Otrexup (methotrexate) injection

 

Otrexup is a once weekly medication that 98%
of RA patients studied agreed was easy to use.

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Indications and Important Safety Information Including Boxed Warning

INDICATIONS:

Otrexup is indicated in:

  • the management of selected adults with severe, active rheumatoid arthritis (RA) (ACR criteria), or children with active polyarticular juvenile idiopathic arthritis (pJIA), who have had an insufficient therapeutic response to, or are intolerant of, an adequate trial of first-line therapy including full dose non-steroidal anti-inflammatory agents (NSAIDs).
  • in adults for the symptomatic control of severe, recalcitrant, disabling psoriasis that is not adequately responsive to other forms of therapy, but only when the diagnosis has been established, as by biopsy and/or after dermatologic consultation. It is important to ensure that a psoriasis “flare” is not due to an undiagnosed concomitant disease affecting immune response.

Otrexup should not be used for the treatment of cancer.

Otrexup should not be used for the treatment of children with psoriasis.

This product includes the following Boxed Warning:

WARNING: SEVERE TOXIC REACTIONS, INCLUDING EMBRYO-FETAL TOXICITY AND DEATH

Otrexup should be used only by physicians whose knowledge and experience include the use of antimetabolite therapy. Because of the possibility of serious toxic reactions (which can be fatal), Otrexup should be used only in patients with psoriasis or rheumatoid arthritis with severe, recalcitrant, disabling disease which is not adequately responsive to other forms of therapy. Deaths have been reported with the use of methotrexate in the treatment of malignancy, psoriasis, and rheumatoid arthritis. Patients should be closely monitored for bone marrow, liver, lung, skin, and kidney toxicities. Patients should be informed by their physician of the risks involved and be under a physician’s care throughout therapy.

  1. Methotrexate has been reported to cause fetal death and/or congenital anomalies. Therefore, Otrexup is not recommended for females of childbearing potential unless there is clear medical evidence that the benefits can be expected to outweigh the considered risks.
  2. Methotrexate elimination is reduced in patients with impaired renal functions, ascites, or pleural effusions. Such patients require especially careful monitoring for toxicity, and require dose reduction or, in some cases, discontinuation of Otrexup administration.
  3. Unexpectedly severe (sometimes fatal) bone marrow suppression, aplastic anemia, and gastrointestinal toxicity have been reported with concomitant administration of methotrexate (usually in high dosage) along with some nonsteroidal anti-inflammatory drugs (NSAIDs).
  4. Methotrexate causes hepatotoxicity, fibrosis and cirrhosis, but generally only after prolonged use. Acutely, liver enzyme elevations are frequently seen. These are usually transient and asymptomatic, and also do not appear predictive of subsequent hepatic disease. Liver biopsy after sustained use often shows histologic changes, and fibrosis and cirrhosis have been reported; these latter lesions may not be preceded by symptoms or abnormal liver function tests in the psoriasis population. For this reason, periodic liver biopsies are usually recommended for psoriatic patients who are under long-term treatment. Persistent abnormalities in liver function tests may precede appearance of fibrosis or cirrhosis in the rheumatoid arthritis population.
  5. Methotrexate-induced lung disease, including acute or chronic interstitial pneumonitis, is a potentially dangerous lesion, which may occur acutely at any time during therapy and has been reported at low doses. It is not always fully reversible and fatalities have been reported. Pulmonary symptoms (especially a dry, nonproductive cough) may require interruption of treatment and careful investigation.
  6. Diarrhea and ulcerative stomatitis require interruption of therapy: otherwise, hemorrhagic enteritis and death from intestinal perforation may occur.
  7. Malignant lymphomas, which may regress following withdrawal of methotrexate, may occur in patients receiving low-dose methotrexate and, thus, may not require cytotoxic treatment. Discontinue Otrexup first and, if the lymphoma does not regress, appropriate treatment should be instituted
  8. Like other cytotoxic drugs, methotrexate may induce “tumor lysis syndrome” in patients with rapidly growing tumors.
  9. Severe, occasionally fatal, skin reactions have been reported following single or multiple doses of methotrexate. Reactions have occurred within days of oral, intramuscular, intravenous, or intrathecal methotrexate administration. Recovery has been reported with discontinuation of therapy.
  10. Potentially fatal opportunistic infections, especially Pneumocystis jiroveci pneumonia, may occur with methotrexate therapy.
  11. Methotrexate given concomitantly with radiotherapy may increase the risk of soft tissue necrosis and osteonecrosis.

Otrexup is contraindicated in the following:

  • Females and Males of Reproductive Potential: Contraception should be used by both females and males while taking Otrexup. Pregnancy should be avoided if either partner is receiving Otrexup:
    • for a minimum of 3 months after treatment with Otrexup for males.
    • during and for at least 1 menstrual cycle after treatment with Otrexup for females.
  • Pregnancy: Otrexup can cause fetal death or teratogenic effects when administered to a pregnant woman. Otrexup is contraindicated in pregnant women. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.
  • Nursing Mothers: Because of the potential for serious adverse reactions from methotrexate in breast fed infants, Otrexup is contraindicated in nursing mothers.
  • Alcoholism or Liver Disease: Patients with alcoholism, alcoholic liver disease or other chronic liver disease.
  • Immunodeficiency Syndromes: Patients who have overt or laboratory evidence of immunodeficiency syndromes.
  • Preexisting Blood Dyscrasias: Patients who have preexisting blood dyscrasias, such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia.
  • Hypersensitivity: Patients with a known hypersensitivity to methotrexate. Severe hypersensitivity reactions have been observed with methotrexate use.

