Avoid drinking alcohol. It may increase your risk of liver damage.
Do not receive a “live” vaccine while using methotrexate, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), and zoster (shingles).
This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient’s body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds), especially if you are being treated for psoriasis. Methotrexate can make your skin more sensitive to sunlight and your psoriasis may worsen.
Methotrexate side effects
Get emergency medical help if you have signs of an allergic reaction to methotrexate (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).
Call your doctor at once if you have:
- fever, chills, swollen lymph glands, night sweats, weight loss;
- vomiting, white patches or sores inside your mouth or on your lips;
- diarrhea, blood in your urine or stools;
- dry cough, cough with mucus, stabbing chest pain, wheezing, feeling short of breath;
- seizure (convulsions);
- kidney problems – little or no urination, swelling in your feet or ankles;
- liver problems – stomach pain (upper right side), dark urine, jaundice (yellowing of the skin or eyes);
- nerve problems – confusion, weakness, drowsiness, coordination problems, feeling irritable, headache, neck stiffness, vision problems, loss of movement in any part of your body; or
- signs of tumor cell breakdown – confusion, tiredness, numbness or tingling, muscle cramps, muscle weakness, vomiting, diarrhea, fast or slow heart rate, seizure.
Side effects may be more likely in older adults.
Common methotrexate side effects may include:
- fever, chills, tiredness, not feeling well;
- mouth sores;
- nausea, upset stomach;
- dizziness; or
- abnormal liver function tests.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect methotrexate?
Methotrexate can harm your liver, especially if you also use certain other medicines for infections, tuberculosis, depression, birth control, hormone replacement, high cholesterol, heart problems, high blood pressure, seizures, or pain or arthritis medicines (including acetaminophen, Tylenol, Advil, Motrin, and Aleve).
Many drugs can interact with methotrexate. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor and pharmacist about all your current medicines and any medicine you start or stop using.