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Overview

Methotrexate

Prescription vs OTC : Prescription by Doctor required

About Methotrexate

Methotrexate is an antimetabolite. It is used in the treatment of chemotherapy and to bring under control rheumatoid arthritis. It functions by stopping the growth of cancerous cells, bone marrow cells and Skin cells.

. It may also be prescribed for treating trophoblastic neoplasms; leukemias; psoriasis; breast, head and neck, and lung carcinomas; osteosarcoma; sarcomas; carcinoma of gastric, esophagus, testes; lymphomas.

Methotrexate is only given when other medications have failed in the above mentioned conditions. Methotrexate can be given on its own or in combination. It acts as a barrier to the body’s folic acid requirement. Methotrexate can be taken orally or by injection.

On using Methotrexate you may experience some side effects which in certain cases might prove to be fatal. These side effects include abdominal pain, nausea, vomiting, hair loss, lightheadedness, darkening of the urine, reduced appetite, mouth ulcers, diarrhea, liver and kidney disorders, difficulty in breathing, cough, bleeding through the urinary tract.

While under Methotrexate treatment it is recommended that you be closely monitored by your physician on a regular basis to bring to immediate control any kind of adverse side effects. Before starting your Methotrexate treatment you should notify your doctor if you are :

  • Pregnant, are planning to become pregnant or are breastfeeding a baby;
  • Alcoholic;
  • Have a history of liver, kidney, bone marrow or lung disease;
  • Have Folate/Folic acid deficiency;
  • Have any history of infections,
  • Already under any treatment especially a radiation treatment or
  • Taking any kind of medication.

Ensure not to get pregnant while you are under Methotrexate treatment as it might fatally harm the fetus. In case you do get pregnant, discontinue Methotrexate usage right away and tell your doctor. The dosage for Methotrexate will be prescribed by the doctor taking into consideration your age, gender, overall health and the severity of your condition.

Methotrexate if not taken in the proper dosage as prescribed can prove to be life-threatening. In case of suspected drug overdose, contact your health care provider immediately.

Avoid alcohol to prevent serious side effects. Avoid intake of extra dietary folic acid, maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake) and adequate nutrition (frequent small meals may help).

You may experience nausea and vomiting (small frequent meals may help or request antiemetic from prescriber); drowsiness, tingling, numbness, or blurred vision (avoid driving or engaging in tasks that require alertness until response to drug is known); mouth sores (frequent oral care is necessary); loss of hair; permanent sterility; skin rash; photosensitivity (use sunscreen, wear protective clothing and eyewear, and avoid direct sunlight).

Report black or tarry stools, fever, chills, unusual bleeding or bruising, shortness of breath or difficulty breathing, yellowing of skin or eyes, dark or bloody urine, or acute joint pain or other side effects you may experience.

    Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Oncologist before using this medicine.

    What are the uses of Methotrexate

    Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Oncologist before using this medicine.

    What are the contraindications of Methotrexate ?

    • 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.

    Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Oncologist before using this medicine.

    What are the side effects of Methotrexate ?

    Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Oncologist before using this medicine.

    Key highlights of Methotrexate

    • Is It safe with alcohol?

      Taking Methotrxate with alcohol increases the risk of liver damage.

    • Are there any pregnancy warnings?

      Rhutrax 7.5mg tablet is highly unsafe to use during pregnancy.
      Human and animal studies have shown significant adverse effects on the foetus. Please consult your doctor.

    • Are there any breast-feeding warnings?

      Rhutrax 7.5mg tablet is probably unsafe to use during breastfeeding. Please consult your doctor.

    • Is it safe to drive while on this medicine?

      There is no interaction between driving and consuming this drug. So dose alteration is not needed.

    • Does this affect kidney function?

      Caution to be advised in patients with impaired renal function.

    • Does this affect liver function?

      There is no data available. Please consult doctor before consuming the drug.

    Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Oncologist before using this medicine.

    What are the dosage instructions?

    • Missed Dose instructions

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

    • Are there any overdose instructions?

      Seek emergency medical treatment or contact the doctor in case of an overdose.

    Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Oncologist before using this medicine.

    Where is the Methotrexate approved?

    • India

    • United States

    • Japan

    Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Oncologist before using this medicine.

    Medicines containing Methotrexate

    Below is the list of medicines, which contains Methotrexate as ingredient

    Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Oncologist before using this medicine.

    How does this medication work?

    This medication belongs to the category of an antimetabolite which has immunosuppressant properties. It has an inhibiting effect on the enzyme tetrahydrofolate dehydrogenase which in turn prevents the synthesis of tetrahydrofolate, a compound necessary for the synthesis of thymidylate, an essential component of DNA.

      Information given here is based on the salt content of the medicine. Uses and effects of the medicine may vary from person to person. It is advisable to consult a Oncologist before using this medicine.

      What are the interactions of Methotrexate ?

