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XATMEP (METHOTREXATE)
- Acute lymphoid leukemia
- Polyarticular juvenile idiopathic arthritis
2.5 mg/mL oral solution
- Dosage information is not available
- acitretin
- natalizumab
- Soriatane
- Tysabri
Contraindicated
- acetaminophen-mag sal-pamabrom
- Added Strength Headache Relief
- Added Strength Pain Reliever
- adenovirus vac live type-4 & 7
- adenovirus vaccine live type-4
- adenovirus vaccine live type-7
- Advil
- Advil Allergy Sinus
- Advil Allergy-congestion Rlf
- Advil Cold & Sinus
- Advil Congestion Relief
- Advil Liqui-gel
- Advil Migraine
- Advil Pm
- Advil Pm Liqui-gels
- Aleve
- Aleve Cold & Sinus
- Aleve Sinus & Headache
- Aleve-d Sinus & Cold
- Aleve-d Sinus & Headache
- Alka-seltzer
- Alka-seltzer Extra Strength
- Alka-seltzer Original
- Alka-seltzer Plus C/c(pe,dm)
- Alka-seltzer Plus Cold (pe)
- Alka-seltzer Plus Day-night
- Alka-seltzer Plus Night
- Alka-seltzer Pm
- All Day Pain Relief
- All Day Pain Relief Sinus & Co
- All Day Relief
- amoxicil-clarithromy-lansopraz
- amoxicillin
- amoxicillin-pot clavulanate
- ampicillin
- ampicillin sodium
- ampicillin-sulbactam
- Anacin
- Anacin Maximum Strength
- Analgesic
- Anaprox
- Anaprox Ds
- Ansaid
- Antacid & Pain Relief
- Apriso
- Arthri-flex
- Arthrotec 50
- ASA-acetaminophen-caff-buffers
- ASA-acetaminophen-salicyl-caff
- Asacol Hd
- Ascomp With Codeine
- asparaginase
- asparaginase (Erwinia chrysan)
- aspirin
- aspirin, buffered
- aspirin-acetaminophen-caffeine
- aspirin-caffeine
- aspirin-diphenhydramine
- aspirin-diphenhydramine citrat
- aspirin-sod bicarb-citric acid
- Augmentin
- Augmentin Es-600
- Augmentin Xr
- Azulfidine
- Azulfidine En-tabs
- Back & Body Pain Reliever
- Back Pain-off
- Backache Relief
- Backache Relief Extra Strength
- Bactrim
- Bactrim Ds
- balsalazide
- Bayer Advanced
- Bayer Aspirin (with Caffeine)
- Bayer Back & Body
- Bayer Plus Extra Strength
- Bayer Pm
- Bc
- Bc Arthritis
- BCG vaccine, live (PF)
- Bicillin C-r
- Bicillin L-a
- Bismatrol
- Bismuth
- Bismuth Maximum Strength
- bismuth subsalicylate
- Butalbital Compound W/codeine
- Butalbital Compound-codeine
- butalbital-aspirin-caffeine
- Caldolor
- Cambia
- Canasa
- carisoprodol-ASA-codeine
- carisoprodol-aspirin
- Cataflam
- Child Ibuprofen
- Children's Advil
- Children's Ibu-drops
- Children's Ibuprofen
- Children's Medi-profen
- Children's Motrin
- Children's Profen Ib
- chlorphen-phenyleph-DM-aspirin
- chlorphen-phenyleph-ibuprofen
- chlorphen-pseudoeph-ibuprofen
- chlorphenir-phenylephrn-aspirn
- choline & magnesium salicylate
- clozapine
- Clozaril
- codeine-butalbital-ASA-caff
- Colazal
- colchicine-probenecid
- Cold & Sinus Pain Relief
- Cold Relief
- Cold Relief Plus
- Cold-sinus Relief
- cyclosporine
- cyclosporine modified
- Cystex (methenamine & Sod Sal)
- Daypro
- deferiprone
- Delzicol
- Diarrhea Relief (bismuth Subs)
- diclofenac epolamine
- diclofenac potassium
- diclofenac sodium
- diclofenac submicronized
- diclofenac-misoprostol
- dicloxacillin
- diflunisal
- dihydrocodeine-aspirin-caff
- Diotame
- Diotame Instydose
- Dipentum
- doxylamine-phenylep-DM-aspirin
- Duexis
- Ec-naprosyn
- Efferves Pain Relief Antacid
- Effervescent Antacid