Warnings and Precautions:

  • Organ system toxicity: Potential for serious toxicity. Only for use by physicians experienced in antimetabolite therapy.
  • Embryo-fetal toxicity: Exclude pregnancy before treatment. Avoid pregnancy if either partner is receiving Otrexup. Advise males to avoid pregnancy for a minimum of three months after therapy and females to avoid pregnancy for at least one ovulatory cycle after therapy.
  • Effects on reproduction: May cause impairment of fertility, oligospermia and menstrual dysfunction.
  • Laboratory tests: Monitor complete blood counts, renal function and liver function tests.
  • Risks from improper dosing: Mistaken daily use has led to fatal toxicity.
  • Patients with impaired renal function, ascites, or pleural effusions: Elimination is reduced.
  • Dizziness and fatigue: May impair ability to drive or operate machinery.

Adverse Reactions

Common adverse reactions are: nausea, abdominal pain, dyspepsia, stomatitis/mouth sores, rash, nasopharyngitis, diarrhea, liver function test abnormalities, vomiting, headache, bronchitis, thrombocytopenia, alopecia, leucopenia, pancytopenia, dizziness, photosensitivity, and “burning of skin lesions”.

Drug Interactions

  • Aspirin, NSAIDs, and steroids: concomitant use may elevate and prolong serum methotrexate levels and cause increased toxicity.
  • Proton pump inhibitors: concomitant use may elevate and prolong serum methotrexate levels and cause increased toxicity.

Use in Special Populations

  • Pregnancy: Methotrexate has been reported to cause embryotoxicity, fetal death, congenital anomalies, and abortion in humans and is contraindicated in pregnant women.
  • Nursing Mothers: Because of the potential for serious adverse reactions from methotrexate in breast fed infants, Otrexup is contraindicated in nursing mothers.
  • Females and Males of Reproductive Potential: Contraception should be used by both females and males while taking Otrexup. Pregnancy should be avoided if either partner is receiving Otrexup:
    • for a minimum of 3 months after treatment with Otrexup for males.
    • during and for at least 1 menstrual cycle after treatment with Otrexup for females.
  • Pediatric use: Safety and efficacy of methotrexate, including Otrexup, have not been established in pediatric patients with psoriasis. Safety and efficacy of Otrexup have not been established in pediatric patients with malignancy.
  • Geriatric use: Use caution in dose selection.

Dosage and Administration

Otrexup is for once weekly subcutaneous use only.

Administer Otrexup in the abdomen or thigh.

For full prescribing information including boxed warning, please click here.

About Otrexup

Otrexup is easy to use for patients with RA

Otrexup has been designed to make it easy for patients to handle and inject their medicine.

Why use Otrexup?

More than 2 decades of scientific evidence have proven that oral methotrexate works.1 However, oral methotrexate may not work well enough or may not be tolerated well enough in some patients with RA.2 In these cases, doctors may switch patients from oral methotrexate to subcutaneous methotrexate.

Clinical evidence has shown the potential benefits of parenteral methotrexate compared with oral methotrexate.3-5 One recent study demonstrated no dose proportionality between oral and subcutaneous methotrexate above a dose of 15 mg.6

Indications

Otrexup is indicated in certain adults with severe, active rheumatoid arthritis, children with active polyarticular juvenile idiopathic arthritis (pJIA) and adults with severe, resistant, disabling psoriasis.7

 

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Otrexup Injector
Meet The Injector

Designed for the rheumatoid arthritis patient.

References:

  1. Rezaei H, Saevarsdottir S, Forslind K, et al. In early rheumatoid arthritis, patients with a good clinical response to methotrexate have excellent 2-year clinical outcome, but radiological progression is not fully prevented: data from the methotrexate responders population in the SWEFOT trial. Ann Rheum Dis. 2012;71:186-191.
  2. Yazici Y, Sokka T, Kautiainen H, et al. Long term safety of methotrexate in routine clinical care: discontinuation is usual and rarely the result of laboratory abnormalities. Ann Rheum Dis. 2005;64:207–211.
  3. Braun J, Kästner P, Flaxenberg P, et al. Comparison of the clinical efficacy and safety of subcutaneous versus oral administration of methotrexate in patients with active rheumatoid arthritis: results of a six-month, multicenter, randomized, double-blind, controlled, phase IV trial. Arthritis Rheum. 2008;58(1):73-8.
  4. Wegrzyn J, Adeleine P, Miossec P. “Better efficacy of methotrexate given by intramuscular injection than orally in patients with rheumatoid arthritis.” Ann Rheum Dis. 2004;63;1232-1234.
  5. Mainman H, McClaren E, Heycock C, et al. When should we use parenteral methotrexate? Clin Rheumatol. 2010;29(10):1093-1098.
  6. Schiff MH, Jaffe JS, Freundlich B. Head-to-head, randomised, crossover study
of oral versus subcutaneous methotrexate in patients with rheumatoid arthritis: drug-exposure limitations of oral methotrexate at doses ≥15 mg may be overcome with subcutaneous administration. Ann Rheum Dis. 2014;73(8):1549-1551. 2
  7. Otrexup [prescribing information]. Ewing, NJ: Antares Pharma Inc.; 2016.

