Brand name: Rheumatrex®,
Other names: Amethopterin, MTX, Methotrexate
Distributor: Sanofi Aventis
Methotrexate is available
by prescription only
Indications: Methotrexate is used to
treat a variety of cancers, mainly:
- head and neck
( a common form of bone cancer)
- Cutaneous T-cell
lymphoma (also known as mycosis fungoides).
Methotrexate is also used to treat
certain non-cancerous conditions such as psoriasis, rheumatoid arthritis, polymyalgia rheumatica (PMR) and
Crohn's disease. Talk to your doctor or pharmacist for more information.
form: Methotrexate can be taken several
- by mouth, in pill
infusion (into the vein IV)
injection (into the muscle)
infusion (within a ventricle)
- Intrathecal infusion
(inside the spinal canal).
Methotrexate comes as a tablet and injection. The form of treatment (pill or injection) and dosage prescribed by
your doctor depends on several criteria: your health status, type of cancer being treated and its severity. In
addition, you doctor will consider your body surface area (weight and height) and whether or not you are taking
other drugs. In case you are prescribed injection, the treatment usually consists of injecting a dose of
Methotrexate one or several times per week. The drug can be taken every few weeks, or on a regular basis, depending
on the condition being treated.
oncologist may recommend that you take
mouth. In this case, you will be prescribed an appropriate dosage capable of fighting the disease. It is important
that you follow the instruction or the directions on the prescription label carefully. Take methotrexate and all
drugs exactly as indicated by your health care provider. Do not change or stop the treatment without first
consulting your doctor.
when methotrexate is given in hospital by professionals, the risk of overdose is almost nonexistent; however,
accidental overdose or administrative mistake can happen. When the drug is taken by mouth chance of overdose
increases. An overdose of methotrexate can cause a decrease in the number of blood cells in your bone marrow, which
can lead to severe health problems and even death. Even in absence of therapeutic overdose, Methotrexate
intoxication can lead to:
- damage to the lining
of the mouth, stomach or intestines
- severe skin reactions
- lung Infections such
- bone and soft tissue
- severe damage to the
liver, kidney, lungs, and gastrointestinal tract
- lymphoma, a cancer
that rises in the lymphocytes of the immune system
- Tumor lysis syndrome, a
life-threatening complication of cancer treatment.
experience any symptom (see
that may indicate presence of these medical conditions, contact your physician or emergency clinic/hospital
as soon as possible. Even in the absence of signs, it is important to see your doctor regularly during the
treatment; do not neglect the appointments with your doctor and the laboratory.
methotrexate is given by injection, it is administered in hospital; missing dose is basically difficult if you
keep all your doctor’s appointments. If for some reasons you cannot be present at the hospital for the
treatment, contact your health care provider before the date scheduled for the injection.
are recommended to take methotrexate by mouth in tablet form, it may happen you forget to take it. If you miss a
dose, take it as soon as you remember it if it is not almost time to take the next dose. If you forgot to take
the medicine, and it is almost time for the nest dose, wait for the next one; in any case, do not double the
is contraindicated or should be used with precaution in the following medical conditions :
- excess fluid in the
stomach area or around the lungs
- low number of blood
to methotrexate or any of its ingredients
to antimetabolites in general
infants or children should be treated with methotrexate only under medical supervision.
Mechanism of action (MOA): methotrexate is classified as an
“antimetabolite”; it slows the proliferation of cancer cells by blocking DNA synthesis
as well as
regeneration and replication of cancer cells.
Some medicines may interact with methotrexate
, and increase your risk of developing side effects. Talk you to your doctor before
vitamins, nutritional supplements, and all nonsteroidal anti-inflammatory drugs
(NSAID): aspirin, salsalate, choline magnesium trisalicylate (Tricosal, Trilisate), ibuprofen (Advil, Motrin),
magnesium salicylate (Doan's), and naproxen (Aleve, Naprosyn).
In addition, talk to your doctor before taking
thiazide diuretics, amoxicillin (Amoxil)
and other penicillins, acitretin (Soriatane), azathioprine
(Imuran), isotretinoin (Accutane), sulfasalazine (Azulfidine), or tretinoin (Vesanoid).
Side effects: methotrexate not only attack
cells but also healthy
cells, which often leads to, in most patients, the following side effects:
- Mild nausea and vomiting.
If the side
effects above persist for weeks, contact your oncologist. In addition, contact your doctor immediately if you
experience symptoms that indicate:
Damage to the liver, heart or lung: persistent nausea, extreme tiredness,
pain in the upper right part of the stomach, dry cough, fast and irregular heartbeat, fever, shortness of breath or
any flu-like symptom.
Damage to the lining of the mouth,
stomach or intestine: mouth sores, persistent diarrhea,
black, tarry or bloody stools, sore throat, or bloody vomitting.
Damage to the skin or
pain, fever, rash, blisters, peeling skin, yellowing of the skin or eyes, or
purple, blue or black discoloration of the skin.
: anxiety, depression,
dehydration, nose bleeding, vision changes, red itchy eye, or intense headaches