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Methotrexate is a medication with potential for serious, sometimes fatal, side effects and should only be used for treating cancer or severe immune-related conditions like psoriasis and rheumatoid arthritis.

Key Safety Information:

• Pregnancy Risks: Methotrexate can cause birth defects and fetal death. Women must avoid becoming pregnant while on this medication. It is contraindicated for pregnant women with psoriasis or rheumatoid arthritis.

• Kidney and Fluid Retention: Individuals with kidney issues or fluid retention conditions (such as ascites or pleural effusion) require close monitoring. Dosage adjustments or discontinuation may be necessary.

• Blood, Bone Marrow, and Gastrointestinal Concerns: High doses of methotrexate, especially when taken with NSAIDs (e.g., indomethacin, ketoprofen), can cause severe blood, bone marrow, and gastrointestinal issues. Avoid NSAIDs with high-dose methotrexate. Low-dose NSAIDs or aspirin may be permitted under medical supervision for conditions like rheumatoid arthritis. Continue low-dose aspirin for heart conditions unless advised otherwise by your doctor.

• Liver Health: Long-term methotrexate use may lead to liver problems. Regular liver function tests and potentially a liver biopsy are recommended.

• Other Severe Reactions: Methotrexate can rarely cause lung issues, infections (such as Pneumocystis jiroveci pneumonia), skin reactions, diarrhea, and mouth sores. Report any new symptoms to your doctor immediately.

• Tumor Growths: Very rarely, methotrexate can prompt new abnormal growths. Discontinue use and seek medical advice if this occurs.

• Tumor Lysis Syndrome: When treating tumors, methotrexate may lead to tumor lysis syndrome, resulting in serious side effects. Stay well-hydrated and follow your doctor’s guidance. Report symptoms such as irregular heartbeat, kidney discomfort, or muscle issues to your healthcare provider promptly.

• Radiation Interaction: Methotrexate may increase the risk of tissue and bone damage when used with radiation therapy. Discuss potential risks and benefits with your healthcare provider.

For any concerns or unusual symptoms, contact your healthcare provider immediately. Adherence to prescribed doses and regular medical checkups are essential for safe methotrexate use.

You might experience mild side effects such as nausea, vomiting, stomach pain, drowsiness, or dizziness. These are generally temporary, but if they persist or worsen, consult a healthcare professional. Temporary hair loss could also occur, but hair growth typically resumes after treatment ends.

While many people do not experience serious side effects, it's important to be aware of them. Contact a healthcare provider if you notice mouth sores, diarrhea, signs of anemia like unusual tiredness or pale skin, symptoms of liver issues such as persistent nausea, dark urine, abdominal pain, or yellowing of the skin or eyes. Other serious side effects include easy bruising or bleeding, black stools, swollen glands, bone pain, unusual skin pain or discoloration, signs of kidney problems like changes in urine output, a persistent dry cough, or muscle weakness.

Seek immediate medical assistance for very serious side effects such as weakness on one side of the body, neck stiffness, severe headache, vision changes, irregular heartbeat, mood changes, or seizures. This medication may also reduce your body's ability to fight infections, increasing the risk of serious infections. Contact a healthcare provider if you develop persistent sore throat, fever, chills, or cough.

Although rare, severe allergic reactions can occur. Seek emergency help if you experience symptoms like rash, itching or swelling (particularly of the face, tongue, or throat), severe dizziness, or difficulty breathing. This summary does not cover all possible side effects. If you notice other unusual effects, reach out to a healthcare provider for advice.