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Methotrexate is a medication associated with serious, sometimes fatal, side effects and should only be used for treating certain cancers or severe autoimmune conditions like psoriasis and rheumatoid arthritis. Below are important safety and warning details to consider when using this medication:

• Birth Defects and Pregnancy Risk: Methotrexate can cause birth defects and fetal death. Women should not become pregnant while taking this medication. It is contraindicated for pregnant women with psoriasis or rheumatoid arthritis. Discuss contraception and potential risks with your healthcare provider.

• Blood Cell Concerns: The medication can lead to low blood cell counts, increasing risks of fatigue, bleeding, and infections. This is especially relevant at cancer-treatment dosages. Regular monitoring of blood counts is advisable.

• Infection Risk: Methotrexate increases susceptibility to serious infections, particularly opportunistic ones. Symptoms like fever, severe tiredness, or respiratory issues should be reported to your healthcare provider immediately.

• Kidney Health: Methotrexate can harm the kidneys, potentially leading to failure, especially in patients with pre-existing kidney issues. Regular kidney function tests are recommended.

• Digestive and Liver Issues: Long-term use can damage the liver and digestive tract, causing conditions like cirrhosis or stomach bleeding. Patients with a history of alcohol use, liver disease, or concurrent NSAID use should exercise caution and undergo regular liver function tests.

• Lung and Skin Reactions: There is a risk of serious lung problems like interstitial lung disease and severe skin reactions. Any sudden respiratory symptoms or skin changes should be evaluated by a healthcare professional.

• Fertility Impact: Methotrexate may affect fertility, causing changes in sperm count or menstrual cycles. Discuss any concerns with your healthcare provider.

• Potential for New Cancers: There is a risk of developing new cancers during treatment. Regular check-ups are necessary to monitor for any unusual symptoms.

• Fluid Retention: Those with excess body fluid (ascites, pleural effusion) may experience enhanced side effects and require careful monitoring and management.

• Radiation Therapy: Combining methotrexate with radiation therapy can increase the risk of tissue and bone damage. Discuss the risks with your healthcare provider if undergoing such treatments.

• Drug Interactions: Avoid using high-dose methotrexate with NSAIDs, as this can increase the risk of serious side effects. Low-dose aspirin may be permissible under medical supervision.

In case of overdose or severe side effects, seek emergency medical attention immediately. Discuss all risks, benefits, and potential interactions with your healthcare provider to ensure the safe use of methotrexate.

When taking this medication, you may experience common side effects such as nausea, vomiting, dizziness, drowsiness, stomach pain, and temporary hair loss, which should resolve after treatment. Mild side effects typically include mouth sores, fatigue, and diarrhea. If any of these persist or worsen, consult your healthcare provider. Additionally, some individuals may notice changes in their infection-fighting abilities, potentially leading to more frequent infections. A sore throat, fever, chills, or persistent cough could indicate an infection and should be reported to your healthcare provider.

More serious side effects, though less common, require immediate medical attention. These include severe allergic reactions characterized by rash, itching, swelling, or difficulty breathing. Watch for signs of liver problems such as persistent nausea, vomiting, dark urine, or yellowing of the skin or eyes, as well as symptoms of kidney issues like changes in urination. Other concerning symptoms include severe headache, vision changes, seizures, irregular heartbeat, or weakness on one side of the body.

Rare but serious conditions include severe skin reactions, such as painful blisters or peeling, as well as severe lung issues manifesting as sudden cough or trouble breathing. Blood disorders like anemia can appear as unusual tiredness and pale skin. Unexplained bruising, bleeding, or signs of stomach bleeding like black stools or vomiting blood also warrant urgent care. Always be vigilant for these symptoms and seek medical help promptly if they occur.