Methotrexate (Injection, Subcutaneous)

Methotrexate injections are used on their own or in combination with other medications to treat multiple different kinds of cancers, including breast, lung, head and neck, blood, bone, uterus and lymph node cancers.

Overview

Methotrexate injections are used on their own or in combination with other medications to treat multiple different kinds of cancers, including breast, lung, head and neck, blood, bone, uterus and lymph node cancers.

Methotrexate can also be used in the treatment of severe rheumatoid arthritis in adults and polyarticular juvenile idiopathic arthritis in children who have experienced little to no improvement with other treatments. This medication can also be used to help control the symptoms of severe psoriasis in adults who have experienced little to no improvement with other treatments.

Methotrexate belongs to a type of medication known as antineoplastics (also known as cancer medications). It works by blocking an enzyme that is necessary for certain cells to live. This helps to interfere with the growth of the cancerous cells, which can then eventually be destroyed by the body. In patients with rheumatoid arthritis and psoriasis, this medication can work by improving the patient's immune system.

This medication is only available with a prescription from your healthcare provider.

This medication is available in these following dose forms:

  • Solution
  • Powder for Solution
  • Injectable

Condition(s) treated?

  • Cancer, severe psoriasis, rheumatoid arthritis and polyarticular juvenile idiopathic arthritis.

Type of medication?

  • Antineoplastics (cancer medication)

Side Effects

Along with the intended effects, a medication can sometimes cause unwanted side effects. And though you may not experience all or any of these side effects, if they are to occur they could warrant medical attention.

It is important to make contact with your health care provider urgently if you experience any of these side effects:

More common:

  • Blurred vision
  • Convulsions (seizures)
  • Reddening of the skin
  • Urination is difficult or painful
  • Short of breath
  • Tarry or black stool
  • Blood in the urine or stools
  • Less common:
  • Stomach pain
  • Pains in either side or lower back
  • Blistering, bleeding, coldness, burning, skin discoloration, feeling pressure in some body parts, infection, hives, unusual inflammation, lumps, itching, pain, numbness, redness, rash, soreness, scarring, swelling, stinging, unusual tenderness, unexplained tingling, or feeling heat or warmth around the site of the injection
  • Confusion
  • Swelling of the feet or lower legs
  • Back pain
  • Sores in the mouth or lips
  • Cough or hoarseness
  • Diarrhea
  • Yellow eyes or skin
  • Unusual tiredness or weakness
  • Unusual bleeding or bruising
  • Dizziness
  • Bloody vomit
  • Fever or sudden chills
  • Headache
  • Pinpoint red spots on the skin
  • Drowsiness
  • Dark urine
  • Joint pain

Some additional side effects could occur that in most cases do not require medical attention. These side effects should disappear during your treatment when your body naturally begins to adjust to the medication. Your health care professional will be able to inform you of the ways in which you can prevent or help to reduce some of the side effects. You should contact your health care professional if any of these side effects continue for more than a few days or are particularly distressing or if you have further questions regarding them:

More common:

  • Lost appetite
  • Less common
  • Skin rash or itching
  • Boils on skin
  • Nausea or vomiting
  • Hair loss, temporary
  • Pale skin
  • Acne

Some other side effects that are not listed above can also occur in some patients. If you become aware of any other side effects, check with your healthcare professional.

Please contact your healthcare professional if you are in need of further medical advice about side effects.

Dosage

A trained healthcare professional will administer this medication to you, either in a hospital or a cancer treatment center. This medication is given as an injection underneath the skin into a muscle, a vein or into the spine via the back or neck.

If you are taking this injection at home:

The medication comes with a leaflet with patient information. You should read this thoroughly and follow the instructions extremely carefully. If you have any questions you should discuss this further with your healthcare provider.

The medication is given as an injection underneath your skin, usually on the fattier parts of the body like the stomach, buttocks or thighs.

You should use a different area of the body each time you give yourself an injection. Make sure to keep track of the area you inject each time to ensure you change injected areas. This can help to prevent any skin problems sustained by the injection.

Do not use this medication if the liquid inside the syringe has had a change in color, or if there appears to be particles in it.

  • Dosing

The dose of this medication will differ between patients. You should aim to follow your healthcare professional's advice or any directions on the label. The following advice is provided to include only average dosages of this medication. If your prescribed dosage is not the same, you should not alter it unless your health care professional specifically advises you to do this.