Indications and Important Safety Information Including Boxed Warning

INDICATIONS:

Otrexup is indicated in:

  • the management of selected adults with severe, active rheumatoid arthritis (RA) (ACR criteria), or children with active polyarticular juvenile idiopathic arthritis (pJIA), who have had an insufficient therapeutic response to, or are intolerant of, an adequate trial of first-line therapy including full dose non-steroidal anti-inflammatory agents (NSAIDs).
  • in adults for the symptomatic control of severe, recalcitrant, disabling psoriasis that is not adequately responsive to other forms of therapy, but only when the diagnosis has been established, as by biopsy and/or after dermatologic consultation. It is important to ensure that a psoriasis “flare” is not due to an undiagnosed concomitant disease affecting immune response.

Otrexup should not be used for the treatment of cancer.

Otrexup should not be used for the treatment of children with psoriasis.

This product includes the following Boxed Warning:

WARNING: SEVERE TOXIC REACTIONS, INCLUDING EMBRYO-FETAL TOXICITY AND DEATH

Otrexup should be used only by physicians whose knowledge and experience include the use of antimetabolite therapy. Because of the possibility of serious toxic reactions (which can be fatal), Otrexup should be used only in patients with psoriasis or rheumatoid arthritis with severe, recalcitrant, disabling disease which is not adequately responsive to other forms of therapy. Deaths have been reported with the use of methotrexate in the treatment of malignancy, psoriasis, and rheumatoid arthritis. Patients should be closely monitored for bone marrow, liver, lung, skin, and kidney toxicities. Patients should be informed by their physician of the risks involved and be under a physician’s care throughout therapy.

  1. Methotrexate has been reported to cause fetal death and/or congenital anomalies. Therefore, Otrexup is not recommended for females of childbearing potential unless there is clear medical evidence that the benefits can be expected to outweigh the considered risks.
  2. Methotrexate elimination is reduced in patients with impaired renal functions, ascites, or pleural effusions. Such patients require especially careful monitoring for toxicity, and require dose reduction or, in some cases, discontinuation of Otrexup administration.
  3. Unexpectedly severe (sometimes fatal) bone marrow suppression, aplastic anemia, and gastrointestinal toxicity have been reported with concomitant administration of methotrexate (usually in high dosage) along with some nonsteroidal anti-inflammatory drugs (NSAIDs).
  4. Methotrexate causes hepatotoxicity, fibrosis and cirrhosis, but generally only after prolonged use. Acutely, liver enzyme elevations are frequently seen. These are usually transient and asymptomatic, and also do not appear predictive of subsequent hepatic disease. Liver biopsy after sustained use often shows histologic changes, and fibrosis and cirrhosis have been reported; these latter lesions may not be preceded by symptoms or abnormal liver function tests in the psoriasis population. For this reason, periodic liver biopsies are usually recommended for psoriatic patients who are under long-term treatment. Persistent abnormalities in liver function tests may precede appearance of fibrosis or cirrhosis in the rheumatoid arthritis population.
  5. Methotrexate-induced lung disease, including acute or chronic interstitial pneumonitis, is a potentially dangerous lesion, which may occur acutely at any time during therapy and has been reported at low doses. It is not always fully reversible and fatalities have been reported. Pulmonary symptoms (especially a dry, nonproductive cough) may require interruption of treatment and careful investigation.
  6. Diarrhea and ulcerative stomatitis require interruption of therapy: otherwise, hemorrhagic enteritis and death from intestinal perforation may occur.
  7. Malignant lymphomas, which may regress following withdrawal of methotrexate, may occur in patients receiving low-dose methotrexate and, thus, may not require cytotoxic treatment. Discontinue Otrexup first and, if the lymphoma does not regress, appropriate treatment should be instituted
  8. Like other cytotoxic drugs, methotrexate may induce “tumor lysis syndrome” in patients with rapidly growing tumors.
  9. Severe, occasionally fatal, skin reactions have been reported following single or multiple doses of methotrexate. Reactions have occurred within days of oral, intramuscular, intravenous, or intrathecal methotrexate administration. Recovery has been reported with discontinuation of therapy.
  10. Potentially fatal opportunistic infections, especially Pneumocystis jiroveci pneumonia, may occur with methotrexate therapy.
  11. Methotrexate given concomitantly with radiotherapy may increase the risk of soft tissue necrosis and osteonecrosis.

