to control symptoms of severe psoriasis in adults who have not been helped by other treatments. Methotrexate oral solution is used to treat acute lymphoblastic leukemia (ALL) in children, and help manage polyarticular juvenile idiopathic arthritis (pJIA) in children who had other treatments that did not work well. Methotrexate belongs to the group of medicines known as antineoplastics (cancer medicines). It blocks an enzyme that is needed by cells to live. This interferes with the growth of cancer cells, which are eventually destroyed by the body. For patients with arthritis or psoriasis, methotrexate may work by improving the immune system. This medicine is available only with your doctor's prescription. Before Using Rheumatrex Dose Pack 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 for the treatment of cancer (including acute lymphoblastic leukemia) and juvenile idiopathic arthritis in children. However, safety and efficacy have not been established in children with psoriasis. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of methotrexate in the elderly. However, elderly patients are more likely to have kidney problems, which may require caution and an adjustment in the dose. Breast Feeding 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. Interactions with Medicines 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 taking 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 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. Aceclofenac Acemetacin Adenovirus Vaccine Amoxicillin Amtolmetin Guacil Asparaginase Aspirin Bacillus of Calmette and Guerin Vaccine, Live Bentiromide Bromfenac Bufexamac Capecitabine Celecoxib Chloral Hydrate Cholera Vaccine, Live Choline Salicylate Clonixin Dantrolene Dasabuvir Dexibuprofen Dexketoprofen Dexlansoprazole Diclofenac Dicloxacillin Diflunisal Dipyrone Doxifluridine Doxycycline Droxicam Esomeprazole Etodolac Etofenamate Felbinac Fenbufen Fenoprofen Fepradinol Feprazone Floctafenine Floxacillin Flufenamic Acid Fluorouracil Flurbiprofen Foscarnet Fosphenytoin Hydrochlorothiazide Ibuprofen Ibuprofen Lysine Indomethacin Influenza Virus Vaccine, Live Ketoprofen Ketorolac Leflunomide Levetiracetam Lornoxicam Loxoprofen Lumiracoxib Meclofenamate Mefenamic Acid Meloxicam Mezlocillin Morniflumate Nabumetone Naproxen Nepafenac Niflumic Acid Nimesulide Nimesulide Beta Cyclodextrin Omeprazole Oxaprozin Oxyphenbutazone Pantoprazole Parecoxib Penicillin G Penicillin V Phenylbutazone Phenytoin Piketoprofen Piperacillin Piroxicam Pirprofen Poliovirus Vaccine, Live Pristinamycin Probenecid Proglumetacin Propionic Acid Propyphenazone Proquazone Pyrimethamine Rabeprazole Salicylic Acid Salsalate Simeprevir Smallpox Vaccine Sodium Salicylate Sulfamethizole Sulfamethoxazole Sulfapyridine Sulfisoxazole Sulindac Tamoxifen Tegafur Tenoxicam Teriflunomide Tiaprofenic Acid Ticarcillin Tolfenamic Acid Tolmetin Triamterene Trimethoprim Typhoid Vaccine Valdecoxib Warfarin Yellow Fever Vaccine 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. Amiodarone Cyclosporine Eltrombopag Etoricoxib Mercaptopurine Procarbazine Rofecoxib Theophylline Interactions with Food/Tobacco/Alcohol 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 Methotrexate tablets 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. Proper Use of methotrexate This section provides information on the proper use of a number of products that contain methotrexate. It may not be specific to Rheumatrex Dose Pack. Please read with care. Take this medicine only as directed by your doctor . Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup. Dosing The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For oral dosage form (tablets): For cancer: Adults Dose is based on type of cancer and body size and must be determined by your doctor. A dose of 10 to 30 milligrams (mg) once per day may be given for several days and then repeated after a rest period. For some conditions, 5 to 50 mg once per week may be used. Your doctor may adjust your dose as needed. Children Dose is based on type of cancer and body size and must be determined by your doctor. The dose is generally given once per day for several days and then repeated after a rest period. The dose may also be given once per week. Your doctor may adjust your dose as needed. For psoriasis: Adults At first, 10 to 25 milligrams (mg) once per week or 2.5 mg every 12 hours for 3 doses once each week. Your doctor may adjust your dose as needed. However, the dose is usually not more than 30 mg once per week. Children Use and dose must be determined by your doctor. For rheumatoid arthritis or juvenile arthritis: Adults At first, 7.5 milligrams (mg) once per week or 2.5 mg every 12 hours for 3 doses once each week. Your doctor may adjust your dose as needed. Children Dose is based on body size and must be determined by your doctor. The starting dose is 10 milligrams (mg) per square meter (m(2)) of body size once per week. Your doctor may adjust your dose as needed. For oral dosage form (solution): For acute lymphoblastic leukemia (ALL): Children Dose is based on body size and must be determined by your doctor. At first, 20 milligrams (mg) per meter squared (m(2)) of body size once a week. Your doctor may adjust your dose as needed. For