- Effervescent Pain Relief
- Effervescent Pain Reliever
- Elspar
- Endodan
- Erwinaze
- erythromycin-sulfisoxazole
- etodolac
- Excedrin Extra Strength
- Excedrin Migraine
- Extra Strength Bayer
- Fazaclo
- Feldene
- fenoprofen
- Ferriprox
- Fiorinal
- Fiorinal-codeine #3
- Flanax
- Flector
- flu vac,qval 2013-14 (2-49yrs)
- Flumist 2013-2014
- flurbiprofen
- Gengraf
- Giazo
- gluc-msm-coll2-hyal-antiarthr3
- glucos-msm-C-Mn-ginger-willow
- glucos-msm-C-Mn-herb#21
- glucos-msm-collagen-C-Mn-hrb21
- Glucosamine-msm Complex
- Goody's Extra Strength
- Goody's Migraine Relief
- Headache Formula
- Headache Formula Added Str
- Headache Relief
- hydrocodone-ibuprofen
- Hyophen
- I-prin
- Ibu-drops
- Ibudone
- ibuprofen
- Ibuprofen Cold
- Ibuprofen Cold-sinus(with Pse)
- Ibuprofen Ib
- Ibuprofen Jr Strength
- ibuprofen lysine (PF)
- Ibuprofen Pm
- ibuprofen-diphenhydramine
- ibuprofen-diphenhydramine HCl
- ibuprofen-famotidine
- ibuprofen-oxycodone
- ibuprofen-phenylephrine HCl
- Indocin
- indomethacin
- indomethacin sodium
- Infant's Ibuprofen
- Infant's Medi-profen
- Infant's Motrin
- Infants Ibu-drops
- Infants Profenib
- K-pec Antidiarrheal (bism Sub)
- Kao-tin (bismuth Subsalicylat)
- Kaopectate (bismuth Subsalicy)
- Kaopectate Child(bis Ssalicyl)
- Kaopectate Ex Str (bismuth Ss)
- ketoprofen
- ketorolac
- Kola-pectin Ds
- Levacet
- Lialda
- M-m-r Ii (pf)
- magnesium salicylate
- measles,mumps&rubella vacc(PF)
- measles,mumps,rub,varicel(PF)
- Medi-bismuth
- Medi-profen
- Medi-seltzer
- Mediproxen
- mefenamic acid
- meloxicam
- mesalamine
- mesalamine-cleansing wipes
- methen-hyos-me blue-ba-salicyl
- methen-hyosc-m.blue-sal-naphos
- methenamine-sodium salicylate
- Mg salicylat-acetaminophen-caf
- Midol (naproxen)
- Migraine Formula
- Migraine Pain Reliever
- Migraine Relief
- Mobic
- Motrin Ib
- Motrin Pm
- Msm Glucosamine Complex
- mth-me blue-sod phos-phsal-hyo
- nabumetone
- nafcillin
- nafcillin in dextrose iso-osm
- Nalfon
- Naprelan Cr
- Naprosyn
- naproxen
- naproxen sodium
- naproxen-esomeprazole
- naproxen-pseudoephedrine
- Neoprofen (ibuprofen Lysn)(pf)
- Neoral
- olsalazine
- Omeclamox-pak
- omeprazole-clarith-amoxicillin
- Orphenadrine Compound Forte
- Orphenadrine Compound-ds
- orphenadrine-ASA-caffeine
- oxacillin
- oxacillin in dextrose(iso-osm)
- oxaprozin
- oxycodone-aspirin
- Pain Relief
- Pain Relief Extra Strength
- Pain Reliever
- Pain Reliever Extra Strength
- Pain Reliever Plus
- Pain-off
- Pamprin (with Mag Salicylate)
- Pamprin Max
- PE-DM-ASA/doxyla-PE-DM-ASA
- penicillin G benzathine
- penicillin G benzathine & proc
- penicillin G pot in dextrose
- penicillin G potassium
- penicillin G procaine
- penicillin G sodium
- penicillin V potassium
- Pennsaid
- Pentasa
- Peptic Relief
- Pepto-bismol
- Pepto-bismol Max St
- Pepto-bismol To-go
- Percodan
- Pfizerpen-g
- Phosphasal
- Pink Bismuth
- Pink Bismuth Maximum Strength
- piperacillin-tazobactam
- piperacillin-tazobactam-dextrs
- piroxicam
- Ponstel
- Prevpac
- Primsol
- probenecid
- Proquad (pf)
- Prosed/ds (atropine Free)
- Provil
- pseudoephedrine-ibuprofen
- Reprexain
- Rotateq Vaccine
- rotavirus vaccine live, penta
- Rowasa
- salsalate
- Sandimmune
- Sfrowasa