The exact dosage of medication that you will be prescribed will depend on the strength of the medication.

For injection dosage form (solution):

For psoriasis:

Adults ' To begin with, 10 to 25 milligrams once weekly should be administered. Your health care provider may wish to adjust your dosage as necessary. However, the dosage is usually never more than 30 mg once weekly.

Children ' The use and dosage will be determined by your healthcare provider.

For rheumatoid arthritis or juvenile arthritis:

Adults To begin with, 7.5 milligrams once weekly. Your health care provider may wish to adjust your dosage as necessary.

Children The dosage is based on the size of the body and will be determined by your healthcare provider. The normal start dose is 10 milligrams per square meter of body size once weekly. Your healthcare provider will adjust the dosage as required.

Missed Dose

This medication must be administered on a very fixed timing schedule. Make sure that if you miss a scheduled dose to contact your health care provider immediately.

Interactions

Although certain medications should not be taken together at all, there are other cases in which two completely different medications may be used in conjunction, even if an interaction is likely to occur. In these cases, your healthcare provider may want to alter the dosages of one or both medications or follow other precautions which may be necessary. When you are taking this medication, it is very important that your healthcare provider knows if you are taking any of the medications that are listed below. The listed interactions below have been chosen based on their potential significance and other interactions could occur that are not listed below.

The use of this medication with any of the following medications is not recommended. Your healthcare provider may choose not to treat you with this medication or may also alter some of the other medications you take.

The use of this medication with any of the following medications is usually not recommended, but in some case, it may be required in lowered or altered dosages. When both medications are prescribed jointly, your healthcare provider may alter the dosage amount or duration you use one or both medications.

  • Bacillus of Calmette and Guerin Vaccine, Live
  • Oxaprozin
  • Fosphenytoin
  • Propyphenazone
  • Fepradinol
  • Adenovirus Vaccine
  • Aceclofenac
  • Dexlansoprazole
  • Fenoprofen
  • Tenoxicam
  • Pristinamycin
  • Indomethacin
  • Penicillin V
  • Phenylbutazone
  • Rabeprazole
  • Diclofenac
  • Sulfisoxazole
  • Poliovirus Vaccine, Live
  • Fluorouracil
  • Influenza Virus Vaccine, Live
  • Droxicam
  • Etodolac
  • Capecitabine
  • Meloxicam
  • Aspirin
  • Esomeprazole
  • Sulfamethoxazole
  • Ibuprofen Lysine
  • Diflunisal
  • Tegafur
  • Tolmetin
  • Meclofenamate
  • Penicillin G
  • Levetiracetam
  • Dantrolene
  • Amtolmetin Guacil
  • Loxoprofen
  • Salicylic Acid
  • Dicloxacillin
  • Sulindac
  • Lumiracoxib
  • Acemetacin
  • Floxacillin
  • Dexibuprofen
  • Trimethoprim
  • Piketoprofen
  • Nabumetone
  • Niflumic Acid
  • Amoxicillin
  • Lornoxicam
  • Sulfamethizole
  • Sodium Salicylate
  • Foscarnet
  • Naproxen
  • Choline Salicylate
  • Pirprofen
  • Piperacillin
  • Piroxicam
  • Doxifluridine
  • Ibuprofen
  • Leflunomide
  • Smallpox Vaccine
  • Doxycycline
  • Mezlocillin
  • Celecoxib
  • Simeprevir
  • Asparaginase
  • Mefenamic Acid
  • Proglumetacin
  • Bromfenac
  • Salsalate
  • Parecoxib
  • Oxyphenbutazone
  • Floctafenine
  • Triamterene
  • Felbinac
  • Tolfenamic Acid
  • Flufenamic Acid
  • Clonixin
  • Warfarin
  • Hydrochlorothiazide
  • Omeprazole
  • Yellow Fever Vaccine
  • Tiaprofenic Acid
  • Ketorolac
  • Bufexamac
  • Morniflumate
  • Phenytoin
  • Dexketoprofen
  • Teriflunomide
  • Feprazone
  • Valdecoxib
  • Bentiromide
  • Ketoprofen
  • Cholera Vaccine, Live
  • Pyrimethamine
  • Sulfapyridine
  • Typhoid Vaccine
  • Proquazone
  • Dipyrone
  • Probenecid
  • Pantoprazole
  • Chloral Hydrate
  • Dasabuvir
  • Flurbiprofen
  • Ticarcillin
  • Nimesulide Beta Cyclodextrin
  • Tamoxifen
  • Nepafenac
  • Propionic Acid
  • Fenbufen
  • Nimesulide
  • Etofenamate

Using this medication with any of the following medications can cause an increased risk of certain side effects, however, using both medications may be determined by your health care provider as the best treatment. When both medications are prescribed jointly, your healthcare provider may alter the dosage amount or duration you use one or both medications.

  • Procarbazine
  • Eltrombopag
  • Mercaptopurine
  • Amiodarone
  • Rofecoxib
  • Cyclosporine
  • Etoricoxib
  • Theophylline

Other Interactions

There are certain medications which should not be used at or close to the time of eating food or certain kinds of food as interactions may occur. The use of alcohol or tobacco when taking certain medications may also cause interaction occurrence. It is important to discuss with your healthcare provider about the use of your medication with food, tobacco or alcohol.

  • Cola

Other Medical Problems

The presence of any other medical problems can affect the use of this medication. It is extremely important to tell your healthcare provider if you experience any other medical problems, especially the following:

  • Pleural effusion (extra fluid in the lung)'Use with caution. The effects may be increased because of slower removal of the medication from the body.
  • Leukopenia (low white blood cells) or
  • Liver disease or
  • Peptic ulcers or
  • Weak immune system'Should not be used in patients with these conditions.
  • Ulcerative colitis (inflammation of the colon)'Use with caution. May cause side effects to become worse.
  • Diabetes or
  • Anemia or
  • Liver disease, severe or
  • Obesity or
  • Alcohol abuse, or history of or
  • Infection (bacteria, fungus, virus)'Use with caution. May decrease your ability to fight an infection.
  • Thrombocytopenia (low platelet blood level) or
  • Kidney disease or
  • Ascites (extra fluid in the stomach area)

Warnings

It is extremely important that your health care provider checks your progress while you are taking this medication. This will allow your health care provider to make sure the medication is working correctly and decide if you can continue taking it.

Allergies

Tell your healthcare provider if you have in your life experienced any abnormal, adverse or allergenic reactions to any other medications. Also tell your healthcare 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 that have been performed to date have not shown any pediatric-specific issues that would in any way limit the functionality of methotrexate injections in the treatment of cancers and juvenile idiopathic arthritis in children. Safety and desired results have not, however, been demonstrated for children with psoriasis.

Geriatric

Elderly patients are much more likely to have age-related kidney, heart or liver issues, which could require more caution used and adjustments made in the dosage for all elderly patients receiving the minocycline injection.

Pregnancy

Studies conducted in pregnant women have positively demonstrated that there is a risk to the fetus. However, there may be benefits of the treatment in life-threatening situations or if there is a presence of a serious disease that can outweigh the potential risk.

Breastfeeding

Studies conducted in breastfeeding women have positively demonstrated harmful effects in infants. Alternative medication should be prescribed to you or you should discontinue breastfeeding while using this medication.

While using this medication during pregnancy can harm the unborn baby, the medication can also cause birth defects if the father is administered it when his sexual partner falls pregnant. If a pregnancy does occur while you are taking this medication, tell your healthcare provider immediately.

Although rare, infertility can happen when using this medication in both men and women. Speak to your healthcare provider before taking this medication if you do plan to have children.

It is advised that you should limit any alcohol use when taking this medication. Alcohol consumption can increase the risk of liver problems.

This medication can cause organ system toxicity. Contact your healthcare provider immediately if you have any of the following symptoms: seizures, a fever, dry cough, irritability, diarrhea, neck stiffness, severe skin rash, confusion, sleepiness, weakness, trouble breathing, problems with coordination or vomiting.

Speak to your healthcare provider immediately if you or your child have any pains or experience tenderness to the upper area of your stomach, urine that is darker colored than normal, pale colored stools, nausea or vomiting, losing of the patients appetite or yellowing of the skin or eyes. These symptoms could suggest liver issues which are serious in nature.

