• Talk with healthcare provider before receiving any vaccinations. Use with this medicine may either increase the risk of serious infection or make the vaccination less effective.
• If you have had hepatitis B or C, talk with healthcare provider.
• If you have drug or alcohol addiction, talk with healthcare provider.
• If you have kidney disease, talk with healthcare provider.
• If you have liver disease, talk with healthcare provider.
• If you have a weakened immune system, develop infections easily, or are on antibiotics, talk with healthcare provider.
• If you have mouth sores, stomach irritation or ulcers, talk with healthcare provider.
• Do not donate blood while using this medicine and for 1 month after stopping.
• Check medicines with healthcare provider. This medicine may not mix well with other medicines.
• Talk with healthcare provider before using aspirin, aspirin-containing products, other pain medicines, blood thinners, garlic, ginseng, ginkgo, or vitamin E.
• Avoid alcohol (includes wine, beer, and liquor).
• You can get sunburned more easily. Avoid sun, sunlamps, and tanning beds. Use sunscreen; wear protective clothing and eyewear. Continue to protect yourself against sunburn for at least a month after methotrexate therapy.
• Use birth control that you can trust to prevent pregnancy while taking this medicine.
• Anemia, low white blood cell count, and low platelet count.
• Risk of infection. Avoid people with infections, colds, or flu.
• Nausea or vomiting. Small frequent meals, frequent mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help.
• Not hungry.
• Diarrhea.
• Mouth irritation. Frequent mouth care with a soft toothbrush or cotton swabs and rinsing mouth may help.
• Sore throat.
• Headache.
• Hair loss. Hair usually grows back when medicine is stopped.
• Kidney failure can rarely occur.
• Liver damage can rarely occur.
• Lung damage can rarely occur.
• Other forms of cancer can rarely occur later in life.
• If you suspect an overdose, call your local poison control center or emergency department immediately.
• Signs of a life-threatening reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat.
• Signs or symptoms of infection. These include a fever of 100.5 degrees or higher, chills, severe sore throat, ear or sinus pain, cough, increased sputum or change in color, painful urination, mouth sores, wound that will not heal, or anal itching or pain.
• Chest pain or pressure.
• Difficulty breathing.
• Persistent cough.
• Pinpoint red spots on skin.
• Severe belly pain.
• Severe nausea or vomiting.
• Severe diarrhea.
• Not able to eat.
• Unusual bruising or bleeding.
• Dark urine or yellow skin or eyes.
• Feeling extremely tired or weak.
• For females, if you become pregnant while taking this medicine.
• Any rash.
• No improvement in condition or feeling worse.