Otrexup is contraindicated in the following:

  • Females and Males of Reproductive Potential: Contraception should be used by both females and males while taking Otrexup. Pregnancy should be avoided if either partner is receiving Otrexup:
    • for a minimum of 3 months after treatment with Otrexup for males.
    • during and for at least 1 menstrual cycle after treatment with Otrexup for females.
  • Pregnancy: Otrexup can cause fetal death or teratogenic effects when administered to a pregnant woman. Otrexup is contraindicated in pregnant women. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.
  • Nursing Mothers: Because of the potential for serious adverse reactions from methotrexate in breast fed infants, Otrexup is contraindicated in nursing mothers.
  • Alcoholism or Liver Disease: Patients with alcoholism, alcoholic liver disease or other chronic liver disease.
  • Immunodeficiency Syndromes: Patients who have overt or laboratory evidence of immunodeficiency syndromes.
  • Preexisting Blood Dyscrasias: Patients who have preexisting blood dyscrasias, such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia.
  • Hypersensitivity: Patients with a known hypersensitivity to methotrexate. Severe hypersensitivity reactions have been observed with methotrexate use.

Warnings and Precautions:

  • Organ system toxicity: Potential for serious toxicity. Only for use by physicians experienced in antimetabolite therapy.
  • Embryo-fetal toxicity: Exclude pregnancy before treatment. Avoid pregnancy if either partner is receiving Otrexup. Advise males to avoid pregnancy for a minimum of three months after therapy and females to avoid pregnancy for at least one ovulatory cycle after therapy.
  • Effects on reproduction: May cause impairment of fertility, oligospermia and menstrual dysfunction.
  • Laboratory tests: Monitor complete blood counts, renal function and liver function tests.
  • Risks from improper dosing: Mistaken daily use has led to fatal toxicity.
  • Patients with impaired renal function, ascites, or pleural effusions: Elimination is reduced.
  • Dizziness and fatigue: May impair ability to drive or operate machinery.

Adverse Reactions

Common adverse reactions are: nausea, abdominal pain, dyspepsia, stomatitis/mouth sores, rash, nasopharyngitis, diarrhea, liver function test abnormalities, vomiting, headache, bronchitis, thrombocytopenia, alopecia, leucopenia, pancytopenia, dizziness, photosensitivity, and “burning of skin lesions”.

Drug Interactions

  • Aspirin, NSAIDs, and steroids: concomitant use may elevate and prolong serum methotrexate levels and cause increased toxicity.
  • Proton pump inhibitors: concomitant use may elevate and prolong serum methotrexate levels and cause increased toxicity.

Use in Special Populations

  • Pregnancy: Methotrexate has been reported to cause embryotoxicity, fetal death, congenital anomalies, and abortion in humans and is contraindicated in pregnant women.
  • Nursing Mothers: Because of the potential for serious adverse reactions from methotrexate in breast fed infants, Otrexup is contraindicated in nursing mothers.
  • Females and Males of Reproductive Potential: Contraception should be used by both females and males while taking Otrexup. Pregnancy should be avoided if either partner is receiving Otrexup:
    • for a minimum of 3 months after treatment with Otrexup for males.
    • during and for at least 1 menstrual cycle after treatment with Otrexup for females.
  • Pediatric use: Safety and efficacy of methotrexate, including Otrexup, have not been established in pediatric patients with psoriasis. Safety and efficacy of Otrexup have not been established in pediatric patients with malignancy.
  • Geriatric use: Use caution in dose selection.

Dosage and Administration

Otrexup is for once weekly subcutaneous use only.

Administer Otrexup in the abdomen or thigh.

For full prescribing information including boxed warning, please click here.

For more information, call 1-855-Otrexup (1-855-687-3987).    OTX 344-15-03B

Indications and Important Safety Information Including Boxed Warning

INDICATIONS:

Otrexup is indicated in:

  • the management of selected adults with severe, active rheumatoid arthritis (RA) (ACR criteria), or children with active polyarticular juvenile idiopathic arthritis (pJIA), who have had an insufficient therapeutic response to, or are intolerant of, an adequate trial of first-line therapy including full dose non-steroidal anti-inflammatory agents (NSAIDs).
  • in adults for the symptomatic control of severe, recalcitrant, disabling psoriasis that is not adequately responsive to other forms of therapy, but only when the diagnosis has been established, as by biopsy and/or after dermatologic consultation. It is important to ensure that a psoriasis “flare” is not due to an undiagnosed concomitant disease affecting immune response.

Otrexup should not be used for the treatment of cancer.

Otrexup should not be used for the treatment of children with psoriasis.

This product includes the following Boxed Warning:

WARNING: SEVERE TOXIC REACTIONS, INCLUDING EMBRYO-FETAL TOXICITY AND DEATH

Otrexup should be used only by physicians whose knowledge and experience include the use of antimetabolite therapy. Because of the possibility of serious toxic reactions (which can be fatal), Otrexup should be used only in patients with psoriasis or rheumatoid arthritis with severe, recalcitrant, disabling disease which is not adequately responsive to other forms of therapy. Deaths have been reported with the use of methotrexate in the treatment of malignancy, psoriasis, and rheumatoid arthritis. Patients should be closely monitored for bone marrow, liver, lung, skin, and kidney toxicities. Patients should be informed by their physician of the risks involved and be under a physician’s care throughout therapy.

