Consumer Medicine Information (CMI) summary
The full CMI on the next page has more details. If you are worried about using this medicine, speak to your doctor or pharmacist.
WARNING: Important safety information is provided in a boxed warning in the full CMI. Read before using this medicine.
1. Why am I using Methotrexate Ebewe?
Methotrexate Ebewe contains the active ingredient methotrexate. Methotrexate Ebewe is used to treat certain types of cancers and severe psoriasis when the condition does not improve with other medicines.
For more information, see Section 1. Why am I using Methotrexate Ebewe? in the full CMI.
2. What should I know before I use Methotrexate Ebewe?
Do not use if you have ever had an allergic reaction to Methotrexate Ebewe or any of the ingredients listed at the end of the CMI. Talk to your doctor if you have any other medical conditions, take any other medicines, or are pregnant or plan to become pregnant or are breastfeeding.
For more information, see Section 2. What should I know before I use Methotrexate Ebewe? in the full CMI.
3. What if I am taking other medicines?
Some medicines may interfere with Methotrexate Ebewe and affect how it works. A list of these medicines is in Section 3. What if I am taking other medicines? in the full CMI.
4. How do I use Methotrexate Ebewe?
- The dose of medicine given to you will depend on the condition being treated, your medical condition, your age, your size and how well your kidneys and liver are working. More instructions can be found in Section 4. How do I use Methotrexate Ebewe? in the full CMI.
5. What should I know while using Methotrexate Ebewe?
Things you should do |
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Things you should not do |
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Driving or using machines |
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Drinking alcohol |
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For more information, see Section 5. What should I know while using Methotrexate Ebewe? in the full CMI.
6. Are there any side effects?
Side effects include nausea, stomach pain, sore mouth (mouth ulcers, blisters), fatigue, generally feeling unwell, dizziness, drowsiness, blurred vision, sore eyes, ringing in ears and low numbers of blood cell counts. Methotrexate Ebewe can cause serious side effects including severe allergic reaction; sore throat, fever, chills, achiness; severe skin rash with blistering; injection site reactions, persistent cough, pain or difficulty breathing, or becoming breathless; spitting or coughing blood; skin rash and fever with swollen glands; swelling of the hands, ankles or feet; yellowing of the skin and eyes; loss of coordination, ability to speak or understand speech, weakness and inability to move one side of the body or the whole body, convulsions or fits. For more information, including what to do if you have any side effects, see Section 6. Are there any side effects? in the full CMI.
WARNING:
Methotrexate Ebewe should only be used for severe disease and when diagnosis has been made. It is a toxic medicine which can cause severe reactions and death. You should be treated under the constant care and follow up of your doctor or specialist.
Methotrexate can cause blood disorders such as low numbers of red blood cells, white blood cells or platelets. At high or repeated doses, methotrexate may be toxic to your liver. Your doctor will need to do tests to check your liver regularly, before and during treatment. Avoid alcohol while be treated with methotrexate.
Tell your doctor if you have cancer of the lymphatic system as methotrexate can affect the treatment of this condition.
Serious infections, leading to death may occur with methotrexate treatment.
Methotrexate can cause birth defects, harm the unborn child or cause miscarriage. Methotrexate should not be used in pregnant women or women who plan to become pregnant.
Methotrexate should not be started until it is confirmed you are not pregnant. If you become pregnant during treatment or think you might be pregnant, speak to your doctor as soon as possible. Your doctor will provide advice regarding the risk of harmful effects on the child through treatment.
You must avoid becoming pregnant or avoid fathering a child during treatment and for at least 6 months after the end of treatment. Both you and your partner must use a reliable method of contraception (birth control pills or condom) during this period.
Women should not breastfeed while being treated with methotrexate.
Methotrexate should not be used if you have severe kidney problems.
Tell your doctor if you take medicines to relieve pain, swelling of inflammation (nonsteroidal anti-inflammatory drugs – NSAIDs) as this can result in serious side effects when being treated with methotrexate. It can affect your blood, stomach or gut and may lead to death.
Tell your doctor if you develop a dry, non-productive cough or shortness of breath. Your doctor will stop treatment and monitor you closely as these may be signs of damage to the lungs.
Use of methotrexate for non-cancer conditions in children has not been well established.
Methotrexate should only be used once a week to treat certain conditions. Using methotrexate more frequently than once a week for these conditions may cause serious reactions and death.
Tell your doctor if you are to have radiotherapy (also known as radiation therapy) while on methotrexate as this can cause damage to tissue and bone.
Tell your doctor if you are to have any vaccinations while on methotrexate as this may lead to serious infections or death.