      Whenever you take more than one medicine, or mix it with certain foods or beverages, you"re at risk of a drug interaction.

        test
      • Interaction with Alcohol

        Avoid its use.
      • Interaction with Medicine

        Decreased effect:
        • Corticosteroids: Reported to decrease uptake of MTX into leukemia cells. Administration of these drugs should be separated by 12 hours. Dexamethasone has been reported to not affect methotrexate influx into cells.
        • Decreases phenytoin, 5-FU.
        Increased toxicity:
        • Live virus vaccines vaccinia infections
        • Vincristine: Inhibits MTX efflux from the cell, leading to increased and prolonged MTX levels in the cell; the dose of VCR needed to produce this effect is not achieved clinically.
        • Organic acids: Salicylates, sulfonamides, probenecid, and high doses of penicillins compete with MTX for transport and reduce renal tubular secretion. Salicylates and sulfonamides may also displace MTX from plasma proteins, MTX levels.
        • Ara-C: Increases formation of the Ara-C nucleotide can occur when MTX precedes Ara-C, thus promoting the action of Ara-C.
        • Cyclosporine: CSA and MTX interfere with each others renal elimination, which may result in increased toxicity.
        • Nonsteroidal anti-inflammatory drugs (NSAIDs): Should not be used during moderate or high-dose methotrexate due to increased and prolonged methotrexate levels may increase toxicity.
        • Hepatotoxic agents (azathioprine, retinoids, sulfasalazine) may increase the risk of hepatotoxic reactions.
      • Interaction with Disease

        Contraindicated in the following case:
        • Hypersensitivity to Methotrexate or any component; severe renal or hepatic impairment; pre-existing profound bone marrow suppression in patients with psoriasis or rheumatoid arthritis, alcoholic liver disease, AIDS, pre-existing blood dyscrasias.
        • Because of the possibility of severe toxic reactions, fully inform patient of the risks involved. Do not use in women of childbearing age unless benefit outweighs risks; may cause hepatotoxicity, fibrosis, and cirrhosis, along with marked bone marrow depression. Death from intestinal perforation may occur. Risk of hepatotoxicity may be increased when administered with other hepatotoxic drugs (eg, azathioprine, retinoids, sulfasalazine).
        • Patients should receive 1-2 L of I.V. fluid prior to initiation of high-dose Methotrexate. Patients should receive sodium bicarbonate to alkalinize their urine during and after high-dose Methotrexate (urine SG <1.010 and pH >7 should be maintained for at least 24 hours after infusion).
        • Toxicity to Methotrexate or any immunosuppressive is increased in elderly; must monitor carefully. For rheumatoid arthritis and psoriasis, immunosuppressive therapy should only be used when disease is active and less toxic, traditional therapy is ineffective. Recommended doses should be reduced when initiating therapy in elderly due to possible decreased metabolism, reduced renal function, and presence of interacting diseases and drugs.
        • Methotrexate penetrates slowly into 3rd space fluids, such as pleural effusions or ascites, and exits slowly from these compartments (slower than from plasma).

      FAQs about Methotrexate

      • Ques : What is Methotrexate?

        Ans : Methotrexate is an antimetabolite. It is used in the treatment of chemotherapy and to bring under control rheumatoid arthritis. It functions by stopping the growth of cancerous cells, bone marrow cells and Skin cells..

      • Ques : What are the uses of Methotrexate?

        Ans : Methotrexate acid used for the treatment of different types of cancer.

      • Ques : What are the side effect of this Methotrexate?

        Ans : Side effects include abdominal pain, nausea, vomiting, hair loss, lightheadedness, darkening of the urine, reduced appetite, mouth ulcers, diarrhea, liver and kidney disorders, difficulty in breathing, cough, bleeding through the urinary tract.

      • Ques : How long do I need to use Methotrexate before I see improvement in my condition?

        Ans : This medication is to be taken till the time you see an improvement in your health conditions.

      • Ques : At what frequency do I need to use Methotrexate?

        Ans : This medication should be taken in the dosage as prescribed by the doctor.

      • Ques : Should I use Methotrexate empty stomach, before food or after food?

        Ans : This medication should be taken after food in a prescribed dosage.

      • Ques : What are the instructions for the storage and disposal of Methotrexate?

        Ans : This medication should be kept in a cool dry place and in its original packaging. Make sure this medication remains unreachable to children and pets.

      • Ques : How is this Methotrexate administered?

        Ans : This medication is administered Orally.

      References

      • Methotrexate-Drug Information Portal [Internet].druginfo.nlm.nih.gov 2022 [Cited 27 May 2022].Available from:

        https://druginfo.nlm.nih.gov/drugportal/name/methotrexate

      • Methotrexate-DrugBank Online [Internet].go.drugbank.com 2022 [Cited 27 May 2022].Available from:

        https://go.drugbank.com/drugs/DB00563

      • METHOTREXATE injection,solution-DailyMed [Internet].dailymed.nlm.nih.gov 2022 [Cited 27 May 2022].Available from:

        https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=METHOTREXATE

      Disclaimer : The information produced here is best of our knowledge and experience and we have tried our best to make it as accurate and up-to-date as possible, but we would like to request that it should not be treated as a substitute for professional advice, diagnosis or treatment.

      Lybrate is a medium to provide our audience with the common information on medicines and does not guarantee its accuracy or exhaustiveness. Even if there is no mention of a warning for any drug or combination, it never means that we are claiming that the drug or combination is safe for consumption without any proper consultation with an expert.

      Lybrate does not take responsibility for any aspect of medicines or treatments. If you have any doubts about your medication, we strongly recommend you to see a doctor immediately.
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      Written ByDrx Hina FirdousPhD (Pharmacology) Pursuing, M.Pharma (Pharmacology), B.Pharma - Certificate in Nutrition and Child CarePharmacology
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      Reviewed ByDr. Garima SharmaMBBS, Master in Healthcare Administration, Diploma in Occupational HealthGeneral Physician
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