Methotrexate may lower the number of white blood cells in the blood, which can increase the chances of contracting an infection. It may also lower the number of platelets in the blood, which are needed for effective blood clotting. If this were to occur, there are precautions you should take, especially if your blood counts are low, to reduce the risk of bleeding or contracting an infection:

  • If at all possible try to avoid anyone with an infection. Contact your healthcare provider urgently if you believe you have contracted an infection or if you experience the following symptoms: a fever or chills, coughing or unusual hoarseness, pains in either side or lower back and painful or difficulty in urinating.
  • Contact your healthcare provider urgently you also experience any of the following symptoms: unusual bruising or bleeding, tarry or black stools, blood present in your stool or urine, small, pin-like red-colored spots on the skin.
  • Be vigilant when you are using a normal toothpick, toothbrushes or dental flosses. Your medical health care provider, nurse or dentist may advise other ways of cleaning your teeth and gums. Contact your healthcare provider before undergoing any dental treatments.

Serious skin reactions may occur when taking this medication. Contact your healthcare provider immediately if you experiencing any peeling, blistering or loosening skin, reddened skin lesions, a skin rash or severe acne, sores or ulcers on your skin when taking this medication.

Methotrexate can cause your skin to become much more sensitive to direct sunlight than it usually would be. Exposure to direct sunlight, even for short periods of time, could cause a rash, redness, severe sunburn, itching or other discoloration of the skin.

This medication can cause some patients to experience dizziness or feelings of lightheadedness. Be sure you are aware of how you react to this medication before you attempt to drive, use machinery or do any other activity that could be classed as dangerous to avoid injury.

This medication can increase your risk of experiencing a lymphoma, which is cancer of the lymphatic system. You should discuss any possible side effects with your healthcare provider.

This medication can cause a severe reaction known as tumor lysis syndrome. Contact your healthcare provider urgently if you have a change in the amount of urine, joint pains, swelling, side, lower back or stomach pains, unexplained or rapid weight gain, swelling in the lower legs or feet, any unusual tiredness or weakness.

Taking this medication alongside radiation therapy can increase your risk of bone or tissue problems, such as either area not getting enough blood. Speak to your healthcare provider if you are also receiving radiation therapy while using this medication.

Storage

Store this medication in a sealed container at room temperature. Keep away from any heat, moisture or direct light. Make sure this medication does not freeze.

Keep out of children's reach.

Do not keep outdated medication or medication no longer needed. Unneeded medications should be disposed of. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community

Once used, dispose of the syringe in a puncture-resistant container.

Summary (450)

Methotrexate injections are used on their own or in combination with other medications to treat multiple different kinds of cancers, including: breast, lung, head and neck, blood, bone, uterus and lymph node cancers.

Methotrexate can also be used in the treatment of severe rheumatoid arthritis in adults and polyarticular juvenile idiopathic arthritis in children who have experienced little to no improvement with other treatments. This medication can also be used to help control the symptoms of severe psoriasis in adults who have experienced little to no improvement with other treatments.

Methotrexate belongs to a type of medication known as antineoplastics (also known as cancer medications). It works by blocking an enzyme that is necessary for certain cells to live. This helps to interfere with the growth of the cancerous cells, which can then eventually be destroyed by the body. In patients with rheumatoid arthritis and psoriasis, this medication can work by improving the patient's immune system.

While using this medication during pregnancy can harm the unborn baby, the medication can also cause birth defects if the father is administered it when his sexual partner falls pregnant. If a pregnancy does occur while you are taking this medication, tell your health care provider immediately.

Although rare, infertility can happen when using this medication in both men and women. Speak to your health care provider before taking this medication if you do plan to have children.

It is advised that you should limit any alcohol use when taking this medication. Alcohol consumption can increase the risk of liver problems.

This medication can cause organ system toxicity. Contact your health care provider immediately if you have any of the following symptoms: seizures, a fever, dry cough, irritability, diarrhea, neck stiffness, severe skin rash, confusion, sleepiness, weakness, trouble breathing, problems with coordination or vomiting.

Speak to your health care provider immediately if you or your child have any pains or experience tenderness to the upper stomach, darker colored urine, pale colored stools, vomiting or nausea, losing appetite or yellowing of the skin or eyes. These symptoms could suggest liver issues that are serious in nature.

Methotrexate may lower the amount of white blood cells that are in the blood, which can increase the chances of contracting infections. It may also lower the amount of platelets in the blood, which are needed for effective blood clotting. If this were to occur, precautions you should be taken to reduce the risk of bleeding or contracting infections.

Taking this medication alongside radiation therapy can increase your risk of bone or tissue problems, such as either area not getting enough blood. Speak to your health care provider if you are also receiving radiation therapy while using this medication.