Guest guest Posted July 1, 2004 Report Share Posted July 1, 2004 Search Methotrexate (Matrex®) Introduction What it looks like How it is given Possible side effects Less common side effects Additional information Things to remember about methotrexate tablets References Introduction Methotrexate is chemotherapy that is given as a treatment for many types of cancer. This section describes methotrexate, how it is given and some of its possible side effects. It should ideally be read with CancerBACUP's general informtaion on chemotherapy, which gives more information. You will see your doctor regularly while you have this treatment so that he or she can monitor the effects of the chemotherapy. This section should help you to discuss any queries about your treatment and its side effects with your doctor or chemotherapy nurse, as they are in the best position to help and advise you. back to top What it looks like Methotrexate is a yellow fluid. It is also available as yellow tablets of 2.5mg and 10mg. back to top How it is given Methotrexate may be given: as an injection into the vein (intravenously) through a cannula (a fine tube inserted into the vein) through a central line, which is inserted under the skin into a vein near the collarbone, or into a PICC line which is inserted into a vein in the crook of the arm. as an infusion (drip) into the vein through a cannula or line by injection into a muscle (intramuscularly) by injection into an artery (intra-arterially) by injection into the fluid around the spinal cord through a lumbar puncture (intrathecally) or an ommaya reservoir (a device which has been inserted into an area beneath the scalp). Only specially trained doctors and nurses can give drugs in this way and the procedure has to be carried out in a special area, so you may be given this treatment by different staff and in a different hospital from the rest of your chemotherapy as tablets that should be swallowed whole with plenty of water. back to top Possible side effects Each person's reaction to chemotherapy is unique. Some people have very few side effects, while others may experience more. The side effects described in this section will not affect everyone who is given methotrexate, and may be different if you are having more than one chemotherapy drug. We have outlined the most common and the less common side effects, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any side effects which you think may be due to the drug, but which are not listed here, please discuss them with your doctor or chemotherapy nurse. Temporary reduction in the production of blood cells by the bone marrow This can result in anaemia leading to tiredness; an increased risk of bruising or bleeding and an increased risk of infection. The number of cells in your blood may begin to reduce from about seven days after the treatment has been given and usually reaches its lowest point at 10-14 days after the chemotherapy. The number of blood cells will then increase steadily and will have usually returned to normal within 21-28 days. The extent to which your blood cells are reduced depends on the dose of chemotherapy you have and which other chemotherapy drugs, if any, are given in combination. Your doctor can advise you how likely it is that your blood cells will be lowered by the chemotherapy. Your blood will be checked regularly to see how well your bone marrow is working. If your temperature goes above 38°C (100.5°F); you develop any unexplained bruising or bleeding; or you suddenly feel unwell, even if you have a normal temperature, contact your doctor or the hospital straight away. Sore mouth and taste change Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly and gently with a soft toothbrush can help to reduce the risk of this happening. Tell your doctor if you have any of these problems as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed. You may notice that your food tastes different. Normal taste will come back after the treatment finishes. CancerBACUP's section on diet and the cancer patient has tips on boosting appetite, coping with eating difficulties and maintaining weight. Diarrhoea can usually be easily controlled with medicine but let your doctor know if it is severe or continues. It is important to drink plenty of fluids if you have diarrhoea. Tiredness and a general feeling of weakness It is important to allow yourself plenty of time to rest. Skin changes Your skin may darken, due to excess production of pigment. This usually returns to normal a few months after the treatment finishes. Your kidneys may be affected Methotrexate in very high doses can damage the kidneys. It is uncommon for this to happen when standard doses are given. To prevent this happening, an alkaline solution (sodium bicarbonate) is given into the vein for several hours before the methotrexate is given. Your kidney function will be checked by a blood test before each methotrexate treatment. Gritty eyes due to inflammation of the cornea If this occurs it is important that you tell your doctor, who can prescribe soothing eye drops. back to top Less common side effects Nausea (feeling sick) and vomiting There are now very effective anti-sickness drugs to prevent or greatly reduce nausea and vomiting. If you do feel sick it may begin soon after the treatment is given and can last for a few days. If the sickness is not controlled or continues tell your doctor, who can prescribe other anti-sickness drugs that may be more effective. Blurred vision Methotrexate may affect your eyesight. Tell your doctor about any eye pain or vision changes. Hair loss is very uncommon at low doses but often happens when high doses are given. Hair may thin, or occasionally be lost completely. If this