Methotrexate

Therapeutic Group

Anti-neoplastics

Indication Dosage

Methotrexate is a medication prescribed for a variety of medical conditions. Its primary indications include:

  • Rheumatoid Arthritis: Methotrexate is commonly used to treat rheumatoid arthritis, a chronic inflammatory disorder that affects the joints. It helps reduce pain, inflammation and slows down the progression of the disease.
  • Psoriasis: Methotrexate is an effective treatment for psoriasis, a skin condition characterized by red, scaly patches. It helps to alleviate the symptoms and control the skin's excessive cell growth.
  • Certain Cancers: Methotrexate is employed in higher doses to treat certain types of cancer, such as leukemia, lymphoma, and gestational trophoblastic disease. It works by inhibiting the growth of cancer cells.
  • Ectopic Pregnancy: In cases of ectopic pregnancy (a pregnancy occurring outside the uterus), Methotrexate may be used to terminate the pregnancy when surgery is not immediately necessary.
  • Inflammatory Bowel Disease: Methotrexate is sometimes prescribed for Crohn's disease and ulcerative colitis, both of which are chronic inflammatory bowel diseases, to help control symptoms and reduce inflammation in the digestive tract.
  • Systemic Lupus Erythematosus (SLE): Methotrexate can be used to manage certain symptoms of systemic lupus erythematosus, an autoimmune disease that can affect various organs and tissues in the body.
  • Vasculitis: This medication may also be utilized in the treatment of certain forms of vasculitis, which are disorders characterized by inflammation of blood vessels.

Antineoplastic; Buricitt's Lymphoma: Stages I & II: 

Oral:

  • Adults: 10-25 Mg/day For 4-8 days for Several Courses; Separate By 7-10 Day Rest Period. 

Antineoplastic; Buricitt's Lymphoma: Stage III: 

Oral: 

  • Adult: 0.625-2.5 Mg/kg/day. 

Leukaemia: 

  • Induction: 3.3 Mg/m2 With Prednisone Every Day. Remission Maintenance: 15 Mg/m2orally/im Twice a week or 2.5 Mg/kg IV every 14 Days. 
  • Mycosis fungoides: 5-50 Mg Every Week, If Poor Response, Increase To 15-37.5 Mg Twice Weekly. 

Osteosarcoma: 

  • By IV Inj: Initially 12 Gm./m2, Increase To 15 Gm/m2 If Peak Levels Of 1000 Micro-molar Not Reached At End Of Infusion. 

Choriocarcinoma, Trophoblastic Diseases: 

  • Oral Or By Im: 1530 Mg Every Day X 5 Days, Rest For At least 1 Wk & Repeat 3-5 Times. 

Meningeal Leukaemias: 

By Intrathecal Inj: 

  • Children 3 Yr: 12 Mg. 
  • 2 Yr: 10 Mg. 
  • 1 Yr: 8 Mg. 
  • <1 Yr: 6 Mg. Dilute Preservative Free Methotrexate To 1 Mg/ml, Dose Every 2-5 Day. 

Rheumatoid Arthritis: 

  • Adults: Initially 7.5 Mg Once Weekly Or 2.5 Mg Every 12 Hr X 3 Doses Once Weekly. Max: 20 Mg/week. Reduce To the Lowest Effective Dose. 

Juvenile Rheumatoid Arthritis: 

  • Children 2-16 Yr: 10mg/m2 once Weekly, Adjust Dose To Optimal Response. 
    Psoriasis: 

Oral Or By IV or IM: 

  • Adults: Usual: 10-25 Mg/week Until Adequate Response Achieved Or Use 2.5 Mg Every 12 Hr X 3 Doses, May Increase Gradually. Max: 30 Mg/wk.

Content

  • Tab 2.5mg /10mg: Methotrexate 2.5mg /10mg.
  • Inj 5mg /50mg / 500mg /1gm: Methotrexate 5mg /50mg /500mg /1gm; Vial.

Pregnancy

Contraindicated In Pregnancy.

Stability

  • Folic Acid Antagonist

Contra Indications

  • Severe Renal Or Hepatic Impairment, Active Infectious Disease, Immune Deficiency Syndrome, Serious Anaemia, Leukopenia, Thrombocytopenia, Aids, Pre-existing Blood Dyscrasias.

Precautions

  • Severe Renal Or Hepatic Impairment, Active Infectious Disease, Immune Deficiency Syndrome, Serious Anaemia, Leukopenia, Thrombocytopenia, Aids, Pre-existing Blood Dyscrasias.

Lactation

  • Contraindicated. Discontinue Breast-feeding

Side Effects

  • Alopecia
  • Anaphylactic Reactions
  • Anorexia
  • Arthralgia
  • Blood Disorders
  • Changes In Nail & Skin Pigmentation
  • Chills
  • Chronic Pulmonary Fibrosis
  • Confusion
  • Conjunctivitis
  • Cystitis
  • Diarrhoea
  • Drowsiness
  • Dyspepsia
  • Dysuria
  • Ecchymosis
  • Furuncolosis
  • Gi Bleeding & Ulceration
  • Haematuria
  • Hepatotoxicity
  • Hypotension
  • Impotence
  • Interstitial Pneumonitis
  • Malaise
  • Menstrual Disturbances
  • Mucositis
  • Myalgia
  • Myelosuppression
  • Nausea
  • Neurotoxicity
  • Osteoporosis
  • Paraesthesia
  • Pericardial Tamponade
  • Pericarditis
  • Photosensitivity
  • Pleuritic Pain
  • Precipitation Of Diabetes
  • Pruritus
  • Pulmonary Fibrosis
  • Pulmonary Oedema
  • Rash
  • Renal Failure
  • Stevens-johnson Syndrome
  • Telangiectasia
  • Thrombosis
  • Toxic Epidermal Necrolysis
  • Toxic Megacolon
  • Urticaria
  • Vaginitis
  • Vasculitis
  • Visual Disturbance
  • Vomiting.
  • Rare: Pneumonitis