Your doctor may have prescribed you a subcutaneous injection of methotrexate. Maybe you have a condition like arthritis, or maybe you have a skin condition like psoriasis. It's normal to feel a little scared and curious about this medication. So today, let's talk about it in a simple way that you can understand.
What exactly is Methotrexate?
Simply put, methotrexate is a drug that reduces inflammation in your body. When you have a condition like arthritis, your immune system attacks your joints. This causes pain and swelling. The same thing happens with shingles.
So what this medicine does is control this unwanted activity of your immune system and reduce inflammation. This not only reduces pain and swelling , but also prevents long-term damage to your joints or skin .
Things you need to tell your doctor before starting this medication
For your safety, it is essential to discuss these matters with your doctor. If you have any of the conditions below, be sure to tell them before starting the medication.
- If you are pregnant, trying to get pregnant, or breastfeeding. (This is extremely important)
- If you have a condition where your stomach or lungs are filled with water
- If you are a regular drinker
- If you have an infection or a weakened immune system
- If you have kidney disease
- If you have liver disease
- If you have low red blood cells, white blood cells, or platelets
- If you have a lung disease
- If you have undergone radiation therapy
- If you have diseases like stomach ulcers or ulcerative colitis
- If you have an allergic reaction to methotrexate or any other medicine, food, or dye.
How exactly is this vaccine used?
This vaccine is given as a subcutaneous injection. The hospital or clinic will teach you how to give it at home. So don't be afraid of it.
This is something you should remember: This medicine should only be given once a week. Do not take it every day for any reason! Get the vaccine exactly on the day and at the time your doctor tells you.
Do not throw used needles and syringes in the trash. There is a special container for them (sharps container). If you don't have one, ask your doctor how to get one.
What to do if you overdose?
If you think you have taken too much of this medicine by mistake, do not delay. Immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
What if I forget to get vaccinated?
If you miss your scheduled dose, or if you are unsure whether you received the vaccine correctly, do not get another dose. Call your doctor immediately for advice.
Other drugs that are incompatible with this medicine (Drug Interactions)
Methotrexate is a drug that can interact with other medications. Therefore, it is very important to tell your doctor about all the medications you are taking (including vitamins, herbal remedies, and supplements). Below are just a few examples.
| Drug type | Examples |
|---|---|
| Medicines for some skin diseases | Acitretin |
| Painkillers and anti-inflammatory drugs (NSAIDs) | Aspirin, Ibuprofen, Naproxen |
| Some antibiotics | Penicillin, Tetracycline, Trimethoprim/sulfamethoxazole |
| Medications for gastritis (PPIs) | Esomeprazole, Omeprazole, Pantoprazole |
| Live virus vaccines | Avoid receiving live vaccines while taking this medicine. |
| Other medications | Hydroxychloroquine, Sulfasalazine, Theophylline, Phenytoin |
Things you should be careful about when taking medication
Alcohol and sunlight
Avoid drinking alcohol completely while taking this medication. Also, this medication may make your skin sensitive to sunlight. So, limit your exposure to the sun as much as possible. If you do go out in the sun, apply a good sunblock and wear clothing that covers your body.
Protection from infections
Methotrexate can reduce your body's ability to fight infections. Therefore,
- If you develop symptoms such as fever, cold, or sore throat, do not self-medicate and see a doctor immediately.
- Try to stay away from people who have illnesses like colds.
- Be careful when brushing and flossing your teeth. Bleeding gums and infections are more likely to occur. If you are undergoing any dental treatment, tell your dentist that you are taking this medicine.
Pregnancy and childbearing
This is very important. If you are a woman, do not get pregnant for any reason while taking this medicine. Do not plan to have a child for at least 6 months after stopping the medicine. If you are a man, avoid fathering a child while taking this medicine and for 3 months after stopping it. This medicine can seriously harm an unborn baby. Ask your doctor for more information about this.
Also, avoid breastfeeding your baby while taking this medicine and for one week after stopping.
What are the possible side effects?
Like any medicine, this one can have 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 |
| Liver injury | Pain in the upper right abdomen, loss of appetite, nausea, light-colored stools, dark yellow urine, yellowing of the eyes or skin, extreme fatigue |
| Lung-related problems | Unexplained dry cough, difficulty breathing |
| Signs of infection | Fever, chills, sore throat, non-healing wounds, urinary tract infections |
| Abnormal bleeding | Unexplained bruising and blue skin, bleeding gums |
| Kidney injury | Decreased urine output, swelling of the ankles, hands, or feet |
| If it persists or is bothersome, tell your doctor. | |
| Common side effects | Nausea, vomiting, diarrhea, dizziness, mouth sores, hair loss. |
Take-Home Message
- Methotrexate should only be given once a week . Avoid taking it daily.
- Tell your doctor about all other medications, vitamins you are taking, and any medical conditions you have.
- Avoid becoming pregnant while taking this medication and for as long as your doctor recommends.
- Seek immediate medical attention if serious side effects (fever, difficulty breathing, unusual bleeding) occur.
- Avoid alcohol completely.
- Always follow your doctor's instructions and recommendations exactly.
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