You may not be able to take MTX if you have any blood disorders (i.e., anemia, low platelets), an active infection, severe kidney or liver disorders, problems with your immune system or if you suffer from alcoholism or alcoholic liver disease. If you have any of these conditions, please discuss the situation with your prescriber.
MTX has the potential to harm your liver so your alcohol use must be restricted while taking MTX.
Taking MTX can make it more difficult for your body to fight infections. If you have a fever or think you may have an infection, contact your health-care provider. You may need to stop taking MTX if you are having surgery until you are healed and there is no sign of infection. Please discuss this with your prescriber.
Taking MTX before or during pregnancy can cause birth defects or even a miscarriage. Therefore, if you are pregnant or trying to get pregnant, both partners (man and woman) should refrain from taking this drug. The best time to stop MTX before getting pregnant, for both partners, is not entirely clear. Typically, it is recommended that both partners discontinue MTX for at least three months before pregnancy. If you or your partner are planning to get pregnant, please discuss this with your health-care provider.
Anyone who has had a previous allergic reaction to MTX should avoid the medication. Any woman who is breastfeeding should also avoid MTX.
MTX interacts with a number of other medications, including some commonly used antibiotics. Please speak with your health-care provider about whether any of the other medications you currently take interact with MTX. If you need an antibiotic while you are taking MTX, be sure to discuss this possible interaction with your prescriber and/or pharmacist.