METHOTREXATE SODIUM is a chemotherapy drug. This medicine affects cells that are rapidly growing, such as cancer cells and cells in your mouth and stomach. It is used for leukemias, lymphomas, breast cancer, lung cancer, head and neck cancers, and other cancers. This medicine also works on the immune system and is commonly used to treat psoriasis and rheumatoid arthritis. If used for arthritis or psoriasis, the drug is only given once a week.

They need to know if you have any of these conditions:

• bleeding or blood disorders
• HIV-positive or have acquired immunodeficiency syndrome (AIDS)
• if you frequently drink alcohol-containing drinks
• infection or weak immune system
• kidney disease
• liver disease
• lung disease
• stomach ulcers
• ulcerative colitis
• an unusual or allergic reaction to methotrexate, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

Take this medicine by mouth. Swallow it with a full glass of water. Do not take your medicine more often than directed. Finish the full course prescribed by your doctor or health care professional. Do not stop taking except on your doctor's advice.

If you take methotrexate for rheumatoid arthritis or psoriasis, the dose is given only once a week. Do not take more frequently.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

If you miss a dose, talk with your doctor or health care professional. Do not take double or extra doses. If you vomit after taking a dose, call your doctor or health care professional for advice.

• antibiotics and other medicines for infections
• aspirin and aspirin-like medicines including bismuth subsalicylate (Pepto-Bismol)
• NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
• probenecid
• trimetrexate
• vaccines

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Visit your doctor or health care professional for checks on your progress. You will need to have regular blood checks. You will also need a chest X-ray before starting the medicine.

If you take the medicine for rheumatoid arthritis or psoriasis, you may not see an improvement in your condition for several weeks.

Do not drink alcohol-containing drinks while taking this medicine. Both alcohol and the medicine may cause damage to your liver.

This medicine may increase your risk of getting an infection. Stay away from people who are sick.

To protect your kidneys, drink water or other fluids as directed while you are taking this medicine.

Both men and women must use effective birth control. Use 2 reliable forms of birth control together. Do not become pregnant while taking this medicine. Women should continue to use birth control until after their first normal menstrual cycle after stopping the medicine. Call your doctor right away if you think you or your partner might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine. Men should continue to use birth control for at least 3 months after stopping the medicine.

If you are going to have surgery or dental work, tell your health care professional that you are taking this medicine.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

Side effects that you should report to your doctor or health care professional as soon as possible:

• bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine
• changes in vision
• diarrhea
• difficulty breathing or a dry cough
• mouth and throat ulcers
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• skin rash, hives, or itching
• symptoms of infection like fever or chills, cough, sore throat, pain or difficulty passing urine
• unusually weak or tired, fainting spells
• vomiting
• yellow coloring of skin or eyes

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• dizziness
• drowsiness
• loss of appetite
• nausea

This list may not describe all possible side effects.

Keep out of the reach of children.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Protect from light. Throw away any unused medicine after the expiration date.