- Sinus & Cold-d
- Solaraze
- Soothe (bismuth Subsalicylate)
- Soothe Regular Strength
- Sprix
- Stomach Relief
- Stomach Relief Max Strength
- Stomach Relief Original
- sulfadiazine
- sulfamethoxazole-trimethoprim
- sulfasalazine
- Sulfatrim
- Sulfazine
- Sulfazine Ec
- sulindac
- Super Pain Relief
- Synalgos-dc
- ticarcillin-clavulanate
- Timentin
- tolmetin
- trimethoprim
- typhoid vaccine
- Unasyn
- Ur N-c
- Urelle
- Uretron D-s
- Uribel
- Urimar-t
- Urin Ds
- Ustell
- Uta
- Vanquish
- varicella virus vacc live (PF)
- Varivax (pf)
- Versacloz
- Vicoprofen
- Vimovo
- Vivotif Berna Vaccine
- Voltaren-xr
- Wal-profen
- Wal-profen Cold-sinus
- Wal-proxen
- yellow fever vaccine live (PF)
- Yf-vax (pf)
- Zipsor
- Zorvolex
- Zostavax (pf)
- zoster vaccine live (PF)
- Zosyn
- Zosyn In Dextrose (iso-osm)
Severe
Moderate
- Aciphex
- Aciphex Sprinkle
- Arava
- Aubagio
- Cerebyx
- Dexilant
- dexlansoprazole
- Digox
- digoxin
- Dilantin
- Dilantin Extended
- Dilantin Infatabs
- Dilantin Kapseal
- Dilantin-125
- esomeprazole magnesium
- esomeprazole sodium
- esomeprazole strontium
- ethotoin
- First-lansoprazole
- First-omeprazole
- fosphenytoin
- Heartburn Relief 24 Hour
- Heartburn Treatment 24 Hour
- Lanoxin
- lansoprazole
- leflunomide
- Nexium
- Nexium Iv
- Nexium Packet
- omeprazole
- omeprazole magnesium
- Omeprazole+syrspend Sf Alka
- omeprazole-sodium bicarbonate
- pantoprazole
- Peganone
- Phenytek
- phenytoin
- phenytoin sodium
- phenytoin sodium extended
- Prevacid
- Prevacid 24Hr
- Prevacid Solutab
- Prilosec
- Prilosec Otc
- Protonix
- rabeprazole
- teriflunomide
- Zegerid
- Zegerid Otc
- Alcoholic liver damage
- Alcoholism
- Aplastic anemia
- Hepatic cirrhosis
- Hepatic fibrosis
- Interstitial pneumonitis
- Lactating mother
- Pregnancy
- Pulmonary fibrosis
- Severe anemia
- Severe hepatic disease
- Severe thrombocytopenia
Contraindicated
- Abnormal hepatic function tests
- Aphthous stomatitis
- Ascites
- Bone marrow depression
- Diarrhea
- Disorder of immune function
- Kidney disease with reduction in GFR
- Leukopenia
- Peptic ulcer
- Pleural effusions
- Severe infection
- Ulcerative colitis
Severe
Moderate
- Dehydration
XATMEP (METHOTREXATE)
- Acute lymphoid leukemia
- Polyarticular juvenile idiopathic arthritis
- Aphthous stomatitis
- Azotemia
- Bacterial infection
- Bacterial sepsis
- Gastroenteritis
- Gastrointestinal hemorrhage
- Gastrointestinal ulcer
- Intestinal perforation
- Skin photosensitivity
- Thrombocytopenic disorder
- Anorexia
- Dizziness
- Fatigue
- Gingivostomatitis
- Malaise
- Nausea
- Vomiting
More Frequent
Severe
Less Severe
- Anemia
- Chemical arachnoiditis
- Drug-induced hepatitis
- Hepatic cirrhosis
- Hepatic necrosis
- Interstitial pneumonitis
- Leukoencephalopathy
- Leukopenia
- Pulmonary fibrosis
- Abnormal hepatic function tests
- Acne vulgaris
- Alopecia
- Chills
- Diarrhea
- Fever
- Furunculosis
- Pharyngitis
- Pruritus of skin
- Skin rash
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Acute hepatic failure
- Acute respiratory insufficiency
- Agranulocytosis
- Alveolitis
- Anaphylaxis
- Aplastic anemia
- Arterial thrombosis
- Avascular necrosis of bone
- Cerebral thrombosis
- Chemotherapy-induced hyperuricemia
