Part Two of Methotrexate Information, Focusing on Side Effects, Discontinuation or Withdrawal Effects, and Additional Information

This second section of our medication database entry focuses on potential side effects, withdrawal or discontinuation effects, and additional information, while part one covers basic drug characteristics, uses and benefits.

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What are the possible side effects of methotrexate?

  • Methotrexate may cause side effects that could be dangerous or life-threatening. Discuss with your doctor the risks and benefits of using methotrexate before starting treatment. Methotrexate has been reported to cause blood and bone marrow problems (fever, chills, sore throat, unusual bruising or bleeding, black, bloody or tarry stools,); lung problems (unexplained shortness of breath, coughing, or wheezing); stomach problems (diarrhea, abdominal pain); sores in or around the mouth; liver problems (yellow skin or eyes, unusual fatigue); kidney problems (blood in the urine; darkened urine, swelling of the feet or legs); and others. Notify your doctor immediately if you develop any of these symptoms.
  • If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:
    • an allergic reaction (shortness of breath; closing of the throat; difficulty breathing; swelling of the lips, face, or tongue; or hives);
    • joint pain; or
    • confusion, unusual behavior, or seizures.
  • Other, less serious side effects may be more likely to occur. Continue to take methotrexate and notify your doctor if you experience
    • nausea, vomiting, or decreased appetite;
    • itching or a skin rash;
    • hair loss;
    • boils or acne;
    • dizziness;
    • increased sensitivity of the skin to sunlight;
    • headache;
    • drowsiness; or
    • blurred vision.
  • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect methotrexate?

  • Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, Nuprin, others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox), and others except under the direction of your doctor. Although these medications may be prescribed together to treat certain conditions, methotrexate may interact with aspirin and NSAIDs, and possibly cause serious side effects.
  • Before taking methotrexate, tell your doctor if you are taking any of the following medicines:
    • etretinate (Tegison);
    • acitretin (Soriatane);
    • theophylline (Theo-Dur, Theolair, Theochron, Elixophyllin, Slo-Phyllin, others);
    • phenytoin (Dilantin);
    • probenecid (Benemid);
    • procarbazine (Matulane);
    • folic acid or a vitamin supplement that contains folic acid;
    • a penicillin antibiotic such as ampicillin (Principen, others), amoxicillin (Amoxil, Trimox, Augmentin, others), dicloxacillin (Dynapen, others), penicillin (Pen-Vee-K, Veetids, others), and others;
    • a tetracycline antibiotic such as minocycline (Minocin, Dynacin, others), doxycycline (Vibramycin, Vibra-Tabs, others), tetracycline (Sumycin, others), and others; or
    • a sulfa-based medicine such as sulfamethoxazole (Bactrim, Septra, Sulfatrim, Gantanol), sulfisoxazole (Gantrisin), and others.
  • You may not be able to take methotrexate, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.
  • Drugs other than those listed here may also interact with methotrexate. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

  • Your pharmacist has additional information about methotrexate written for health professionals that you may read.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Limitations and the Source of Our Online Medication Information Database

Although we have made considerable efforts to ensure that the information provided here is accurate, up-to-date, and complete, MedLibrary.org makes no guarantee to that effect. Drug information contained herein may be time sensitive. This medication information does not endorse drugs, diagnose patients or recommend any specific pharmacotherapy. This is an educational resource only -- intended to supplement but not to replace the expertise, skill, knowledge and judgment of medically qualified healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, please check with your doctor, nurse or local pharmacist. MedLibrary.org does not assume any responsibility for any aspect of healthcare administered with the aid of information provided here.

Full public license and copyright information is available separately from Cerner Multum, Inc.

Version: 5.01. Revision date: 12/10/03.

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