Dosage form:

• Scored tablet 2.5 mg

What is Merexate used for?

• It is used to treat cancer.
• It is used to treat some types of arthritis.
• It is used to treat some types of psoriasis.

 What do I need to tell my doctor BEFORE I take Merexate?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances.
• If you have any of these health problems: Alcohol use disorder, bone marrow disease (like low white blood cell count, low platelet count, or anemia), kidney disease, liver disease, or a weak immune system.
• If you are breast-feeding, as this drug is present in breast milk.
• If you are not able to swallow tablets.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Merexate?

• Tell all of your health care providers (doctors, nurses, pharmacists, and dentists) that you take this drug.
• Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
• You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.
• You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
• Talk with your doctor before getting any vaccines. Use of some vaccines with this drug may either raise the chance of an infection or make the vaccine not work as well.
• Talk with your doctor if you consume alcohol while using this medicine.
• You may get sunburned more easily. Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
• Tell your doctor if you have fluid loss, unusual sweating, throwing up, diarrhea, decreased appetite, or unusual thirst.
• If you have nervous system problems, talk with your doctor.
• If you have had radiation, talk with your doctor.
• If you are 65 or older, use this drug with care. You could have more side effects.
• This drug may affect fertility in both women and men. If you are planning to have children or suspect you may be pregnant, call your doctor right away.
• In case of cancer treatment, if you are taking a product that has folic acid or folinic acid in it, talk with your doctor. It may make this drug not work as well.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have serious side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
• Signs of bleeding like throwing up or coughing up blood; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
• Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.
• Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
• Signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
• Signs of lung or breathing problems like shortness of breath or other trouble breathing, cough, or fever.
• Signs of nerve problems like a burning, numbness, or tingling feeling that is not normal; weakness; or not being able to move a part of the body (paralysis).
• Pinpoint red spots on the skin.
• Severe dizziness or passing out.
• Feeling confused.
• Feeling sleepy.
• Change in eyesight.
• Bone pain.
• Swelling, warmth, numbness, change of color, or pain in a leg or arm.
• Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
• Neck stiffness.
• In case of cancer treatment, signs of a severe health problem called tumor lysis syndrome (TLS) like fast or abnormal heartbeat; passing out; trouble passing urine; muscle weakness or cramps; upset stomach, throwing up, diarrhea, or not able to eat; or feeling sluggish.

What are some other side effects of Merexate?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Decreased appetite.
• Hair loss.
• Feeling dizzy, tired, or weak.
• Stomach pain.
• Signs of a common cold.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor.

How is Merexate best taken?

Use this drug exactly as ordered by your doctor.

• Your dose and how often you take it will be based on the health problem that is being treated. This drug must NEVER be taken daily unless used for some types of cancer. If you do not understand what your dose is and how often to take it, talk with your doctor.
• How this drug is taken may change based on blood work results, side effects, and how well the drug is working.
• You will need to take special care when handling this drug. Check with the doctor or pharmacist to see how to handle this drug.
• Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.

What do I do if I miss a dose?

• Call your doctor to find out what to do.

How do I store and/or throw out Merexate?

• Store at room temperature protected from light. Store in a dry place.
• Do not freeze.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are

told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs.