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Oral methotrexate should be given at least an hour after the evening meal;some sources say two hours after a meal.

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Signs of tumor cell breakdownconfusiontirednessnumbness or tinglingmuscle crampsmuscle weaknessvomitingdiarrheafast or slow heart rateseizure.

DrRanganathan recommends taking 1 mg of folic acid dailythough for convenience some other physicians instruct patients to pop a single 5 mg dose once a weekSome doctors recommend taking folic acid 24 hours after receiving a dose of methotrexateask your physician for complete instructions on using folic acid supplements

Before taking methotrexatetell your doctor or pharmacist if you are allergic to itor if you have any other allergiesThis product may contain inactive ingredientswhich can cause allergic reactions or other problemsTalk to your pharmacist for more details.

12 mg/m2 intrathecally every 2 to 5 days until the cell count of the CSF returns to normalAt this pointone additional dose is advisableAdministration at intervals of less than 1 week may result in increased subacute toxicity.

Methotrexate should NOT be taken if you are pregnant or planning to get pregnant or breast-feedingMethotrexate may be temporarily discontinued if you are having surgeryincluding dental surgeryInform Purchase zestoretic drug your surgeon or dentist about the medication prior to the surgeryMethotrexate sensitises your skin to sunlightAvoid unnecessary or prolonged sun exposure and wear protective gearIf you have psoriasisyour sores may worsen if you expose your skin to sunlight while you are taking methotrexateVaccinationsespecially live onesare not to be given while you are taking methotrexateDiscuss this with your doctor for safer options.

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