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Always toss any leftover product after four weeks

As a result, there may be a notable rise in MTX-related toxicities due to prolonged, persistent, or elevated MTX plasma levels

2019 Aug;97(8):1183-1193

A patient with rapidly spreading redness, high fever, diabetes, immune suppression, facial involvement, a surgical wound infection, or concern for a deeper infection may need blood tests, imaging, intravenous antibiotics, inpatient observation, and consultation with specialists such as infectious diseases, dermatology, vascular surgery, wound care, endocrinology, or plastic and reconstructive surgery