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John s wort, or sulfinpyrazone because the effectiveness of quibron-t may be decreased allopurinol, cimetidine, disulfiram, enoxacin, estrogen, fluvoxamine, interferon alpha-a, macrolide antibiotics eg, clarithromycin, erythromycin , methotrexate, mexiletine, oral contraceptives birth control pills , pentoxifylline, quinolone antibiotics eg, ciprofloxacin , tacrine, thiabendazole, ticlopidine, troleandomycin, verapamil, viloxazine, or zileuton because the risk of side effects of quibron-t may be increased ephedrine because side effects such as nausea, nervousness, and trouble sleeping may be increased halothane because the risk of side effects such as irregular heartbeat may be increased ketamine because the risk of seizures may be increased adenosine, benzodiazepines eg, diazepam, lorazepam , dipyridamole iv, lithium, midazolam, or nondepolarizing muscle relaxants eg, pancuronium because effectiveness may be decreased by quibron-t.

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Methotrexate must not be used during pregnancyIt may harm an unborn babyIt is important to prevent pregnancy during and after treatment with methotrexateThereforemales and females must use reliable forms of birth controlsuch as condomsbirth control pillsduring treatmentMales should continue to use birth control for at least 3 months after the end of treatmentFemales should continue to use birth control for at least 1 menstrual cycle after the end of treatmentIf you become pregnant or think you may be pregnanttell your doctor right away.

If you are a manuse a condom to keep from causing a pregnancy while you are using methotrexateContinue using condoms for at least 3 months after your last dose.

If the patient is vomiting or unable to tolerate oral medicationleucovorin should be added to this regimen at the same dose and schedule as the methotrexate.

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tretinoin, atra major concomitant use of systemic retinoids, such as tretinoin, and methotrexate could increase risk of liver-related side effects of methotrexate and such patients should be monitored closely during methotrexate therapy.

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