- Cutaneous vasculitis
- Deep venous thrombosis
- Diabetes mellitus
- Encephalopathy
- Eosinophilia
- Erythema multiforme
- Exfoliative dermatitis
- Fracture
- Hemiplegia
- Hepatic fibrosis
- Increased cerebrospinal fluid pressure
- Kidney disease with reduction in GFR
- Neutropenic disorder
- Pancytopenia
- Pericardial effusion
- Pericarditis
- Pneumocystis jirovecii pneumonia
- Proteinuria
- Pulmonary hemorrhage
- Pulmonary thromboembolism
- Renal failure
- Seizure disorder
- Stevens-johnson syndrome
- Subacute necrotizing encephalomyelopathy
- Thrombophlebitis
- Thrombosis of retinal vein
- Toxic epidermal necrolysis
- Transient blindness
Less Severe
- Acute confusion
- Aphasia
- Arthralgias
- Blurred vision
- Conjunctivitis
- Cystitis
- Drowsy
- Dysarthria
- Headache disorder
- Hematuria
- Infection
- Libido changes
- Lymphadenopathy
- Oligospermia
- Stinging of skin
- Tinnitus
Contraindicated
None
Severe Precaution
None
Management or Monitoring Precaution
None
Methotrexate
- Severity Level:
1
- Additional Notes: Reports of embryotoxicity, fetal death, abortion
Contraindicated
Methotrexate
Low levels excreted; potential for serious adverse effects in infant
| General | Excretion Potential | Effect on Infant | Notes |
| Drug should not be given to breast feeding mothers | Excreted | Not known; no or inclusive data | Low levels excreted; potential for serious adverse effects in infant |
Precaution Exists
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Methotrexate
Renal- Consider lower dose. Monitor closely for early signs of renal, hepatic and bone toxicity especially with renal impairment. Hepatic-Monitor LFTs regularly. Hematologic-Monitor CBC regularly. Consider folate supplement with chronic use. Pulmonary-Monitor closely for symptoms suggestive of fibrosis.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | Y | Y | N | N | Y | N |
BEERS: N HEDIS: N STOPP: Y
No Known Risk
None
- Methotrexate has rarely caused serious (sometimes fatal) side effects. Therefore, this medication should be used only to treat cancer or severe diseases caused by an overactive immune system (such as psoriasis, rheumatoid arthritis). Methotrexate has caused birth defects and death in unborn babies.<br /><br />Women must avoid becoming pregnant while taking this medication. Pregnant women who have psoriasis or rheumatoid arthritis must not use methotrexate. (See also Precautions section.) 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 by your doctor.<br /><br /> Methotrexate (usually at high dosages) has rarely caused severe (sometimes fatal) blood/bone marrow problems (decreasing your body's ability to fight infections) and stomach/intestinal disease (such as bleeding) when used at the same time as non-steroidal anti-inflammatory drugs (NSAIDs such as indomethacin, ketoprofen). Therefore, NSAIDs should not be used with high-dose methotrexate. Caution is advised if you also take aspirin.<br /><br />NSAIDs/aspirin may be used with low-dose methotrexate such as for the treatment of rheumatoid arthritis if directed by your doctor. If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details on the safe use of these drugs (such as close monitoring by your doctor, keeping the same doses of NSAIDs).