happens, it usually begins about 3-4 weeks after starting treatment, although it may occur earlier. You may also have thinning and loss of eyelashes, eyebrows and other body hair. This is temporary, and the hair will return to normal once the treatment is finished. Sensitivity of the skin to sunlight During treatment with methotrexate, and for several months afterwards, you will be more sensitive to the sun, and your skin may burn more easily than normal. You can still go out in the sun, but always wear a high protection suncream and protective clothing. Skin changes Methotrexate can cause a rash, which may be itchy. Your doctor can prescribe medicine to help. Areas of skin that have previously been treated with radiotherapy may become red and sore. Let your doctor know if this happens. Changes to lung tissue Tell your doctor if you notice any cough or breathlessness. Your liver may be temporarily affected Methotrexate may cause changes in the way that your liver works, which return to normal when the treatment is finished. This is unlikely to cause you any harm but your doctor will monitor this carefully. Samples of your blood will be taken from time to time to check your liver function. Allergic reaction You will be monitored for any signs of an allergic reaction during the treatment. Signs include skin rashes and itching, a high temperature, shivering, redness of the face, a feeling of dizziness, headache, breathlessness, anxiety and a need to pass urine. Tell your doctor or nurse if you have any of these signs, as medicine can be given to reduce them. back to top Additional information When methotrexate is given into the fluid around the spinal cord or into the brain it can cause a headache, dizziness, tiredness, blurred vision and loss of balance for a few hours. Tell your doctor if you have any of these effects. Some medicines can be harmful to take when you are having chemotherapy. Always tell your doctor about any other medicine you are taking. Methotrexate may be prescribed for conditions other than cancer. The drug dosage will then usually be lower and these effects will probably not happen. A drug called folinic acid may be given 24 hours after starting methotrexate treatment, to reduce the side effects. While you have a drip in, the folinic acid can be given intravenously (into the vein), otherwise it is given as tablets. It is very important that the folinic acid is taken on time and that all the tablets are taken as directed by your doctor. Folinic acid is often called a 'rescue' when it is given in this way after methotrexate treatment. Fertility Your ability to become pregnant or father a child may be affected by taking this drug. Discuss fertility with your doctor before starting treatment. Contraception It is not advisable to become pregnant or father a child while taking methotrexate as it may harm the developing foetus. It is important to use effective contraception whilst taking this drug, and for at least a few months afterwards. It is important to discuss this with your doctor. back to top Things to remember about methotrexate tablets It is important to take your tablets at the right times. You must take them as directed by your doctor. Keep tablets in a safe place where children cannot reach them, as methotrexate could harm them. If your doctor decides to stop the treatment, return any remaining tablets to the pharmacist. Do not flush them down the toilet or throw them away. If you are sick just after taking the tablet tell your doctor, as you may need to take another dose. Do not take another tablet without first telling your doctor. If you forget to take a tablet do not take a double dose. Tell your doctor and keep to your regular dose schedule. back to top References This section has been compiled using information from a number of reliable sources including: dale: The Complete Drug Reference (33rd edition). Eds. Sweetman et al, Pharmaceutical Press, 2002. British National Formulary (46th edition). British Medical Association and Royal Pharmaceutical Society of Great Britain, September 2003. The Chemotherapy Source Book (3rd edition). Ed. , Lippincott and Wilkins, 2001. For futher references, please see general bibliography. back to top Content last reviewed: 01 March 2004Page last modified: 20 June 2004 Related information Cancer types Resources Avoiding infection Mouth care Diet Fatigue Nausea & vomiting Hair loss Fertility Order publications Ways to donate You are in: HOME > TREATMENTS > CHEMOTHERAPY ABOUT US SITEMAP SEARCH Chemotherapy Chemotherapy Individual chemotherapy drugs Altretamine Bleomycin Busulphan Calcium Folinate Capecitabine Carboplatin Carmustine Chlorambucil Cisplatin Cladribine Crisantaspase Cyclophosphamide Cytarabine Dacarbazine Dactinomycin Daunorubicin Docetaxel Doxorubicin Epirubicin Etoposide Fludarabine Fluorouracil Gemcitabine Hydroxyurea Idarubicin Ifosfamide Irinotecan Liposomal doxorubicin Lomustine Melphalan Mercaptopurine Methotrexate Mitomycin Mitoxantrone Oxaliplatin Paclitaxel Pentostatin Procarbazine Raltitrexed Streptozocin Tegafur-uracil Temozolomide Thiotepa Tioguanine/Thioguanine Topotecan Treosulfan Vinblastine Vincristine Vindesine Vinorelbine Combination chemotherapy regimes Managing a central line Managing a PICC line Managing an implantable port Lumbar puncture ( & intrathecal chemotherapy) About cancer Cancer type Treatments Resources & support Trials Health professionals News Get involved ABOUT US CONTACT US ORDER PUBLICATIONS WAYS TO DONATE SITEMAP TERMS & CONDITIONS PRIVACY STATEMENT produced by jamkit© copyright cancerBACUP 2003registered charity number 1019719 Quote Link to comment Share on other sites More sharing options...
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