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Overview	Photos	How To Use	Side Effects	Precautions	Missed Dose	Drug Interactions

Folex PFS Uses Methotrexate is used to treat certain types of cancer or to control severe psoriasis or rheumatoid arthritis. This medication works by interfering with cell growth and by suppressing the immune system.Early treatment of rheumatoid arthritis with more aggressive therapy such as methotrexate helps to reduce further joint damage and to preserve joint function.This medication has also been used to treat other disorders such as lupus, psoriatic arthritis, and ectopic pregnancy. Notes Do not share this medication with others.Laboratory and/or medical tests (e.g., CBC, liver and kidney function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details. Storage Store this medication at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets. Overdose Symptoms of overdose may include severe nausea and vomiting, and bloody stools. How To Use This medication is given by injection by a healthcare professional. The dose and frequency of use are based on your medical condition and response to therapy.Follow all directions for proper mixing. Before using, check this medication visually for particles or discoloration. If either is present, do not use the liquid. If you have questions regarding the use of this medication, consult the pharmacist.Methotrexate formulations with preservatives must not be used for high-dose treatment or injected into the spine (intrathecal). Side Effects See also Warning section.Nausea, vomiting, stomach pain, drowsiness or dizziness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these serious side effects occur: mouth sores, diarrhea, fever, fatigue, persistent sore throat, unusual bleeding or bruising, black stools, skin rash, enlarged glands/lymph nodes, dark urine, bone pain, unusual pain and discoloration of the skin.Tell your doctor immediately if any of these unlikely but serious side effects occur: yellowing eyes/skin, change in the amount of urine, chest pain, dry cough, trouble breathing, calf pain/swelling, vision changes, irregular heartbeat, muscle weakness, severe headache, neck stiffness, mental/mood changes, seizures.Temporary hair loss may occur. Normal hair growth should return after treatment has ended.A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing.If you notice other effects not listed above, contact your doctor or pharmacist. Precautions Before taking methotrexate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: liver disease, severe kidney disease, severe lung disease (e.g., pulmonary fibrosis), alcohol use, suppressed immune system, blood cell/bone marrow disorders.Before using this medication, tell your doctor or pharmacist your medical history, especially of: stomach/intestinal diseases (e.g., peptic ulcer, ulcerative colitis), kidney disease, any active infection (including chickenpox or recent exposure to it), folic acid deficiency.This drug may make you dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery. Avoid alcoholic beverages.This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths or sunlamps. Use a sunscreen and wear protective clothing when outdoors.Do not have immunizations/vaccinations without the consent of your doctor and avoid contact with people who have recently received oral polio vaccine.Use caution with sharp objects like safety razors or nail cutters and avoid activities such as contact sports to lower the chance of getting cut, bruised, or injured.Wash your hands well to prevent the spread of infections.A preservative (benzyl alcohol) which may be found in this product or in the liquid used to mix this product (diluent) can infrequently cause serious problems (sometimes death), if given in large amounts (more than 100 mg/kg daily) to an infant during the first months of life (neonatal period). The risk is also greater with low birth weight infants. Symptoms include sudden gasping, low blood pressure, or a very slow heartbeat. Report these symptoms to the doctor immediately should they occur. If possible, a preservative-free product should be used when treating neonates.Caution is advised when using this drug in children because they may be more sensitive to the side effects of the drug, especially seizures.Methotrexate must not be used during pregnancy. It may cause harm to an unborn baby. If you become pregnant or think you may be pregnant, inform your doctor immediately. Pregnancy must be avoided, therefore males and females must use reliable form(s) of birth control during and for at least 3 months following the end of methotrexate treatment.Methotrexate passes into breast milk. Do not breast-feed while using this drug due to the risk of harm to the infant. Missed Dose It is important to use each dose at the scheduled time. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule. Do not double the dose to catch up. Drug Interactions Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.See also Warnings about non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin use.This drug should not be used with the following medications because very serious interactions may occur: acitretin, asparaginase, live vaccines, pyrimethamine.If you are currently using any of these medications, tell your doctor or pharmacist before starting methotrexate.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of: other cancer treatments potentially toxic to the kidney (e.g., cisplatin), digoxin, leflunomide, other drugs potentially toxic to the liver (e.g., azathioprine, sulfasalazine, retinoids such as isotretinoin), penicillins, phenytoin, probenecid, procarbazine, sulfa medications, theophylline.Certain antibiotics (e.g., chloramphenicol, sulfa, tetracyclines) may interfere with methotrexate blood tests (increase methotrexate blood levels due to protein-binding displacement). Make sure laboratory personnel and your doctors know you are using any of these types of antibiotics.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.