Explanation

Methotrexate is a medicine that kills cancer cells. It belongs to a family of medicines called cytotoxics.

What does methotrexate do?

Methotrexate travels all around your body hunting out cancer cells. When it finds a cancer cell it attacks it and kills it.

It's very good at killing all types of cancer cells, so it can be used to treat lots of different types of cancer.

Methotrexate is also used in small amounts to treat a skin condition called psoriasis, which makes your skin look and feel scaly.

What does it look like?

Methotrexate comes both as a liquid that you can have as injections, and as a tablet.

When do I take it?

You will probably take methotrexate in treatment cycles. This means that you will take it for a set number of days and then have a break before you then take it again for a set number of days - the next 'cycle'.

Your doctor will explain everything about treatment cycles and will tell you exactly how much methotrexate to take and how often you need to take it.

But what if I don't feel like taking it?

You need to keep taking your methotrexate until your doctor is sure that all the cancer in your body has gone. If you stop taking it then the cancer can grow back.

It's really important to keep taking it, even if it's making you feel sick and horrible. Just remember, you won't have to take it forever. Keep thinking about all the cancer cells it's killing inside you! Each cancer cell it kills is one more step towards getting better.

What should I do if I forget to take it?

You will often be in hospital and your doctor or nurse will give you your methotrexate as an injection, so you don't need to worry about forgetting to take it.

If you are taking tablets and you forget to take a dose, tell your doctor or nurse. When you next take your methotrexate, don't take double your normal dose to make up for the dose you missed. Remember the three Ds: Don't Double Dose!

How much do I take?

That depends on how much you weigh and how ill you are. Your doctor will decide the perfect dose for you.

The right dose is important. It's the best way to beat your cancer without getting side effects.

What are the most likely side effects I might get?

The side effects you are most likely to get with methotrexate are:

Feeling sick

Getting more infections (caused by not having enough white blood cells)

A sore tummy, or pain around your tummy

Tell your doctor if you notice these or any other side effects.

What other side effects might I get?

Some other side effects you might get from methotrexate include:

Light patches on your skin

Itchy skin

Bruises or painful bumps on your skin

Pain when you are having a wee

Runny poo (diarrhea)

Having a headache

Feeling sleepy

Blurry vision

Itchy or sore eyes

Feeling dizzy

Finding it hard to talk

Feeling weak

Seizures

Diabetes

Breaking bones (methotrexate can weaken your bones so that they break more easily)

Red or painful blood vessels

Losing your hair

Tell your doctor if you notice these or any other side effects.

Are there any other side effects you haven't mentioned?

There are some other side effects that you could get from your methotrexate, although these are rare. They can sometimes be serious though, so you should tell your doctor immediately if you:

Have a red or sore mouth, with ulcers or blisters

Feel breathless, have a cough, or find that breathing hurts

Get a sudden swelling of your face, throat or hands. This could be could be anaphylaxis.

Have a fever, feel very cold or get a sore throat.

Have blood in your wee

Have bleeding gums

Get red marks on your skin (these are caused by broken blood vessels)

Have black and sticky poo

Get a rash on your skin

Get blisters forming on your eyes , nose, bum or private parts

Is it safe for me to take methotrexate?

Before you take methotrexate, tell your doctor if you are allergic to it or any of its ingredients.

You should also tell your doctor about any other medical problems that you know you have, especially if you have:

Problems with your liver or kidneys

Problems with your blood (these problems will show up in blood tests)

You should also tell your doctor if you:

Have any stomach or gut problems

Have any problems with your lungs

Are having radiotherapy

Are having a vaccination for anything

Have a sugar intolerance

Is it ok for me to take methotrexate if I am taking any other medicines?

Make sure you tell your doctor about all the other medicines you're taking.

You should also mention things you're taking for other medical problems, including drugs, special foods or herbal remedies.

It's especially important to tell your doctor if you're taking:

Any pain killers

Medicines for stomach problems like indigestion or heartburn

Medicines that make you wee more often

Medicines for diabetes

Antibiotics

Medicines for epilepsy

Medicine for treating a condition that causes painful joints called gout

Medicine for psoriasis or acne

Vitamins containing folic acid

Also make sure you tell your doctor if you are going to have an anaesthetic for an operation or tooth surgery.

Do I need to know anything else about methotrexate?

Before you start taking methotrexate, you will probably have a chest x-ray. You will also have blood tests so that the doctors can check the levels of your blood cells and make sure that your liver and kidneys are working properly.

While you are taking methotrexate, your doctor will give you blood tests regularly to keep checking on your liver and kidneys. If you get a cough or pains in your chest at any time, you will have another chest x-ray.

What if I have any more questions?

If you have any other questions, you can ask your doctor, or chat to other people with cancer in the Medikidz forums and virtual world, Mediland.