<br /><br /> In rare instances, this drug may also cause liver problems when it is used for long periods of time. If you are using methotrexate long term, a liver biopsy is usually recommended. Methotrexate use has rarely caused serious (sometimes fatal) side effects, such as lung problems, lung infections (Pneumocystis jiroveci pneumonia), skin reactions, diarrhea, and mouth sores (ulcerative stomatitis).<br /><br />(See also Side Effects section.) Lumps (tumors/abnormal growths) may very rarely appear during methotrexate use. The drug must be stopped and treatment may be needed. Tell your doctor right away if new lumps/growths occur.<br /><br /> When used to treat tumors, methotrexate sometimes causes side effects due to the rapid destruction of cancer cells (tumor lysis syndrome). To lower your risk, drink plenty of fluids unless your doctor directs you otherwise. Also, your doctor may prescribe an additional medication.<br /><br />Tell your doctor right away if you have symptoms such as irregular heartbeat, low back/side pain, signs of kidney problems (such as pink/bloody urine, change in the amount of urine, painful urination), or muscle spasms/weakness. When this medication is used with radiation treatment, it may rarely increase the risk of tissue and bone damage. Discuss the risks and benefits of your treatment with your doctor.
| Acute lymphoid leukemia | |
| C91.0 | Acute lymphoblastic leukemia [ALl] |
| C91.00 | Acute lymphoblastic leukemia not having achieved remission |
| C91.02 | Acute lymphoblastic leukemia, in relapse |
| Polyarticular juvenile idiopathic arthritis | |
| M08.0 | Unspecified juvenile rheumatoid arthritis |
| M08.00 | Unspecified juvenile rheumatoid arthritis of unspecified site |
| M08.01 | Unspecified juvenile rheumatoid arthritis, shoulder |
| M08.011 | Unspecified juvenile rheumatoid arthritis, right shoulder |
| M08.012 | Unspecified juvenile rheumatoid arthritis, left shoulder |
| M08.019 | Unspecified juvenile rheumatoid arthritis, unspecified shoulder |
| M08.02 | Unspecified juvenile rheumatoid arthritis of elbow |
| M08.021 | Unspecified juvenile rheumatoid arthritis, right elbow |
| M08.022 | Unspecified juvenile rheumatoid arthritis, left elbow |
| M08.029 | Unspecified juvenile rheumatoid arthritis, unspecified elbow |
| M08.03 | Unspecified juvenile rheumatoid arthritis, wrist |
| M08.031 | Unspecified juvenile rheumatoid arthritis, right wrist |
| M08.032 | Unspecified juvenile rheumatoid arthritis, left wrist |
| M08.039 | Unspecified juvenile rheumatoid arthritis, unspecified wrist |
| M08.04 | Unspecified juvenile rheumatoid arthritis, hand |
| M08.041 | Unspecified juvenile rheumatoid arthritis, right hand |
| M08.042 | Unspecified juvenile rheumatoid arthritis, left hand |
| M08.049 | Unspecified juvenile rheumatoid arthritis, unspecified hand |
| M08.05 | Unspecified juvenile rheumatoid arthritis, hip |
| M08.051 | Unspecified juvenile rheumatoid arthritis, right hip |
| M08.052 | Unspecified juvenile rheumatoid arthritis, left hip |
| M08.059 | Unspecified juvenile rheumatoid arthritis, unspecified hip |
| M08.06 | Unspecified juvenile rheumatoid arthritis, knee |
