Methotrexate

Description

Methotrexate is used in the treatment of life-threatening conditions like rheumatoid arthritis, psoriasis, and few cancers. It should be used under the supervision of a qualified professional. It may cause severe liver, kidney and lung injury if taken in more quantities. Close monitoring of blood cell count is necessary.

Side effects

Major & minor side effects for Methotrexate

  • Diarrhea
  • Joint pain
  • Abdominal pain
  • Swelling of feet or lower legs
  • Dizziness
  • Fever with chills
  • Unusual bleeding
  • Blurred vision
  • Temporary Hair Loss
  • Loss of appetite
  • Nausea or Vomiting
  • Pale skin
  • Skin rash

Uses of Methotrexate

What is it prescribed for?

  • Acute Lymphoblastic Leukemia
  • Choriocarcinoma
  • Meningeal Leukemia
  • Breast cancer
  • Rheumatoid Arthritis
  • Psoriasis
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Concerns

Commonly asked questions

  • Onset of action
    The effect of this medicine can be observed in 1 to 2 hours after an oral dose and 30 to 60 minutes after an intramuscular injection.
  • Duration of effect
    The effect of this medicine lasts for an average duration of 9 to 30 hours at a low dose and 24 to 45 hours at a high dose.
  • Safe with alcohol?
    Consumption of alcohol is not recommended due to the risk of liver injury. Close monitoring of liver enzymes is necessary. Seek immediate medical treatment if any symptoms like lethargy, yellow colored eyes, and skin, abdominal pain appear.
  • Is it habit forming?
    No habit forming tendencies were reported.
  • Usage in pregnancy?
    This medicine is not recommended for pregnant women.
  • Usage while breast-feeding?
    This medicine is not recommended in breastfeeding women.

Allergy

Not recommended in patients with known allergy to Methotrexate.

Pregnancy

Not recommended for pregnant women due to the risk of birth defects.

Liver disease

Not recommended in patients with the existing liver disease.

Blood disorder

Not recommended in patients with existing blood diseases.
Warnings for special population

Pregnancy

This medicine is not recommended for pregnant women.

Breast-feeding

This medicine is not recommended in breastfeeding women.
General warnings

Liver injury

This medicine is not recommended in the patients with the liver injury. The concentration of this medicine may increase in these patients. The baseline of the liver function tests should be obtained before starting the treatment.

Kidney injury

This medicine is not recommended in the patients with the kidney injury. It may cause kidney injury at higher doses. The dose of this medicine should be adjusted based on the CrCl.

Lung toxicity

This medicine may cause severe lung injuries like pulmonary fibrosis, pulmonary interstitial infiltrates. Any symptoms of breathing difficulty and signs of lung impairment should be informed to the doctor. The treatment should be discontinued if any symptoms appear.

Blood cell count

This medicine may lower the white blood cell count (neutrophils) and platelets. Close monitoring of blood cell count is necessary. The baseline of the blood cell count should be obtained before initiation of the treatment. Do not start the treatment if the counts are less.

Skin reactions

The medicine may cause severe skin reactions stevens-johnson syndrome, skin necrosis, and skin ulceration. Inform the doctor if any symptoms appear. The treatment should be discontinued.

Gastrointestinal injury

This medicine is not recommended for use in patients with gastrointestinal disorders like diarrhea and ulcerative stomatitis. Inform the doctor if you have any gastrointestinal disorders before initiation of the therapy.

Infections

The chances of occurring infections are more in the patients receiving this medicine. Hold the chemotherapy and start with the broad-spectrum antibiotics if there are any signs and symptoms of fever. Close monitoring of the body temperature and the blood cell count is necessary.

Missed Dose

It is advised not to miss any dose. If you missed any dose, you should contact your doctor immediately.

Overdose

Seek emergency medical treatment or contact the doctor in case of an overdose.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

Methotrexate may cause liver problems, and may worsen if taken with other medications that can also affect the liver such as ethanol.

Instructions

Consumption of alcohol is not recommended due to the risk of liver injury. Close monitoring of liver enzymes is necessary. Seek immediate medical treatment if any symptoms like lethargy, yellow colored eyes, and skin, abdominal pain appear.
Interaction with Medicine

Azole antifungal agents

Atorvastatin

Live vaccines

Proton pump inhibitors

Disease interactions

Liver Disease

Methotrexate is not recommended for the treatment of psoriasis and rheumatoid arthritis in patients with liver disease. The baseline of the liver enzymes should be obtained before starting the therapy. The treatment should be discontinued if liver enzymes are elevated.
Food interactions
Information not available.
Lab interactions
Information not available.
Take Methotrexate as instructed by your doctor. Do not take in larger amounts than advised. Do not miss any scheduled dose. Consult the doctor if you experience any undesirable effects. Do not stop taking the medicine without consulting your doctor.
Miscelleneous

Can be taken with or without food, as advised by your doctor

To be taken as instructed by doctor

May cause sleepiness

How it works
It works by interfering the DNA synthesis and stops the growth of the cells.
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

Other immunosuppressant

Schedule

Schedule H

[Internet]. 2017 [cited 4 May 2017]. Available from:

https://www.medicines.org.uk/emc/medicine/21378

Methotrexate: MedlinePlus Drug Information [Internet]. Medlineplus.gov. 2017 [cited 4 May 2017]. Available from:

https://medlineplus.gov/druginfo/meds/a682019.html

DailyMed - methotrexate sodium injection, powder, lyophilized, for solution [Internet]. Dailymed.nlm.nih.gov. 2017 [cited 4 May 2017]. Available from:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ec476b11-0b3c-4139-b1eb-a3daa76bc271#a15d5648-439e-4a6d-b23d-1c02c0329aff

Prescribing medicines in pregnancy database [Internet]. Therapeutic Goods Administration (TGA). 2017 [cited 4 May 2017]. Available from:

https://www.tga.gov.au/prescribing-medicines-pregnancy-database#searchname

[Internet]. Toxnet.nlm.nih.gov. 2017 [cited 4 May 2017]. Available from:

https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/~S9AfYa:6

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Information on this page was last updated on 16 Nov 2017

Disclaimer

We’ve made all possible efforts to ensure that the information provided here is accurate, up-to-date and complete, however, it should not be treated as a substitute for professional medical advice, diagnosis or treatment. Practo only provides reference source for common information on medicines and does not guarantee its accuracy or exhaustiveness. The absence of a warning for any drug or combination thereof, should not be assumed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Practo does not assume any responsibility for any aspect of healthcare administered with the aid of information provided above. If you have any doubts about your medication then we strongly recommend that you consult with your doctor, nurse or healthcare provider. See detailed T&C here.