Do not take this medication with any of the following:
-Acitretin
-Live virus vaccines
-Probenecid
This medication may also interact with the following:
-Alcohol
-Aspirin and aspirin-like medications
-Certain antibiotics, such as penicillin, neomycin, sulfamethoxazole; trimethoprim
-Certain medications for stomach problems, such as lansoprazole, omeprazole, pantoprazole
-Clozapine
-Cyclosporine
-Dapsone
-Folic acid
-Foscarnet
-NSAIDs, medications for pain and inflammation, such as ibuprofen or naproxen
-Phenytoin
-Pyrimethamine
-Steroid medications, such as prednisone or cortisone
-Tacrolimus
-Theophylline

They need to know if you have any of these conditions:
-Dehydration
-Diabetes
-Fluid in the stomach area or lungs
-Frequently drink alcohol
-Having surgery, including dental surgery
-High cholesterol
-Immune system problems
-Inflammatory bowel disease, such as ulcerative colitis
-Kidney disease
-Liver disease
-Low blood cell levels (white cells, red cells, and platelets)
-Lung disease
-Recent or ongoing radiation
-Recent or upcoming vaccine
-Stomach ulcers, other stomach or intestine problems
-An unusual or allergic reaction to methotrexate, other medications, foods, dyes, or preservatives
-Pregnant or trying to get pregnant
-Breastfeeding

Visit your care team for regular checks on your progress. It may be some time before you see the benefit from this medication.
You may need blood work done while you are taking this medication.
If your care team has also prescribed folic acid, they may instruct you to skip your folic acid dose on the day you take methotrexate.
This medication 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 sunscreen. Do not use sun lamps, tanning beds, or tanning booths.
Check with your care team if you have severe diarrhea, nausea, and vomiting, or if you sweat a lot. The loss of too much body fluid may make it dangerous for you to take this medication.
This medication may increase your risk of getting an infection. Call your care team for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.
Talk to your care team about your risk of cancer. You may be more at risk for certain types of cancers if you take this medication.
Talk to your care team if you or your partner may be pregnant. Serious birth defects can occur if you take this medication during pregnancy and for 6 months after the last dose. You will need a negative pregnancy test before starting this medication. Contraception is recommended while taking this medication and for 6 months after the last dose. Your care team can help you find the option that works for you.
If your partner can get pregnant, use a condom during sex while taking this medication and for 3 months after the last dose.
Do not breastfeed while taking this medication and for 1 week after the last dose.
This medication may cause infertility. Talk to your care team if you are concerned about your fertility.

Keep out of the reach of children and pets.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Protect from light. Keep the container tightly closed. Get rid of any unused medication after the expiration date.
To get rid of medications that are no longer needed or have expired:
-Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
-If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.