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See also How to Use section. Nausea, vomiting, and loss of appetite may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Some people using this medication may develop serious side effects including blood problems, especially at higher doses. This risk can be reduced with the use of folic/folinic acid and regular blood tests. Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, signs of serious infection (such as sore throat that doesn't go away, high fever, severe chills), signs of low red blood cell count (such as severe tiredness, pale lips/nails/skin, fast heartbeat/breathing with usual activities), swollen/painful tongue. Get medical help right away if you have any very serious side effects, including: bloody/pink urine, chest pain, slow/fast/irregular heartbeat. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Some products that may interact with this drug include: lorazepam, penicillamine, sulfa drugs (such as sulfamethoxazole), drugs that can lower folate levels (such as phenytoin, trimethoprim), drugs that can lower blood counts (such as proguanil, zidovudine, chemotherapy including methotrexate, daunorubicin, cytosine). This medication can slow down the removal of other medications from your body, which may affect how they work. An example of an affected drug is dofetilide, among others.