  1. Methotrexate has been reported to cause fetal death and/or congenital anomalies. Therefore, Otrexup is not recommended for females of childbearing potential unless there is clear medical evidence that the benefits can be expected to outweigh the considered risks.
  2. Methotrexate elimination is reduced in patients with impaired renal functions, ascites, or pleural effusions. Such patients require especially careful monitoring for toxicity, and require dose reduction or, in some cases, discontinuation of Otrexup administration.
  3. Unexpectedly severe (sometimes fatal) bone marrow suppression, aplastic anemia, and gastrointestinal toxicity have been reported with concomitant administration of methotrexate (usually in high dosage) along with some nonsteroidal anti-inflammatory drugs (NSAIDs).
  4. Methotrexate causes hepatotoxicity, fibrosis and cirrhosis, but generally only after prolonged use. Acutely, liver enzyme elevations are frequently seen. These are usually transient and asymptomatic, and also do not appear predictive of subsequent hepatic disease. Liver biopsy after sustained use often shows histologic changes, and fibrosis and cirrhosis have been reported; these latter lesions may not be preceded by symptoms or abnormal liver function tests in the psoriasis population. For this reason, periodic liver biopsies are usually recommended for psoriatic patients who are under long-term treatment. Persistent abnormalities in liver function tests may precede appearance of fibrosis or cirrhosis in the rheumatoid arthritis population.
  5. Methotrexate-induced lung disease, including acute or chronic interstitial pneumonitis, is a potentially dangerous lesion, which may occur acutely at any time during therapy and has been reported at low doses. It is not always fully reversible and fatalities have been reported. Pulmonary symptoms (especially a dry, nonproductive cough) may require interruption of treatment and careful investigation.
  6. Diarrhea and ulcerative stomatitis require interruption of therapy: otherwise, hemorrhagic enteritis and death from intestinal perforation may occur.
  7. Malignant lymphomas, which may regress following withdrawal of methotrexate, may occur in patients receiving low-dose methotrexate and, thus, may not require cytotoxic treatment. Discontinue Otrexup first and, if the lymphoma does not regress, appropriate treatment should be instituted
  8. Like other cytotoxic drugs, methotrexate may induce “tumor lysis syndrome” in patients with rapidly growing tumors.
  9. Severe, occasionally fatal, skin reactions have been reported following single or multiple doses of methotrexate. Reactions have occurred within days of oral, intramuscular, intravenous, or intrathecal methotrexate administration. Recovery has been reported with discontinuation of therapy.
  10. Potentially fatal opportunistic infections, especially Pneumocystis jiroveci pneumonia, may occur with methotrexate therapy.
  11. Methotrexate given concomitantly with radiotherapy may increase the risk of soft tissue necrosis and osteonecrosis.

Otrexup is contraindicated in the following:

  • Females and Males of Reproductive Potential: Contraception should be used by both females and males while taking Otrexup. Pregnancy should be avoided if either partner is receiving Otrexup:
    • for a minimum of 3 months after treatment with Otrexup for males.
    • during and for at least 1 menstrual cycle after treatment with Otrexup for females.
  • Pregnancy: Otrexup can cause fetal death or teratogenic effects when administered to a pregnant woman. Otrexup is contraindicated in pregnant women. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.
  • Nursing Mothers: Because of the potential for serious adverse reactions from methotrexate in breast fed infants, Otrexup is contraindicated in nursing mothers.
  • Alcoholism or Liver Disease: Patients with alcoholism, alcoholic liver disease or other chronic liver disease.
  • Immunodeficiency Syndromes: Patients who have overt or laboratory evidence of immunodeficiency syndromes.
  • Preexisting Blood Dyscrasias: Patients who have preexisting blood dyscrasias, such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia.
  • Hypersensitivity: Patients with a known hypersensitivity to methotrexate. Severe hypersensitivity reactions have been observed with methotrexate use.

Warnings and Precautions:

  • Organ system toxicity: Potential for serious toxicity. Only for use by physicians experienced in antimetabolite therapy.
  • Embryo-fetal toxicity: Exclude pregnancy before treatment. Avoid pregnancy if either partner is receiving Otrexup. Advise males to avoid pregnancy for a minimum of three months after therapy and females to avoid pregnancy for at least one ovulatory cycle after therapy.
  • Effects on reproduction: May cause impairment of fertility, oligospermia and menstrual dysfunction.
  • Laboratory tests: Monitor complete blood counts, renal function and liver function tests.
  • Risks from improper dosing: Mistaken daily use has led to fatal toxicity.
  • Patients with impaired renal function, ascites, or pleural effusions: Elimination is reduced.
  • Dizziness and fatigue: May impair ability to drive or operate machinery.

