Generic name: methotrexate (injection) [ meth-oh-TREX-ate ]
Brand names: EmGyn Kit, Methotrexate Sodium, Preservative Free, Otrexup, Rasuvo
Drug classes: Antimetabolites, Antipsoriatics, Antirheumatics, Other immunosuppressants
What is Otrexup?
Otrexup is used to treat leukemia and certain types of cancer of the breast, skin, head and neck, or lung.
Otrexup is often used when other medicines have not been effective.
Otrexup may also be used for purposes not listed in this medication guide.
Otrexup should not be used during pregnancy to treat arthritis or psoriasis. This medicine is sometimes used to treat cancer during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant.
Otrexup can cause serious or fatal side effects. Tell your doctor if you have diarrhea, mouth sores, cough, shortness of breath, upper stomach pain, dark urine, numbness or tingling, muscle weakness, confusion, seizure, or skin rash that spreads and causes blistering and peeling.
Before taking this medicine
You should not use Otrexup if you are allergic to it. This medicine should not be used to treat psoriasis or rheumatoid arthritis if you have:
alcoholism, cirrhosis, or chronic liver disease;
low blood cell counts;
a weak immune system or bone marrow disorder; or
if you are pregnant or breastfeeding.
Otrexup is sometimes used to treat cancer in people who have a condition listed above. Your doctor will decide if this treatment is right for you.
Tell your doctor if you have ever had:
any type of infection; or
Otrexup is sometimes used to treat cancer during pregnancy. However, this medicine may cause injury or death to an unborn baby and should not be used during pregnancy to treat arthritis or psoriasis. Tell your doctor if you are pregnant.
Otrexup can harm an unborn baby if the mother or the father is using Otrexup.
If you are a woman, you may need a pregnancy test before starting this treatment. Use effective birth control to prevent pregnancy while you are using Otrexup and for at least 6 months after your last dose.
If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 3 months after your last dose.
Tell your doctor right away if a pregnancy occurs while either the mother or the father is using Otrexup.
This medicine may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because Otrexup may harm the baby if a pregnancy does occur.
Do not breastfeed while using this medicine.
Do not give this medicine to a child without medical advice.
How is Otrexup given?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Otrexup is usually given once per week. You must use the correct dose. Some people have died after incorrectly using this medicine every day.
Otrexup is injected into a muscle, under the skin, or as an infusion into a vein. A healthcare provider will give you this injection and may teach you how to properly use the medication by yourself.
Otrexup may also be injected by a healthcare provider directly into a joint, or into the space around your spinal cord.
Read and carefully follow any Instructions for Use provided with your medicine. You may need to mix Otrexup with a liquid (diluent) before using it. Ask your doctor or pharmacist if you don't understand all instructions.
Prepare an injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine.
Otrexup can be toxic to your organs, and may lower your blood cell counts. You will need frequent medical tests, and you may need an occasional liver biopsy or chest X-ray. Your cancer treatments may be delayed based on the results.
If you need to be sedated for dental work, tell your dentist you currently use Otrexup.
Store Otrexup in its original packaging at room temperature away from moisture, heat, and light. Do not freeze.
A single-use vial (bottle) or auto-injector is for one use only. Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.
What happens if I miss a dose?
Call your doctor for instructions if you miss an appointment for your Otrexup, or if you forget to use the medicine at home.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of methotrexate injection can be fatal.
What should I avoid while receiving Otrexup?
Avoid exposure to sunlight or artificial UV rays (sunlamps, tanning beds, or PUVA treatment), especially if you have psoriasis. Otrexup can make your skin more sensitive to sunlight and your psoriasis may worsen.
Avoid drinking alcohol. It may increase your risk of liver damage.
Do not receive a "live" vaccine while using Otrexup, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.
Otrexup may impair your thinking or reactions. Avoid driving or operating machinery until you know how Otrexup will affect you.
Otrexup side effects
Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).
Otrexup can cause serious or fatal side effects. Call your doctor at once if you have:
sudden chest pain, wheezing, dry cough, cough with mucus, feeling short of breath;
blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;
vomiting, diarrhea, blood in your urine or stools;
skin changes such as redness, warmth, swelling, or oozing;
low blood cell counts--fever, chills, bruising or bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath;
kidney problems--little or no urination, swelling in your feet or ankles;
nerve problems--confusion, weakness, drowsiness, coordination problems, feeling irritable, headache, neck stiffness, vision problems, loss of movement in any part of your body, seizure; or
signs of tumor cell breakdown--tiredness, muscle cramps, nausea, vomiting, diarrhea, fast or slow heart rate, tingling in your hands and feet or around your mouth.
Common side effects may include:
fever, chills, tiredness, not feeling well;
low blood cell counts;
cough, chest tightness, trouble breathing;
nausea, vomiting, stomach pain, indigestion, diarrhea;
abnormal liver function tests;
runny or stuffy nose, sore throat;
rash, hair loss, burning skin lesions; or
being more sensitive to light.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Otrexup?
Otrexup can harm your liver, especially if you also use certain medicines for infections, tuberculosis, birth control, hormone replacement, high cholesterol, heart problems, high blood pressure, seizures, pain, or arthritis (including Tylenol, Advil, Motrin, or Aleve).
Tell your doctor about all your other medicines, especially:
an antibiotic or sulfa drug;
This list is not complete and many other drugs may affect Otrexup. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Methotrexate is a medicine that is commonly prescribed for people with rheumatoid arthritis, psoriasis, or cancer, and it can lower levels of folate (a B vitamin) in your body. You should take folic acid with methotrexate to help prevent a folate deficiency. A folate deficiency can lead to symptoms like tiredness, muscle weakness, mouth sores, and neurological symptoms. Continue reading
Methotrexate was shown to cause a modest amount of weight gain over 6 months, in a study measuring weight changes in people with rheumatoid arthritis. Continue reading
If methotrexate is working for your rheumatoid arthritis (RA), you should experience fewer severe arthritis symptoms (such as fewer swollen or painful joints) and be able to move and complete day-to-day activities more easily. Continue reading
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More about Otrexup (methotrexate)
- Side effects
- Drug interactions
- Dosage information
- During pregnancy or Breastfeeding
- Reviews (2)
- Pricing & coupons
- En español
- Drug class: antimetabolites
- FDA approval history
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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.
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