polyarticular juvenile idiopathic arthritis (pJIA): Children Dose is based on body size and must be determined by your doctor. At first, 10 milligrams (mg) per meter squared (m(2)) of body size once per week. Your doctor may adjust your dose as needed. Missed Dose This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions. Storage Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Precautions While Using Rheumatrex Dose Pack It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects. Blood and urine tests may be needed to check for unwanted effects. Using this medicine while you are pregnant can harm your unborn baby. The medicine may also cause birth defects if it is used by the father when his sexual partner becomes pregnant. Men should use birth control during and for at least 3 months after the last dose. Women should use birth control during and for at least 6 months after the last dose. Tell your doctor right away if pregnancy occurs while you are using this medicine. Talk with your doctor before using this medicine if you plan to have children. Some men and women who use this medicine have become infertile (unable to have children). Limit alcohol use with this medicine . Alcohol may increase the risk for liver problems. Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem. Methotrexate can lower the number of white blood cells in your blood, which increases the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding: If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination. Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin. Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done. Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime. Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters. Avoid contact sports or other situations where bruising or injury could occur. This medicine may cause stomach and bowel problems. Check with your doctor right away if you have abdominal or stomach pain, black, tarry stools, constipation, diarrhea, loss of appetite, nausea, pain in the back of the throat or chest when swallowing, or vomiting blood or material that looks like coffee grounds. Check with your doctor right away if you have cough, fever, or shortness of breath. These could be symptoms of a serious lung or breathing problems. While you are being treated with methotrexate, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. Methotrexate may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor. Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or a skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine. This medicine may cause a serious reaction called tumor lysis syndrome. Tell your doctor right away if you have a change in urine amount, joint pain, stiffness, or swelling, lower back, side, or stomach pain, rapid weight gain, swelling of the feet or lower legs, or unusual tiredness or weakness. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. Rheumatrex Dose Pack Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: More common Black, tarry stools blood in the urine or stools bloody vomit diarrhea joint pain reddening of the skin sores in the mouth or lips stomach pain swelling of the feet or lower legs Less common Back pain blurred vision confusion convulsions (seizures) cough or hoarseness dark urine dizziness drowsiness fever or chills headache lower back or side pain painful or difficult urination pinpoint red spots on the skin shortness of breath unusual bleeding or bruising unusual tiredness or weakness yellow eyes or skin Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Hair loss, temporary loss of appetite nausea or vomiting Less common Acne boils on skin pale skin skin rash or itching Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Side Effects (complete list) The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. Copyright 2017 Truven Health Analytics, Inc. All Rights Reserved. Next Side Effects Print this page Add to My Med List More about Rheumatrex Dose Pack (methotrexate) Side Effects During Pregnancy or Breastfeeding Dosage Information Drug Interactions Support Group En Español 1 Review Add your own review/rating Drug class: antimetabolites Consumer resources Rheumatrex Dose Pack Rheumatrex Other brands: Trexall , Rasuvo , Otrexup , Xatmep Professional resources Rheumatrex (FDA) Methotrexate Sodium (AHFS Monograph) Related treatment guides Psoriatic Arthritis Rheumatoid Arthritis} Drug Status Rx Availability Prescription only X Pregnancy Category Not for use in pregnancy N/A CSA Schedule Not a controlled drug Drug Class Antimetabolites Antipsoriatics Antirheumatics Other immunosuppressants Related Drugs Rheumatoid Arthritis Humira , hydroxychloroquine , Plaquenil , sulfasalazine , leflunomide , Enbrel , Remicade , Rituxan , Arava , Duexis , rituximab , Vimovo , More... Psoriatic Arthritis prednisone , Humira , triamcinolone , methotrexate , dexamethasone , Enbrel , Decadron , Remicade , Deltasone , Otezla , adalimumab , Orencia , More... Rheumatrex Dose Pack Rating 1 User Review 2.0 /10 1 User Review 2.0 Rate it! Help and Support Looking for answers? Ask a question or go join the Rheumatrex Dose Pack support group to connect with others who have similar interests.} } it's vital
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