Adverse Reactions

Common adverse reactions are: nausea, abdominal pain, dyspepsia, stomatitis/mouth sores, rash, nasopharyngitis, diarrhea, liver function test abnormalities, vomiting, headache, bronchitis, thrombocytopenia, alopecia, leucopenia, pancytopenia, dizziness, photosensitivity, and “burning of skin lesions”.

Drug Interactions

  • Aspirin, NSAIDs, and steroids: concomitant use may elevate and prolong serum methotrexate levels and cause increased toxicity.
  • Proton pump inhibitors: concomitant use may elevate and prolong serum methotrexate levels and cause increased toxicity.

Use in Special Populations

  • Pregnancy: Methotrexate has been reported to cause embryotoxicity, fetal death, congenital anomalies, and abortion in humans and is contraindicated in pregnant women.
  • Nursing Mothers: Because of the potential for serious adverse reactions from methotrexate in breast fed infants, Otrexup is contraindicated in nursing mothers.
  • Females and Males of Reproductive Potential: Contraception should be used by both females and males while taking Otrexup. Pregnancy should be avoided if either partner is receiving Otrexup:
    • for a minimum of 3 months after treatment with Otrexup for males.
    • during and for at least 1 menstrual cycle after treatment with Otrexup for females.
  • Pediatric use: Safety and efficacy of methotrexate, including Otrexup, have not been established in pediatric patients with psoriasis. Safety and efficacy of Otrexup have not been established in pediatric patients with malignancy.
  • Geriatric use: Use caution in dose selection.

Dosage and Administration

Otrexup is for once weekly subcutaneous use only.

Administer Otrexup in the abdomen or thigh.

For full prescribing information including boxed warning, please click here.

For more information, call 1-855-Otrexup (1-855-687-3987).    OTX 344-15-03B

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Other Important Information About Our Relationship With Third Parties

IV. Our Children’s Policy

Antares’s website content and services are intended for users over the age of 13. Our site is not designed to attract child users. If we learn that an under-13 user has volunteered personal or health-related information on our site, or that a provider has volunteered information about a patient who is identified as younger than 13, we will delete such information from our active databases in accordance with our deletion policy, which is described in the section below on Your Privacy Choices.

V. Your Privacy Choices

When you access any interactive tool or service on an Antares website, you will be asked to affirmatively choose (“opt-in”) to provide the requested information. You may always choose not to provide the requested information.

Receive E-mail. When you register with our site, you will be given the option of requesting to receive e-mail with information we think you might find useful, including promotions, announcements of new services and products, and newsletters on particular health topics.

Accept Cookies. Your browser software can be set to reject all cookies, but if you reject our cookies, certain aspects of the functions and conveniences of our site may not work properly. Cookies and similar technologies are how we ensure that we can promptly retrieve and deliver the information to you when you use our site.

Deletion Practices. The information that you provide Antares is stored in servers that are operated and maintained by Antares and third parties under contract with Antares. Website users should be aware that it is not technologically possible to remove from our servers each and every record of the information you have provided to Antares. The need to back-up our systems to protect information from inadvertent loss means that a copy of information about you or your health-related interests may exist in non-erasable forms that will be difficult or impossible for us to locate. Nevertheless, we promise that upon receiving your request, Antares will delete all personal and/or health-related personal information stored in the databases Antares actively uses for research and daily business activities, or otherwise stored in readily searchable media. In addition, we will use commercially reasonable efforts not to disclose any personal information stored in a non-erasable format after receiving your request for removal, except as required by law.

Please be aware that Antares may not comply with a consumer’s request to amend or remove information that was provided to Antares by a health care professional or a consumer regarding an adverse drug event.

Communicate With Antares By E-mail. At our website, consumers and providers may communicate with our staff to learn more about our products and services. We also offer interactive tools that enable consumers and health care professionals to submit customized e-mail requests for information about diseases and therapies. Please be aware of the limits on the confidentiality of these e-mail communications. We will not disclose personally identifiable information that we receive in e-mail, but all e-mail transmissions are vulnerable to unauthorized interception. In addition, we remind you that e-mail sent or received through an employer’s computer or computer system is not confidential and may be the legal property of the employer.

VI. Our Security Measures

We want your and your patient’s, if you are a health care professional, personal information to remain as secure as reasonably possible. Our success at improving our products and services depends upon your or your patients’ willingness to share information about patient health and health care with Antares.

Data Security. We use encryption practices to help insure the integrity and privacy of some of the personal and health-related personal information you provide to us. All personal and/or health-related personal information is kept physically behind firewalls that prevent intruders from gaining access. As an added security precaution, we deploy various methods of protection such as host intrusion prevention and detection systems to maintain the integrity and confidentiality of data. Although we will make reasonable efforts to protect personal and/or health-related personal information from loss, misuse, or alteration by third parties, you should be aware that there is always some risk that an unauthorized third party could intercept an Internet transmission, or that someone will find a way to thwart our security systems.

VII. Changes In Our Privacy Statement

We will only use personal information in the manner described in the Privacy Statement in effect when the information was collected from you. However, we reserve the right to change the terms of this Privacy Statement at any time by posting revisions to our site. If at any point, we decide to use personally identifiable information or health-related personal information in a manner different from that stated at the time it was collected, you will be given a choice to allow or disallow any additional uses or disclosures of your personally identifiable information or health-related personal information.

