Has your doctor prescribed you a medication called Methotrexate ? Or does someone you know use this medication? You may have felt a little scared or curious when you heard the name of this medication. It is normal to have questions about it because it is a rather strong medication. So, let's talk about this medication simply and clearly, like everything else.
What is Methotrexate?
Simply put, Methotrexate is a drug that is mainly used to treat several groups of diseases.
- Inflammatory conditions: This medicine helps reduce inflammation in the body, that is , swelling, redness, and pain, in joint diseases like arthritis and skin diseases like psoriasis . In this way , the disease can be controlled and long-term damage to the joints and skin can be prevented.
- Some types of cancer : This drug can slow the growth of cancer cells , so doctors use it to treat some types of cancer.
In addition to the above, your doctor may also prescribe this medication for other medical conditions. So if you have any questions, ask your doctor about it.
Things you need to tell your doctor before taking this medicine
Methotrexate is a medication that should be used with great caution. Therefore, before you start taking this medication, you should definitely tell your doctor if you have any of the conditions below.
| Your situation | Things to consider |
|---|---|
| If you are pregnant or trying to get pregnant | This is very important. This medicine can cause serious harm to the baby in the womb. |
| If a mother is breastfeeding her child | The medicine can be transmitted to the baby through breast milk. |
| If you drink alcohol frequently | The damage to the liver can be very severe. |
| If you have liver or kidney disease | The elimination of the medication from the body may be hindered and side effects may increase. |
| If you have a low number of red blood cells, white blood cells, or platelets in your blood | This medicine may worsen this condition. |
| If you have a lung condition or fluid in your stomach/lungs | The medicine may cause breathing difficulties. |
| If you have stomach or intestinal problems (e.g. ulcers) | These situations can become serious. |
| If you are allergic to this medicine or any other medicine/food | This is important to prevent serious allergic reactions. |
How exactly do I use this medicine?
This is the part you need to pay the most attention to.
It is very important to take this medicine exactly as your doctor has prescribed, in the amount prescribed, and at the time prescribed. If this medicine comes as a solution, use only a special measuring spoon or cup. Do not measure with household teaspoons or tablespoons, as they cannot measure the exact amount.
Most importantly: Know exactly how often you need to take this medicine. This medicine is usually given once a week, not every day . Taking this medicine more often than your doctor tells you to can cause serious side effects, even death. So be very careful about this.
What to do if you take too much medicine? (Overdosage)
If you think you have taken too much medicine, go to the nearest hospital Emergency Department (ETU) immediately . Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
What if I miss a dose of medication?
If you miss a dose, talk to your doctor about it. Never take two doses at once to make up for a forgotten dose.
Other things that may interact with this medicine (Interactions)
Methotrexate is a drug that can interact with other medications, so it is very important to inform your doctor about all medications you are taking.
- Do not take the medicine Acitretin with this at all.
In addition, the following medications may interact with methotrexate:
- Painkillers like aspirin
- Azathioprine
- Some antibiotics - e.g. penicillins, tetracycline
- Medicines that prevent blood clotting - e.g. warfarin, apixaban
- Some medications used for gastritis - e.g. esomeprazole, omeprazole
- Immune-suppressing medications - e.g. Cyclosporine
- Live virus vaccines
- NSAIDs for pain and inflammation - e.g. ibuprofen, naproxen
- Steroid-type medications - e.g. prednisone, cortisone
- Medicines containing sulfa
- Other anticancer drugs
This list is not complete. So tell your doctor about all the medications you take (including vitamins, herbal remedies, and supplements) . Also, tell your doctor if you smoke or drink alcohol.
Things to keep in mind when taking medication
- Regular blood tests: Your doctor will likely order regular blood tests while you are taking this medicine. These will check for any effects on your blood cells, liver, and kidneys. Don't skip these tests.
- Avoid alcohol: Avoid drinking alcohol completely during this time. It can greatly increase the damage to the liver.
- Protect yourself from the sun: This medication may make your skin very sensitive to sunlight. So if you are going to be in the sun, wear clothing that covers your body and use a good sunscreen.
- Be careful of dehydration: Tell your doctor if you have severe diarrhea, vomiting, or excessive sweating. Excessive fluid loss from the body can be dangerous for someone taking this medication.
- Protect yourself from infections: This medicine reduces the body's ability to fight disease (immunity). Therefore, if you experience symptoms such as fever, cold, or sore throat , tell your doctor immediately. Do not take medicine alone. Avoid places where sick people are.
- Watch out for bleeding: Be careful when brushing your teeth and using toothpicks. Your gums may bleed. If you get any bruises on your body, tell your doctor .
- Avoid pregnancy (very important):
- Women: Avoid becoming pregnant completely while taking this medication and for 6 months after stopping the medication.
- Men: If you are taking this medicine, avoid fathering a child while taking the medicine and for 3 months after stopping.
- This medicine can cause serious harm to an unborn baby. Therefore, talk to your doctor about appropriate birth control.
What are the possible side effects of the medication?
Like any medication, methotrexate can cause side effects. Some are serious, some are common.
| Side effect | Description |
|---|---|
| Side effects that you should report to your doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Difficulty breathing | Dry cough, difficulty breathing. |
| Signs of infection | Fever, chills, cough, sore throat, non-healing wounds. |
| Symptoms of liver or kidney damage | Pain in the right abdomen, loss of appetite, yellowing of the eyes or skin, decreased urine output, and ankle swelling. |
| Unusual bleeding or bruising | Bruising, bleeding from the gums or nose for no reason. |
| Skin blisters or sores | Redness of the skin, blistering, peeling of the skin, sores inside the mouth. |
| Tell your doctor if it persists or is bothersome. | |
| Common side effects | Indigestion/diarrhea, nausea, vomiting, hair loss, dizziness, mouth sores. |
Take-Home Message
- Methotrexate is a powerful drug used to treat diseases such as arthritis, psoriasis, and cancer.
- Most importantly: Take this medication exactly as prescribed by your doctor. It is usually a once-a-week medication, not a daily one.
- Tell your doctor about all other medications you are taking and any other medical conditions you have.
- Avoid alcohol completely while taking the medicine.
- Very important: Avoid becoming pregnant while taking this medication and for a certain period of time after stopping it. This applies to both women and men.
- If you experience any serious side effects such as fever, unusual bleeding, or difficulty breathing, inform your doctor immediately.
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