How does this medicine work?
Methotrexate (meth-o-trex-ate) destroys cancer cells by interfering with a specific phase of the cell’s life cycle.
How is it given?
Methotrexate is given as a pill, or by injection into the vein, muscle, or spinal fluid as directed by the doctor.
Methotrexate is usually given weekly; give it at regular times to keep a steady level in the bloodstream. Your child should be awake and alert when taking any medicine.
For children who cannot swallow pills:
- Put on gloves.
- Crush it in a tablet crusher or between 2 spoons inside a clear plastic bag.
- Mix the powder with a very small amount (about 1 teaspoon) of soft food, such as applesauce, chocolate syrup, or jelly. Make sure your child takes all of the mixture.
- Wash spoons and container right after use. Discard the plastic bag and gloves.
Are there any precautions about food or other medicines?
It is best to take methotrexate on an empty stomach (no food from 2 hours before until 1 hour after a dose). Especially avoid milk products, since they can decrease absorption of the medicine.
Avoid alcohol-containing foods, beverages, or over-the-counter medicines such as cough syrup while taking this medicine.
Check with the doctor before giving any other prescription or non-prescription medicines, herbs, or vitamins. Avoid taking ibuprofen products, aspirin, vitamin C, and Bactrim/Septra® during high doses. If your child is taking Dilantin®, talk with your doctor. Do not take folic acid supplements while taking methotrexate, unless your doctor tells you to.
What should I do if a dose is missed?
If one dose is missed, give it as soon as you remember. If your child vomits within 30 minutes after receiving a dose, give it again. If your child vomits after 30 minutes, do not repeat the dose. Call the oncology clinic or your doctor if more than one dose is missed or vomited.
What are the side effects?
Side effects increase with higher doses
Low-dose side effects are:
Common
- low blood cell counts
Occasional
- nausea, vomiting
- hair loss
- eye and skin sensitivity to the sun
Rare
- mouth sores
- liver damage
Moderate to high doses can cause:
Common
- low blood cell counts
Occasional
- nausea, vomiting
- hair loss
- sensitivity to the sun
- mouth sores
- loss of appetite
- diarrhea
- rash
Rare
- tiredness
- osteoporosis (weakened bones)
- kidney, liver, or lung damage