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When I used to take methadone, I was set up with "split dosing" at the clinic; because the methadone always wore off late in the afternoon. I believe the best time to take it is in the morning and then take more later in the day if needed.

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16y ago
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7y ago

Most people take methotrexate before bedtime. It has a tendency to make some people feel sick to the stomach or pretty tired after a dose, so its best just to sleep through it.

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Q: What time of day is the best for taking methotrexate?
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caution Due to aspirin's effect on platelet aggregation and GI mucosa, aspirin should be used cautiously in patients with thrombocytopenia following treatment with antineoplastic agents due to an increased risk of bleeding.[5717] In general, because certain antineoplastic agents can cause clinically significant thrombocytopenia, they may increase the risk of aspirin-associated bleeding (i.e. GI bleeding, inhibited platelet aggregation, and prolonged bleeding time). Also, aspirin may mask signs of infection such as fever and pain in patients following treatment with antineoplastic agents or immunosuppressives.[6859] Aspirin, ASA should be used with caution in patients receiving immunosuppressive therapy. Although usually seen with large salicylate doses, aspirin may displace mercaptopurine, 6-MP from secondary binding sites, resulting in bone marrow toxicities and blood dyscrasias.[5232] Special consideration should be given to myelosuppressed patients prior to receiving aspirin. Due to the thrombocytopenic effects of methotrexate,[5067] when used as an antineoplastic agent, an additive risk of bleeding may be seen in patients receiving concomitant anticoagulants, platelet inhibitors (also see salicylates), strontium-89 chloride, or thrombolytic agents. Caution should be exercised when salicylates are given in combination with methotrexate. Since both are weak acids, salicylates can impair the renal secretion of methotrexate and increase the risk of methotrexate toxicity. Salicylates can also displace methotrexate from protein-binding sites.[5067] Although the risk for drug interactions with methotrexate is greatest during high-dose methotrexate therapy, it has been recommended that any of these drugs be used cautiously with methotrexate even when methotrexate is used in low doses for the treatment of rheumatoid arthritis. A significantly higher incidence of leukopenia has been reported in patients taking aspirin during methotrexate therapy. Bismuth subsalicylate may have similar effects. In addition, large doses of salicylates (>= 3-4 g/day) can cause hypoprothrombinemia,[5170] an additional risk factor for bleeding. Caution should be exercised when aspirin is given in combination with methotrexate. Concomitant administration of salicylates with high-dose methotrexate therapy has been reported to elevate and prolong serum concentrations of methotrexate resulting in deaths from severe hematologic and gastrointestinal toxicity. Although the risk for drug interactions with methotrexate is greatest during high-dose methotrexate therapy, it has been recommended that any salicylate be used cautiously with methotrexate even when lower doses of methotrexate are given for the treatment of rheumatoid arthritis or psoriasis. Elderly patients and patients with renal impairment may be at particular risk. As both methotrexate and salicylates are weak acids, aspirin can impair the renal secretion of methotrexate and increase the risk of methotrexate toxicity. Salicylates can also displace methotrexate from protein-binding sites.[5067] [5232]


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