RHEUMATREX

Drug Name: RHEUMATREX

RHEUMATREX DESCRIPTION:
METHOTREXATE - ORAL (meth-oh-TREX-ate)

COMMON RHEUMATREX BRAND NAME(S):
Rheumatrex

RHEUMATREX SIDE EFFECTS:
RHEUMATREX may cause nausea, stomach pain or drowsiness. If these effects persist or worsen, contact your doctor. Report to your doctor promptly: mouth sores, diarrhea, fever, persistent sore throat, unusual bleeding or bruising, black stools, rash, enlarged glands/lymph nodes, dark urine, bone pain, unusual pain and discoloration of the skin. Unlikely but report promptly: yellowing of the eyes/skin, chest pain, flu-like symptoms, dry cough, neck stiffness, vision changes, headache, muscle weakness, mental changes, seizures. Temporary hair loss may occur; normal hair growth should return after treatment has ended. In the unlikely event you have an allergic reaction to this drug, seek medical attention immediately. Symptoms of an allergic reaction include: rash, itching, swelling, fever, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

HOW TO USE RHEUMATREX:
RHEUMATREX: This is a potent medication. Take it exactly as directed by your doctor. Unless your doctor instructs you otherwise, drink plenty of fluids while taking RHEUMATREX. This helps your kidneys to remove the drug from your body and minimize some of the side effects.

RHEUMATREX WARNING:
Serious, sometimes fatal, side effects have occurred in those using methotrexate. Therefore, RHEUMATREX should be used only to treat life-threatening cancer or severe cases of psoriasis or rheumatoid arthritis. Methotrexate formulations with preservatives must not be used for high-dose treatment nor injected into the spine (intrathecal). Methotrexate has caused birth defects and fetal death. It is not recommended for use in women of child-bearing age unless no alternatives exist. Pregnant women who have psoriasis or rheumatoid arthritis must not use methotrexate. If you have kidney problems or excess body water (ascites, pleural effusion), you must be closely monitored and your dose may be adjusted or stopped. Methotrexate (usually at high dosages) has caused severe, even fatal, bone marrow suppression (e.g., bone marrow makes cells that fight infections) and intestinal or stomach disease (e.g., bleeding) when used at the same time as non-steroidal anti- inflammatory drugs (NSAIDs) (e.g., ibuprofen, naproxen). RHEUMATREX may also cause liver problems when it is used for long periods of time. If you are using methotrexate long-term, liver biopsies should be performed. Methotrexate use has resulted in serious, possibly fatal, lung problems, skin reactions, diarrhea and mouth sores (ulcerative stomatitis). Lumps (tumors/abnormal growths) may appear during methotrexate use. The drug must be stopped and treatment may be needed. Consult your doctor immediately if new lumps/growths occur. When used to treat tumors, methotrexate sometimes causes "tumor lysis syndrome" due to cell destruction. Promptly report symptoms (e.g., irregular heartbeat, high potassium level) if they occur. If you develop any of the following side effects, contact your doctor immediately: nausea, stomach pain, yellowing eyes or skin, dark urine, fever, fatigue, persistent sore throat, easy bruising or bleeding, black stools, change in amount of urine, skin rash, breathing problems, dry cough, diarrhea, or mouth sores.

RHEUMATREX USES:
RHEUMATREX is used to treat certain types of cancer or to control severe psoriasis or arthritis.

RHEUMATREX PRECAUTIONS:
Before using RHEUMATREX, tell your doctor your medical history especially: kidney or liver disease, lung disease, intestinal diseases, chickenpox (or recent exposure to it), alcohol use, any allergies (especially drug allergies). As RHEUMATREX may make you more sensitive to the effects of the sun, avoid prolonged exposure to sunlight or sunlamps. Avoid touching your eyes or inside your nose without first washing your hands to prevent eye infections. Do not have immunizations/vaccinations without consent of your doctor and avoid contact with people who have recently received oral polio vaccine. Avoid alcohol use. Males should insure that effective contraceptive measures are used during and for 3 months after methotrexate treatment. Methotrexate should not be used during pregnancy. If you become pregnant or think you may be pregnant, inform your doctor immediately. Use of RHEUMATREX is not recommended if you wish to become pregnant. Use appropriate contraceptive measures during and for at least one menstrual cycle after methotrexate treatment. Methotrexate is excreted into breast milk. Do not breast-feed while using RHEUMATREX. Consult your doctor before breast-feeding.

RHEUMATREX DRUG INTERACTIONS:
Tell your doctor of all over-the-counter and prescription medication you may take especially: etretinate; folic acid; phenytoin; aspirin; NSAIDs (e.g., ibuprofen, naproxen); sulfa medications (and any other antibiotics); procarbazine; digoxin; theophylline; probenecid; other drugs which may harm the liver (e.g., azathioprine, sulfasalazine). The use of trimethoprim may interfere with methotrexate blood tests. Tell your doctor if you use trimethoprim. Do not start or stop any medicine without doctor or pharmacist approval.

RHEUMATREX OVERDOSE:
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include severe nausea and vomiting, diarrhea, and weakness.

RHEUMATREX NOTES:
RHEUMATREX must be used under close medical supervision so your condition can be monitored. Laboratory tests will be done periodically to be sure the drug is working properly and to monitor for possible side effects.

MISSED RHEUMATREX DOSE:
It is important to use each dose at the scheduled time. If you miss a dose, contact your doctor who will help establish a new dosing schedule. Do not "double-up" the dose to catch up.

RHEUMATREX STORAGE:
Store RHEUMATREX at room temperature between 59 to 86 degrees F (15 to 30 degrees C) away from light and moisture. Do not store in the bathroom. Your condition can cause complications in a medical emergency. For information on enrollment call Medic Alert(TM) at 1-800-854-1166. In Canada call 1-800-668-1507.