| M08.061 | Unspecified juvenile rheumatoid arthritis, right knee |
| M08.062 | Unspecified juvenile rheumatoid arthritis, left knee |
| M08.069 | Unspecified juvenile rheumatoid arthritis, unspecified knee |
| M08.07 | Unspecified juvenile rheumatoid arthritis, ankle and foot |
| M08.071 | Unspecified juvenile rheumatoid arthritis, right ankle and foot |
| M08.072 | Unspecified juvenile rheumatoid arthritis, left ankle and foot |
| M08.079 | Unspecified juvenile rheumatoid arthritis, unspecified ankle and foot |
| M08.08 | Unspecified juvenile rheumatoid arthritis, vertebrae |
| M08.09 | Unspecified juvenile rheumatoid arthritis, multiple sites |
| M08.3 | Juvenile rheumatoid polyarthritis (seronegative) |
| 0-9 | A-Z |
|---|---|
| C91.0 | Acute lymphoblastic leukemia [ALl] |
| C91.00 | Acute lymphoblastic leukemia not having achieved remission |
| C91.02 | Acute lymphoblastic leukemia, in relapse |
| M08.0 | Unspecified juvenile rheumatoid arthritis |
| M08.00 | Unspecified juvenile rheumatoid arthritis of unspecified site |
| M08.01 | Unspecified juvenile rheumatoid arthritis, shoulder |
| M08.011 | Unspecified juvenile rheumatoid arthritis, right shoulder |
| M08.012 | Unspecified juvenile rheumatoid arthritis, left shoulder |
| M08.019 | Unspecified juvenile rheumatoid arthritis, unspecified shoulder |
| M08.02 | Unspecified juvenile rheumatoid arthritis of elbow |
| M08.021 | Unspecified juvenile rheumatoid arthritis, right elbow |
| M08.022 | Unspecified juvenile rheumatoid arthritis, left elbow |
| M08.029 | Unspecified juvenile rheumatoid arthritis, unspecified elbow |
| M08.03 | Unspecified juvenile rheumatoid arthritis, wrist |
| M08.031 | Unspecified juvenile rheumatoid arthritis, right wrist |
| M08.032 | Unspecified juvenile rheumatoid arthritis, left wrist |
| M08.039 | Unspecified juvenile rheumatoid arthritis, unspecified wrist |
| M08.04 | Unspecified juvenile rheumatoid arthritis, hand |
| M08.041 | Unspecified juvenile rheumatoid arthritis, right hand |
| M08.042 | Unspecified juvenile rheumatoid arthritis, left hand |
| M08.049 | Unspecified juvenile rheumatoid arthritis, unspecified hand |
| M08.05 | Unspecified juvenile rheumatoid arthritis, hip |
| M08.051 | Unspecified juvenile rheumatoid arthritis, right hip |
| M08.052 | Unspecified juvenile rheumatoid arthritis, left hip |
| M08.059 | Unspecified juvenile rheumatoid arthritis, unspecified hip |
| M08.06 | Unspecified juvenile rheumatoid arthritis, knee |
| M08.061 | Unspecified juvenile rheumatoid arthritis, right knee |
| M08.062 | Unspecified juvenile rheumatoid arthritis, left knee |
| M08.069 | Unspecified juvenile rheumatoid arthritis, unspecified knee |
| M08.07 | Unspecified juvenile rheumatoid arthritis, ankle and foot |
| M08.071 | Unspecified juvenile rheumatoid arthritis, right ankle and foot |
| M08.072 | Unspecified juvenile rheumatoid arthritis, left ankle and foot |
| M08.079 | Unspecified juvenile rheumatoid arthritis, unspecified ankle and foot |
| M08.08 | Unspecified juvenile rheumatoid arthritis, vertebrae |
| M08.09 | Unspecified juvenile rheumatoid arthritis, multiple sites |
| M08.3 | Juvenile rheumatoid polyarthritis (seronegative) |
Formulary Reference Tool