Rheumatrex Dose Pack

1 What is Rheumatrex Dose Pack?

Brand: Rheumatrex Dose Pack, Trexall

Generic: Methotrexate

Rheumatrex dose pack is an antineoplastic medicine (cancer medicine).

It is used in the treatment of different types of cancers such as:

  • breast
  • head and neck
  • lung
  • blood
  • bone
  • lymph node
  • uterus cancers

It is also used in psoriasis and rheumatoid arthritis. It works by interfering with the growth of rapidly dividing cells such as cancer cells.

It is usually used when other treatments were not successful. It may also be used for other treatment as determined by your doctor. It is available in the form of a tablet, only with your doctor’s prescription.

2 What to Know Before Using

Before using Rheumatrex dose pack, you must know all about the risks and complications associated with it.


Inform your doctor if you are allergic to any food, preservatives, dyes, or had an allergic reaction when you used this drug before.


It does not cause any different side effects from adults in cancer and juvenile idiopathic arthritis. However, safety and efficacy have not been established to be used in children with psoriasis.


This medicine does not cause any different side effects or problem than it does in younger adults. However, it should be used with caution if there are kidney and liver problems.


It is a category X drug. Do not use it in pregnancy as it can cause abnormalities in an unborn baby. If you suspect that you are pregnant while using Methotrexate, inform your doctor right away.

Breast Feeding

Methotrexate may pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breastfeeding a baby.

Drug Interactions

Methotrexate may interact with other drugs. Your doctor should be informed of any other medicines which you are taking. He/she may want to change the dosage or drug. Some of them are listed below:

  • Azathioprine
  • Leucovorin
  • Phenytoin
  • Probenecid
  • Theophylline
  • An antibiotic or sulfa drugs
  • Isotretinoin
  • Retinol
  • Tretinoin
  • Ibuprofen
  • Naproxen
  • Celecoxib
  • Diclofenac
  • Indomethacin
  • Meloxicam,
  • Aspirin
  • Nuprin backache caplet
  • Kaopectate
  • Tricosal
  • Trilisate
  • Amiodarone
  • Cyclosporine
  • Eltrombopag
  • Etoricoxib
  • Mercaptopurine
  • Procarbazine
  • Rofecoxib
  • Theophylline

Other Medical Problem

Several other conditions may reduce its effectiveness.

Make sure you inform your doctor of conditions such as:

3 Proper Usage

Proper usage of Rheumatrex dose pack requires strict adherence to your doctor’s orders. Read the medication guide carefully. Ask your pharmacist if you have any queries.


It is different for different patients. Dosage mentioned below is an average dose. You must follow your doctor’s command.

For cancer

  • Adults: The dose is usually 10 to 30 milligrams (mg) once per day may be given for several days and then repeated after a short period. For some conditions, 5 to 50 mg once per week may be used.
  • Children: Dose is determined by your doctor.

For psoriasis

  • Adults: The dose is usually 10 to 25 mg once per week or you can take 3 doses of 2.5 mg every 12 hours, once every week.
  • Children: Dose is determined by your doctor.

For rheumatoid arthritis or juvenile arthritis

  • Adults: The dose is usually 7.5 mg once per week or you can take 3 doses of 2.5 mg every 12 hours once each week.
  • Children: The starting dose is 10 milligrams (mg) per square meter (m(2)) of body size once per week.

Missed dose

Do not miss the dose. If you forget your dose, ask your pharmacist or doctor for instructions.


Store it at room temperature. Keep it away from children.

4 Precautions to Take

Before using Rheumatrex dose pack, there are some precautions you must take. Your doctor should check your daily progress at regular visits. He/she may want a blood or urine test to check for unwanted effects.

Use an effective form of birth control methods during the treatment and after 1 menstrual cycle from your last dose as Methotrexate can harm an unborn baby. Men should use birth control during and for at least 3 months after the last dose of Methotrexate.

It can result in infertility (unable to have a child). Discuss this with your doctor, if you have any concern regarding this.

Do not drink alcohol while using Methotrexate as it may cause or aggravate liver diseases.

Inform your doctor if you experience:

  • headache
  • stomach pain
  • vomiting
  • dark colored urine
  • loss of appetite
  • weight loss
  • the general feeling of tiredness or weakness
  • light colored stools
  • upper right stomach pain or yellow eyes or skin

Inform your doctor right away if you experience:

These are symptoms of organs toxicity caused by Methotrexate.

Methotrexate may cause drowsiness, dizziness, blurred vision, or light-headedness. These effects may be worse if you take it with food. Use Methotrexate with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

It is a bone marrow suppressant. It temporarily reduces your white blood cells and platelets, and so making you susceptible to infections and bleeding. While using this drug you should avoid people with the infection.

Inform your doctor immediately if you notice:

Be careful when using a regular toothbrush, dental floss, or toothpick. Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.

Do not have any immunization (vaccination) during and after the treatment with this drug without your doctor’s approval. Methotrexate may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent.

It may cause a serious skin reaction.

Inform your doctor right away if you notice any:

  • blistering
  • peeling, loosening of the skin
  • chills
  • cough
  • diarrhea
  • fever
  • itching
  • joint or muscle pain
  • red skin lesions

It also makes skin more sensitive to sunlight. Use sunscreens. Do not take any other medicine unless you discuss it with your doctor.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Rheumatrex dose pack. Some people may experience none or minor side effects.

Consult with your doctor if they become problematic or frequent:

Most common are:

  • Vomiting
  • Upset stomach
  • Headache
  • Dizziness
  • Tired feeling
  • Blurred vision

Less common are:

  • Dry cough
  • Shortness of breath
  • Diarrhea
  • White patches or sores inside your mouth or on your lips.
  • Blood in your urine or stools
  • Swelling, rapid weight gain
  • Little or no urinating
  • Seizure (convulsions)
  • Fever
  • Chills
  • Body aches
  • Light-headed

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.