Methotrexate Ebewe®
Active ingredient: methotrexate
Consumer Medicine Information (CMI)
This leaflet provides important information about using Methotrexate Ebewe. You should also speak to your doctor or pharmacist if you would like further information or if you have any concerns or questions about using Methotrexate Ebewe.
Where to find information in this leaflet:
1. Why am I using Methotrexate Ebewe?
2. What should I know before I use Methotrexate Ebewe?
3. What if I am taking other medicines?
4. How do I use Methotrexate Ebewe?
5. What should I know while using Methotrexate Ebewe?
6. Are there any side effects?
7. Product details
1. Why am I using Methotrexate Ebewe?
Methotrexate Ebewe contains the active ingredient Methotrexate.
Methotrexate Ebewe is an antineoplastic or cytotoxic medicine. It may also be called a chemotherapy medicine. Methotrexate Ebewe is used to treat certain types of cancers. It may also be used in severe psoriasis when the condition does not improve with other medicines.
The medicine works by blocking an enzyme needed by the body’s cells to live. This interferes with the growth of some cells that are growing rapidly in psoriasis and cancer.
2. What should I know before I use Methotrexate Ebewe?
Warnings
Do not use Methotrexate Ebewe if:
- you are allergic to methotrexate, or any of the ingredients listed at the end of this leaflet. Always check the ingredients to make sure you can use this medicine.
- you are pregnant
- you are breastfeeding
- you have severe kidney problems
- you have severe liver problems
- are an alcoholic
- you have lowered immunity due to diseases or due to other treatments
- have bone marrow disease
- have any blood disorders, or conditions which cause a low number of red blood cells, white blood cells, or platelets
- have low iron in the blood (anaemia)
- have infectious disease or severe infections
- you are receiving a live vaccine
- you are taking vitamin A derivatives (such as acitretin), medicines used to treat psoriasis and other skin conditions
- you are receiving radiatiotherapy (radiation therapy) e.g. x-rays, ultra violet radiotherapy
Do not use Methotrexate Ebewe to treat psoriasis if you:
- have stomach ulcers (peptic ulcer disease)
- have a condition where your large bowel is inflamed and has ulcers (ulcerative colitis)
Check with your doctor if you:
- have any other medical conditions
– kidney problems
– liver problems, including hepatitis B or hepatitis C
– lung problems
– diabetes
– low folate levels
– blood disorders including abnormal blood cell count
– immune system disorder
– infection or high temperature
– stomach ulcer or ulcerative colitis (bleeding from your bowel)
Before treatment is started your doctor may carry out blood tests to check the levels of cells in your blood, and also to check how well your kidneys and liver are working. You may also have a chest x-ray. Further tests may also be done during and after treatment.
During treatment, you may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects?
Pregnancy and breastfeeding
Check with your doctor if you are pregnant or intend to become pregnant.
The medicine may harm the unborn child, cause birth defects and miscarriage if either you or your partner is using it.
Both you and your partner must use a reliable method of contraception (birth control pills or condom) during treatment with Methotrexate Ebewe and for at least 6 months after you stop treatment. Your doctor will discuss with you what forms of contraception are suitable and when it is safe to stop using contraception if you wish to do so.
Talk to your doctor if you are breastfeeding or intend to breastfeed.
Methotrexate Ebewe passes into breast milk and should not be used when breastfeeding.
Use in Children and Elderly
- Special care will also be taken in children, the elderly and in those who are in poor physical condition.
3. What if I am taking other medicines?
Tell your doctor or pharmacist if you are taking any other medicines, including any medicines, vitamins or supplements that you buy without a prescription from your pharmacy, supermarket or health food shop.
Some medicines may interfere with Methotrexate Ebewe and affect how it works.
These include:
- some antibiotics
- sulphonylureas, medicines used to treat diabetes
- para-aminobenzoic acid, a medicine used to treat skin and autoimmune disorders
- diuretics, medicines to remove fluid or water from the body
- phenytoin, a medicine used to treat epilepsy
- ciclosporin and azathioprine, medicines used to prevent transplant organ rejection
- vitamin supplements that contain folic acid or folinic acid
- non-steroidal anti-inflammatory medicines (NSAIDs) and salicylates (e.g. aspirin), medicines used to relieve pain, swelling and inflammation
- disease modifying antirheumatic drugs (DMARDs), medicines used to slow down progression of rheumatoid arthritis disease
- allopurinol and probenecid, medicines used to treat gout
- theophylline, a medicine used to relieve asthma
- cholestyramine, a medicine used to lower high cholesterol
- amiodarone, a medicine used to treat heart disorders
- certain other medicines used to treat cancer
- sulfasalazine, a medicine used to treat Crohn’s disease, ulcerative colitis and rheumatoid arthritis
- other medicines that may cause damage to your liver
- retinoids, medicines used to treat skin conditions such as acitretin
- pyrimethamine, a medicine used for malaria
- proton pump inhibitors, medicines used to treat stomach ulcers and reflux
- methoxsalen, a medicine used with ultraviolet light in PUVA therapy for conditions such as severe psoriasis
Methotrexate Ebewe Injection can also be affected by, or interfere with the following:
- nitrous oxide anaesthetics
- vaccines
- blood transfusions
- alcohol
- radiotherapy (radiation therapy) e.g. x-rays, ultra violet radiotherapy
Check with your doctor or pharmacist if you are not sure about what medicines, vitamins or supplements you are taking and if these affect Methotrexate Ebewe.
