Do not take this medicine with any of the following medications:

-acitretin
This medicine may also interact with the following medications:

-aspirin or aspirin-like medicines including salicylates
-azathioprine
-certain antibiotics like chloramphenicol, penicillin, tetracycline
-certain medicines that treat or prevent blood clots like warfarin, apixaban, dabigatran, and rivaroxaban
-certain medicines for stomach problems like esomeprazole, omeprazole, pantoprazole
-cyclosporine
-dapsone
-diuretics
-gold
-hydroxychloroquine
-live virus vaccines
-medicines for infection like acyclovir, adefovir, amphotericin B, bacitracin, cidofovir, foscarnet, ganciclovir, gentamicin, pentamidine, vancomycin
-mercaptopurine
-NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
-other cytotoxic agents
-pamidronate
-pemetrexed
-penicillamine
-phenylbutazone
-phenytoin
-probenacid
-retinoids such as isotretinoin and tretinoin
-steroid medicines like prednisone or cortisone
-sulfonamides like sulfasalazine and trimethoprim/sulfamethoxazole
-theophylline
-zoledronic acid

They need to know if you have any of these conditions:

-fluid in the stomach area or lungs
-if you often drink alcohol
-infection or immune system problems
-kidney disease
-liver disease
-low blood counts, like low white cell, platelet, or red cell counts
-lung disease
-radiation therapy
-stomach ulcers
-ulcerative colitis
-an unusual or allergic reaction to methotrexate, other medicines, foods, dyes, or preservatives
-pregnant or trying to get pregnant
-breast-feeding

Avoid alcoholic drinks.
This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.
You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.
You may need blood work done while you are taking this medicine.
Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body''s ability to fight infections. Try to avoid being around people who are sick.
This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding.
Be careful brushing or flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this medicine
Check with your doctor or health care professional if you get an attack of severe diarrhea, nausea and vomiting, or if you sweat a lot. The loss of too much body fluid can make it dangerous for you to take this medicine.
Talk to your doctor about your risk of cancer. You may be more at risk for certain types of cancers if you take this medicine.
Do not become pregnant while taking this medicine or for 6 months after stopping it. Women should inform their health care provider if they wish to become pregnant or think they might be pregnant. Men should not father a child while taking this medicine and for 3 months after stopping it. There is potential for serious harm to an unborn child. Talk to your health care provider for more information. Do not breast-feed an infant while taking this medicine or for 1 week after stopping it.
This medicine may make it more difficult to get pregnant or father a child. Talk to your health care provider if you are concerned about your fertility.

Keep out of the reach of children and pets.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Protect from light. Get rid of any unused medicine after the expiration date.
Talk to your health care provider about how to dispose of unused medicine. Special directions may apply.