Terms of Use

PLEASE READ THESE TERMS OF USE CAREFULLY!

BY ACCESSING THIS SITE, YOU ACKNOWLEDGE THAT YOU HAVE READ THESE TERMS OF USE, AND UNDERSTAND AND AGREE TO ABIDE BY THEM.

This Terms of Use Agreement (this “Agreement”) describes the terms and conditions applicable to your use of any and all of Antares Pharma, Inc.’s and/or its affiliates (collectively “Antares”) or Antares co-branded websites. If you do not agree to the terms and conditions of this Agreement, please do not use this website. Your use of certain pages or services within this website may be subject to additional terms and conditions. Before being given access to these pages or services, you will be asked to indicate whether you agree to be bound by the additional terms and conditions. If you agree to be bound, you will be given access to the page or service. If you do not agree to be bound, you will not be given access to the page or service.

Antares may at any time revise or modify this Agreement or impose new conditions for use of this website. Such changes, revisions or modifications shall be effective immediately upon notice to you, which may be given by any means including, without limitation, posting on the website or by e-mail. Any use of the website by you after such notice shall be deemed to constitute acceptance of such changes, revisions or modifications. Antares may modify its services at any time.

THIS WEBSITE DOES NOT PROVIDE MEDICAL OR PROFESSIONAL SERVICES ADVICE.

The content on this website is intended to be a general information resource in regard to the subject matter covered, and is provided solely on an “AS IS” and “AS AVAILABLE” basis. You are encouraged to confirm the information contained herein with other sources, and to review the information carefully with your professional health care provider. Antares is not engaged in rendering medical or similar professional services or advice via this website, and the information provided is not intended to replace medical advice offered by a physician. If you desire or need such services or advice, you should consult a professional health care provider. You should not construe Antares’s publication of this content as an endorsement by Antares of the views expressed herein, or any warranty or guarantee of any strategy, recommendation, treatment, action, or application of medication or preparation made by the author of the content.

Scope of Use

Antares invites you to view, use and download a single copy of this website for your informational, personal, non-commercial use. Except as otherwise provided on this page, no part of any content or software on this website may be copied, downloaded or stored in a retrieval system for any other purpose, nor may it be redistributed for any purpose, without the express written permission of Antares. You understand that Antares may discontinue, change, or restrict your use of this website for any reason without notice.

This website is for use by U.S. residents only. By using this website, you represent that you are at least eighteen (18) years old and a United States resident.

No Warranties

ALL CONTENT ON THIS WEBSITE IS PROVIDED TO YOU ON AN “AS IS” “AS AVAILABLE” BASIS WITHOUT WARRANTY OF ANY KIND EITHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, ACCURACY, AND NON-INFRINGEMENT. ANTARES MAKES NO WARRANTY AS TO THE ACCURACY, COMPLETENESS, CURRENCY, OR RELIABILITY OF ANY CONTENT AVAILABLE THROUGH THIS WEBSITE. YOU ARE RESPONSIBLE FOR VERIFYING ANY INFORMATION BEFORE RELYING ON IT. USE OF THE WEBSITE AND THE CONTENT AVAILABLE ON THE WEBSITE IS AT YOUR SOLE RISK. ANTARES MAKES NO REPRESENTATIONS OR WARRANTIES THAT USE OF THE WEBSITE WILL BE UNINTERRUPTED OR ERROR-FREE. YOU ARE RESPONSIBLE FOR TAKING ALL NECESSARY PRECAUTIONS TO ENSURE THAT ANY CONTENT YOU OBTAIN FROM THE WEBSITE IS FREE OF VIRUSES.

The above exclusions may not apply in jurisdictions that do not allow the exclusion of certain implied warranties.

Limitation of Liability

YOUR USE OF THE WEBSITE OR ANY CONTENT ON THE WEBSITE IS AT YOUR OWN RISK. ANTARES SPECIFICALLY DISCLAIMS ANY LIABILITY, WHETHER BASED IN CONTRACT, TORT, STRICT LIABILITY OR OTHERWISE, FOR ANY DIRECT, INDIRECT, INCIDENTAL, CONSEQUENTIAL, OR SPECIAL DAMAGES ARISING OUT OF OR IN ANY WAY CONNECTED WITH ACCESS TO OR USE OF THE WEBSITE, EVEN IF ANTARES HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, INCLUDING BUT NOT LIMITED TO RELIANCE BY ANY PARTY ON ANY CONTENT OBTAINED THROUGH THE USE OF THE WEBSITE, OR THAT ARISES IN CONNECTION WITH MISTAKES OR OMISSIONS IN, OR DELAYS IN TRANSMISSION OF, INFORMATION TO OR FROM THE USER, INTERRUPTIONS IN TELECOMMUNICATIONS CONNECTIONS TO THE WEBSITE OR VIRUSES, WHETHER CAUSED IN WHOLE OR IN PART BY NEGLIGENCE, ACTS OF GOD, WAR, TERRORISM, TELECOMMUNICATIONS FAILURE, THEFT OR DESTRUCTION OF, OR UNAUTHORIZED ACCESS TO THE WEBSITE, OR RELATED INFORMATION OR PROGRAMS.