4. How do I use Methotrexate Ebewe?
How much and when is it given
Your doctor will decide what dose, how often and how long you will receive it. This depends on your condition and other factors, such as your weight, age, blood tests, how well your kidneys and liver are working, and whether or not other medicines are being given at the same time.
Methotrexate should only be used once a week to treat certain conditions. Using methotrexate more frequently than once a week for these conditions may cause serious reactions and death.
This medicine may be given alone or in combination with other drugs. It may be given as a short course or on an ongoing basis.
Additional treatment may not be repeated until your blood cell numbers return to acceptable levels and any unwanted effects have been controlled.
How Methotrexate Ebewe is given
Methotrexate Ebewe may be given as an injection into a muscle, a vein or into the spine.
Methotrexate Ebewe must only be given by a doctor or nurse.
If you use too much Methotrexate Ebewe
As Methotrexate Ebewe will most likely be given to you in hospital or under the supervision of your doctor, it is very unlikely that you will receive an overdose.
If you think that you have been given too much Methotrexate Ebewe or experience severe side effects, you may need urgent medical attention.
Symptoms of a Methotrexate Ebewe overdose may include the side effects listed in section 6, but are usually of a more severe nature. They may include blood in your bowel motions (black tarry stools), bleeding, nausea, vomiting, mouth ulcers and severe infections.
You should immediately:
- phone the Australian Poisons Information Centre
(by calling 13 11 26), or the New Zealand National Poisons Information Centre (by calling 0800 POISONS or 0800 764 766), or - contact your doctor, or
- go to the Emergency Department at your nearest hospital.
You should do this even if there are no signs of discomfort or poisoning.
5. What should I know while using Methotrexate Ebewe?
Things you should do
If you are about to be started on any new medicine, remind your doctor and pharmacist that you are being given Methotrexate Ebewe.
Tell any other doctors, dentists, and pharmacists who are treating you that you are being given this medicine.
If you are going to have surgery, tell the surgeon, anaesthetist or dentist that you are taking this medicine. It may affect other medicines used during surgery.
If you are about to be given an immunisation, remind your doctor that you are using this medicine.
Discuss with your doctor how much water or fluids you should have whilst you are being given this medicine. Inadequate fluid intake can increase the side effects of this medicine.
Ask your doctor if there are any precautions you need to take to prevent your urine becoming too acidic. Acidic urine can increase the side effects of this medicine.
Tell your doctor immediately if you are spitting or coughing up blood when using Methotrexate Ebewe Injection.
Some patients have reported acute bleeding in the lungs when using Methotrexate Ebewe Injection to treat certain conditions.
Keep all of your doctor’s appointments so your progress can be checked.
Methotrexate can cause problems with your blood, liver and kidneys. Your doctor may do blood tests to check for these problems or may ask you to have an operation to have a small sample of your liver removed. There may also be a chest x-ray and a physical examination to check for swelling of your lymph nodes (glands in your neck, armpits and groin).
Things you should not do
Do not go out in the sun without wearing protective clothing (hat and shirt) and using a sunscreen with a high protection factor. Avoid exposure to sunlamps.
Methotrexate Ebewe can increase your sensitivity to sunlight and cause severe reactions, increasing the risk of skin cancer (non-melanoma and melanoma). Symptoms may include a skin rash, itching, swelling, redness, blistering or a severe sunburn.
Things to be careful of
Methotrexate Ebewe can lower the number of white blood cells and platelets in your blood. This means that you have an increased chance of getting an infection or bleeding. The following precautions should be taken to reduce your risk of infection or bleeding:
- Avoid people who have infections. Check with your doctor immediately if you think you may be getting an infection, or if you get a fever, chills, cough, hoarse throat, lower back or side pain or find it painful or difficult to urinate.
- Be careful when using a toothbrush, toothpick or dental floss. Your doctor, dentist, nurse or pharmacist may recommend other ways to clean your teeth and gums. Check with your doctor before having any dental work.
