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What should I discuss with my healthcare provider before taking methotrexate (Rheumatrex Dose Pack, Trexall)?

Do not use this medication if you are allergic to methotrexate. Do not use methotrexate to treat psoriasis or rheumatoid arthritis if you have:

• liver disease;
• alcoholism or cirrhosis of the liver;
• a blood cell disorder such as anemia (lack of red blood cells) or leukopenia (lack of white blood cells);
• a bone marrow disorder; or
• if you are breast-feeding a baby.

Methotrexate is sometimes used to treat cancer even when patients do have one of the conditions listed above. Your doctor will decide if this treatment is right for you.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take methotrexate:

• kidney disease;
• liver disease;
• lung disease or pneumonia;
• stomach ulcers;
• any type of infection; or
• if you are receiving radiation treatments.

FDA pregnancy category X. Methotrexate can cause birth defects in an unborn baby. Do not use methotrexate to treat psoriasis or rheumatoid arthritis if you are pregnant. Tell your doctor right away if you become pregnant during treatment.

Use birth control to prevent pregnancy while you are using methotrexate, whether you are a man or a woman. Methotrexate use by either parent may cause birth defects.

Before you start taking methotrexate, your doctor may want you to have a pregnancy test to make sure you are not pregnant.

If you are a man, use a condom to keep from causing a pregnancy while you are using methotrexate. Continue using condoms for at least 90 days after your treatment ends.

If you are a woman, use an effective form of birth control while you are taking methotrexate, and for at least one cycle of ovulation after your treatment ends.

Do not give this medicine to a child without the advice of a doctor.

Older adults may be more likely to have side effects from this medication.

How should I take methotrexate (Rheumatrex Dose Pack, Trexall)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.

You must use the correct dose of methotrexate for your condition. Methotrexate is usually taken once or twice per week and not every day. Follow the directions on your prescription label. Some people have died after taking methotrexate every day by accident. Ask your doctor if you have any questions about your dose of methotrexate or how often to take it.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

It is important to use methotrexate regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your kidney or liver function may also need to be tested, and you may need an occasional liver biopsy. Do not miss any scheduled appointments.

Store methotrexate at room temperature away from moisture and heat.

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