Methotrexate can cause a decrease in the number of blood cells in your bone marrow. Methotrexate also can cause cancerous lymphomas, tumor lysis syndrome (electrolyte imbalances), severe skin reactions, infections such as pneumonia, bone and soft tissue damage, and severe damage to your liver, kidneys, lungs, and gastrointestinal tract (some of which can be fatal).

Keep all appointments with your doctor and the laboratory. Your doctor will order lab tests before, during, and after your treatment to see if you are affected by this drug.

Tell your doctor if you have ascites (collection of fluid in the abdomen), kidney disease, or lung disease and if you are getting radiation therapy. Tell your doctor if you are taking aspirin, ibuprofen (Advil, Motrin, or Nuprin), indomethacin (Indocin), ketoprofen (Actron, Orudis), naproxen (Aleve, Anaprox, Naprosyn), or other nonsteroidal anti-inflammatory drugs (NSAIDs).

If you experience any of the following symptoms, call your doctor immediately: dry cough; diarrhea; loss of appetite; nausea, stomach pain; weakness; weight loss; excessive tiredness; lack of energy; yellowness of the skin or eyes; enlargement of the lymph nodes; blisters on the cheek, tongue and lips; or skin rash.

Because of the dangers of taking methotrexate, this drug should be used to treat only life-threatening cancer or severe psoriasis or rheumatoid arthritis that does not respond to other treatments. Talk to your doctor about the risks of taking methotrexate.

If you are pregnant or plan to become pregnant, especially if you have psoriasis or rheumatoid arthritis, talk you your doctor about the risks of taking methotrexate for your condition. If you become pregnant, call your doctor immediately. Methotrexate may harm the fetus.

• Amethopterin

• MTX