- Be careful not to cut yourself when you are using sharp objects such as a razor or nail cutters.
- Avoid contact sports or other situations where you may bruise or get injured.
Methotrexate Ebewe may be excreted in body fluids and waste, including blood, urine, faeces, vomit and semen. In general, precautions to protect other people should be taken while you are receiving Methotrexate Ebewe and for one week after the treatment period by:
- Flushing the toilet twice to dispose of any body fluids and waste.
- Wearing gloves to clean any spill of body fluid or waste. Use paper towels or old rags, a strong solution of non-bleaching detergent and large amounts of water to mop up the spill. Discard the towels or rags into a separate waste bag and dispose of fluids in the toilet.
- Washing linen or clothing that is heavily contaminated by body fluids or waste separately from other items. Use a strong solution of non-bleaching detergent and large amounts of water.
- Placing soiled disposable nappies and other pads in a plastic bag, seal and dispose into the garbage.
- For sexual intercourse, use a barrier method such as a condom.
Carers and other people who handle the injection should wear disposable gloves to avoid direct contact with the injection fluid. Pregnant women should not handle the medicine at all.
Driving or using machines
Be careful before you drive, use any machines or tools or do anything else that could be dangerous until you know how Methotrexate Ebewe affects you.
Methotrexate Ebewe may cause dizziness, drowsiness, blurred vision or tiredness in some people and therefore may affect alertness.
Drinking alcohol
You must not drink alcohol whilst you are being given this medicine.
Alcohol may increase the side effects of Methotrexate Ebewe and cause liver damage.
Looking after your medicine
Methotrexate Ebewe is usually stored in the pharmacy, doctor’s surgery or on the ward. It is kept in a cool dry place, protected from light, where the temperature stays below 25°C. Do not freeze.
Keep it where young children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Getting rid of any unwanted medicine
If you no longer need to use this medicine or it is out of date, take it to any pharmacy for safe disposal.
Do not use this medicine after the expiry date.
6. Are there any side effects?
All medicines can have side effects. If you do experience any side effects, most of them are minor and temporary. However, some side effects may need medical attention.
See the information below and, if you need to, ask your doctor or pharmacist if you have any further questions about side effects.
Less serious side effects
Less serious side effects | What to do |
Stomach or gut related
Nervous system related
Skin and nails related
Eye and ear related
Blood related
Other
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Speak to your doctor if you have any of these less serious side effects and they worry you. |
Serious side effects
Serious side effects | What to do |
Allergic reaction related
Heart and blood related
Eye related
Lung related
Nervous system related
Infection related
Severe skin reaction related
Bleeding related
Kidney related
Liver related
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Call your doctor straight away, or go straight to the Emergency Department at your nearest hospital if you notice any of these serious side effects. |
Tell your doctor or pharmacist if you notice anything else that may be making you feel unwell.
Other side effects not listed here may occur in some people.
Some of these side effects can only be found when your doctor does tests from time to time to check your progress
Reporting side effects
After you have received medical advice for any side effects you experience, you can report side effects to the Therapeutic Goods Administration online at www.tga.gov.au/reporting-problems. By reporting side effects, you can help provide more information on the safety of this medicine.
Always make sure you speak to your doctor or pharmacist before you decide to stop taking any of your medicines.
7. Product details
This medicine is only available with a doctor’s prescription.
What Methotrexate Ebewe contains
Active ingredient (main ingredient) |
Methotrexate |
Other ingredients (inactive ingredients) |
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This medicine does not contain lactose, sucrose, gluten, tartrazine or any other azo dyes.
Do not take this medicine if you are allergic to any of these ingredients.
What Methotrexate Ebewe looks like
Methotrexate Ebewe is a clear yellow liquid in glass vials.
METHOTREXATE EBEWE methotrexate 500 mg/5 mL concentrated injection vial – AUST R 98546
METHOTREXATE EBEWE methotrexate 1000 mg/10 mL concentrated injection vial – AUST R 98547
METHOTREXATE EBEWE methotrexate 5000 mg/50 mL concentrated injection vial – AUST R 120618
Who distributes Methotrexate Ebewe
Methotrexate Ebewe is distributed in Australia by:
Sandoz Pty Ltd
100 Pacific Highway
North Sydney, NSW 2060
Australia
Tel 1800 726 369
Methotrexate Ebewe is distributed in New Zealand by:
Sandoz New Zealand Limited
12 Madden Street
Auckland 1010
New Zealand
Telephone: 0800 726 369
This leaflet was revised in December 2023.
® Registered Trade Mark. The trade marks mentioned in this material are the property of their respective owners.
Published by MIMS February 2024