Indemnification

If you violate any terms of this Agreement or if you misuse this website, you agree to defend, indemnify and hold harmless Antares, its officers, directors, employees, agents and licensees from any and all liability including, without limitation, costs, expenses and attorneys’ fees that arise out of or are related to your violation or misuse.

User Submissions

Certain areas of this website enable you to submit e-mails, or otherwise provide feedback or information to Antares.

You agree that by submitting content:

Trademarks

The trademarks, logos, and service marks (collectively, the “Trademarks”) displayed on this website are registered and unregistered Trademarks of Antares and others. Nothing contained in this website should be construed as granting, by implication, estoppel, or otherwise, any license or right in and to the Trademarks. Unauthorized use of any Trademark may be a violation of federal and state trademark laws.

Copyright

This website is protected by United States’ and foreign copyright laws. Except for your informational, personal, non-commercial use as authorized above, you may not modify, reproduce or distribute the design or layout of the website, or individual sections of the design or layout of the website or Antares logos without Antares’s written permission.

Information, News and Press Releases

The website may contain information, news and/or press releases about Antares. While this information was believed to be accurate as of the date it was prepared, Antares disclaims any duty or obligation to update this information, news or any press releases. Information about companies other than Antares contained in the news, press releases or otherwise, should not be relied upon as being provided or endorsed by Antares.

Links

This Antares website may contain links to websites operated by other parties. The linked sites are not under the control of Antares, and Antares is not responsible for the content available on any other Internet sites linked to this website. Such links do not imply Antares’s endorsement of material on any other site and Antares disclaims all liability with regard to your access to such linked websites. Antares provides links to other Internet sites as a convenience to users, and access to any other Internet sites linked to this website is at your own risk.

Unless otherwise set forth in a written agreement between you and Antares, you must adhere to Antares’s linking policy as follows: (i) any link to an Antares website must be a text only link clearly marked “Antares WEBSITE,” (ii) the appearance, position and other aspects of the link may not be such as to damage or dilute the goodwill associated with Antares’s names and trademarks, (iii) the link must “point” to the root domain name of the Antares website and not to other pages within the website, (iv) the appearance, position and other attributes of the link may not create the false appearance that your organization or entity is sponsored by, affiliated with, or associated with Antares, (v) when selected by a user, the link must display the website on full-screen and not within a “frame” on the linking website, and (vi) Antares reserves the right to revoke its consent to the link at any time and in its sole discretion.

Security

This website may require you to register or obtain a password prior to permitting access to the website or certain services available on this site. You are responsible for maintaining the confidentiality of your registration information and password, and for all uses of your password, whether or not authorized by you.

Location, Governing Law and Arbitration

This website is operated by Antares. The law of the State of Delaware shall govern these terms and conditions, without reference to its choice of law rules. Antares makes no representation that the information in the website is appropriate or available for use in other locations, and access to this website from territories where the content of this website may be illegal is prohibited. Those who choose to access this website from other locations do so on their own initiative and are responsible for compliance with applicable local laws.

Any controversy or claim arising under or related to this User Agreement or Antares’s products and/or services shall be settled by binding arbitration in accordance with the commercial rules of arbitration of the American Arbitration Association. Any such controversy or claim shall be arbitrated on an individual basis, and shall not be consolidated in any arbitration with any claim or controversy of any other party. The arbitration shall be conducted in the State of Delaware, and judgment on the arbitration award may be entered by any court of competent jurisdiction. Either you or Antares may seek any interim or preliminary relief from a court of competent jurisdiction in the state of Delaware, necessary to protect the rights or property of you or Antares pending the completion of arbitration.

Violations and Additional Policies

Antares reserves the right to seek all remedies available at law and in equity for violations of these Terms of Use, including the right to block access from a particular Internet address to the website.

Use of Information

Antares reserves the right, and you authorize Antares, to the use and assignment of all information regarding your use of this website and all information provided by you in any manner consistent with this User Agreement and applicable federal law.

Securities Laws

This website may include statements concerning Antares’s operations, prospects, strategies, financial condition, future economic performance and demand for Antares’s products or services, as well as its intentions, plans and objectives, that are forward-looking statements. These statements are based upon a number of assumptions and estimates which are subject to significant uncertainties, many of which are beyond our control. When used on the website, words like “anticipates,” “expects,” “believes,” “estimates,” “seeks,” “plans,” “intends” and similar expressions are intended to identify forward-looking statements designed to fall within securities law safe harbors for forward looking statements. The website and the information contained herein does not constitute an offer or a solicitation of an offer for sale of any securities. None of the information contained herein is intended to be, and shall not be deemed to be, incorporated into any of Antares’s securities-related filings or documents.

Questions

If you have any questions about these Terms of Use, please contact Antares at +1 (609) 359 3020. For all other inquiries, please contact us through the relevant product, support or Antares website.