Methotrexate

Methotrexate: Comprehensive Medication Guide

Common Use

Methotrexate is an antimetabolite medication primarily used in the treatment of various types of cancer and certain autoimmune diseases. Its mechanism of action involves inhibiting dihydrofolate reductase, a crucial enzyme responsible for the synthesis of nucleotides, which are essential building blocks for DNA. By inhibiting this enzyme, Methotrexate disrupts DNA synthesis, repair, and cell mitosis, effectively slowing down the growth and proliferation of rapidly dividing cells.

This medication is particularly effective against cells found in malignant tumors, bone marrow, embryonic tissues, epithelial cells of the intestinal mucosa, bladder, and oral cavity, which are highly sensitive to its effects. Methotrexate is widely used in the treatment of various cancers, including:

• Breast cancer
• Squamous cell carcinoma of the head and neck
• Lung cancer
• Trophoblastic tumor
• Cervical cancer
• Ovarian cancer
• Bladder cancer
• Colorectal cancer
• Esophagus cancer
• Stomach cancer
• Pancreatic cancer
• Testicular cancer
• Acute lymphoblastic leukemia
• Non-Hodgkin's lymphoma
• Osteosarcoma

Beyond cancer treatment, Methotrexate is also a valuable medication for managing autoimmune conditions such as rheumatoid arthritis and psoriasis. In these cases, it helps to suppress the overactive immune system, reducing inflammation and alleviating symptoms.

Dosage and Direction

It is crucial to take Methotrexate exactly as prescribed by your healthcare provider. The dosage and frequency of administration will vary depending on the specific condition being treated and your individual medical history. Methotrexate is typically taken orally, with or without food. Swallow the tablet whole and do not chew or crush it.

For rheumatoid arthritis and psoriasis, Methotrexate is usually administered weekly. A common starting dose is 7.5 mg once a week, or 2.5 mg every twelve hours, taken three times weekly. Cancer treatment regimens require individualized dosage adjustments and must be closely monitored by your doctor.

Important Considerations for Safe and Effective Use:

• Folic Acid Supplementation: Because Methotrexate interferes with folate metabolism, taking folic acid supplements can help reduce some of the side effects. Consult your doctor about the appropriate dosage.
• Hydration: Drink plenty of fluids while taking Methotrexate to help your kidneys function properly and reduce the risk of kidney damage.
• Avoid Alcohol: Alcohol can increase the risk of liver damage when taken with Methotrexate.
• Regular Monitoring: Regular blood tests are essential to monitor liver function, kidney function, and blood cell counts during Methotrexate treatment.

Precautions

Exercise caution when using Methotrexate in the presence of certain medical conditions, including:

• Ascites
• Dehydration
• Obstructive diseases of the digestive tract
• Pleural or peritoneal effusion
• Chronic renal failure
• Parasitic and infectious diseases (viral, fungal, or bacterial)

Methotrexate toxicity may be increased in individuals with:

• Herpes simplex, herpes zoster, chickenpox, measles
• Amoebiasis, strongyloidiasis (helminthosis)
• Gout
• Infection and inflammation of the mucosa in the mouth
• Nausea and vomiting (due to dehydration)
• Stomach and duodenal ulcerations
• Ulcerative colitis
• Prior chemotherapy or radiotherapy
• Asthenia

When used to treat cancer, caution is needed in patients with aciduria (urine pH less than 7) and inhibited bone marrow hematopoiesis. Avoid prolonged exposure to sunlight. Immunizations with live vaccines should be avoided for 3-12 months after completing Methotrexate treatment. Both men and women should use effective contraception during treatment, as this drug is highly toxic to unborn babies.

Contraindications

Methotrexate is contraindicated in patients with:

• Hypersensitivity to its components
• Immune deficiency
• Pregnancy and breastfeeding

When used to treat psoriasis or rheumatic diseases, Methotrexate should not be used in patients with severe suppression of bone marrow hematopoiesis, or severe kidney or liver failure.

Possible Side Effects

Methotrexate is generally well-tolerated, but some patients may experience side effects. Common side effects include:

• Mouth sores
• Stomach upset
• Low white blood cell counts

Methotrexate is known to be toxic to the liver, kidneys, lungs, and bone marrow. Regular blood tests are essential to monitor these organs during treatment.

Other adverse reactions may include:

• Headache
• Drowsiness
• Allergic reactions (skin rash, itching, dizziness)
• Hair loss
• Fatigue
• Loss of appetite
• Nausea
• Diarrhea

Drug Interactions

Inform your doctor about all medications, herbal products, and food supplements you are taking, especially:

• NSAIDs (ibuprofen, diclofenac, naproxen, etc.)
• Azathioprine (Imuran)
• Anti-gout drugs (allopurinol, colchicine, sulfinpyrazone)
• Chloramphenicol (Chloromycetin)
• Hydroxychloroquine (Plaquenil, Quineprox)
• Retinol, tretinoin (Retin-A), isotretinoin (Accutane)
• Steroids (prednisone, etc.)
• Sulfa drugs (Bactrim, Septra, Azulfidine)
• Phenytoin (Dilantin)
• Theophylline (Theobid, Theo-Dur, Elixophyllin, Slo-Bid)
• Probenecid (Benemid)
• Tetracycline (Brodspec, Panmycin, Sumycin, Tetracap)
• Oral anti-diabetes drugs (glipizide, chlorpropamide, acetohexamide, glimepiride, tolbutamide)
• Penicillin antibiotics
• Salicylates (Dolobid, Salflex, Tricosal, Disalcid, Doan's Pills)

This list is not exhaustive. Always inform your doctor about all medications you are taking.

Missed Dose

Consult your doctor if you miss a dose of Methotrexate.

Overdose

Seek immediate medical attention if you suspect an overdose. Symptoms of overdose may include nausea, vomiting, weakness, paleness, easy bruising or bleeding, mouth sores, black or bloody stools, coughing up blood, vomit resembling coffee grounds, decreased urination or anuria.

Storage

Store Methotrexate in a dry, tightly closed container away from sunlight at room temperature between 15-30°C (59-86°F). Keep out of reach of children and pets.

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Methotrexate FAQs

Q: What is Methotrexate used for?

A: Methotrexate is used to treat certain types of cancer, rheumatoid arthritis, and psoriasis.

Q: How often is Methotrexate taken?

A: For rheumatoid arthritis and psoriasis, Methotrexate is usually taken once a week. For cancer, the frequency depends on the specific treatment plan.

Q: What should I avoid while taking Methotrexate?

A: Avoid alcohol and prolonged exposure to sunlight. Discuss any vaccinations with your doctor before getting them.

Q: What are the common side effects of Methotrexate?

A: Common side effects include mouth sores, stomach upset, and low white blood cell counts.

Q: Is Methotrexate safe during pregnancy?

A: No, Methotrexate is not safe during pregnancy and can cause birth defects. Use effective contraception while taking this medication.

Disclaimer: We provide only general information about medications, which does not cover all directions, possible drug integrations, or precautions. Information at this site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed upon with your health care advisor or doctor in charge of the case. We disclaim the reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special, or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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