METHOTREXATE

Generic Name : METHOTREXATE

TradeName : ALLTREX tab ALLTREX vial BIOTREXATE tab BIOTREXATE vial CARDITREX inj CARDITREX tab DERMATREX tab FOLITRAX amp FOLITRAX tab HI-TREX tab IMUTREX inj IMUTREX tab MEREX vial METHOCIP INJ inj METHOREX tab METHOREX vial METOREX INJ. vial METREX tab METREX vial MEXATE tab MEXATE vial NEOTREXATE tab ONCOTREX inj ONCOTREX tab ONOTREX inj ONOTREX tab PLASTOMET tab PLASTOMET vial REMTREX tab REMTREX vial REXTOP GEL gel TEVATREX inj TREX inj TREX tab TRIXILEM tab UNITREXATE vial VIBZI tab ZEXATE inj ZEXATE tab ZEXATE VIAL via

Why it is prescribed (Indications) : This medication is prescribed for certain types of cancer (gestational choriocarcinoma, chorioadenoma destruens, hydatidiform mole; treatment and prophylaxis of acute (meningeal) lymphocytic leukemia; treatment of breast cancer, epidermoid cancers of head and neck, advanced mycosis fungoides, and lung cancer; in combination therapy in advanced-stage non-Hodgkin lymphoma; as adjunct in high doses followed by leucovorin rescue in nonmetastatic osteosarcoma), severe psoriasis, or rheumatoid arthritis (RA) in certain patients. It may be used alone or with other medicines. In cancer treatment, it stops the multiplication of cancer cells, in RA, it suppresses excessive activity of immune system and so reducing inflammation, in psoriasis, it prevents the excessive division and multiplication of skin cells that causes skin scaling and raised plaques.

When it is not to be taken (Contraindications) : In nursing mothers. In patients with psoriasis or rheumatoid arthritis, methotrexate is contraindicated in pregnancy, alcoholism, alcoholic liver disease, chronic liver disease, overt or laboratory evidence of immunodeficiency syndrome, and preexisting blood dyscrasias (eg, low white blood cells, platelets); hypersensitivity to the drug.

When it is to be taken : Oral Burkitt's lymphoma 10-25 mg/day for 4-8 days, repeat after 7-10 days. Oral & IMChoriocarcinoma(Ectopic Pregnancy) 15-30 mg/day for 5 days, repeat after an interval of at least 1 wk for 3-5 courses. Mycosis fungoides 2.5-10 mg/day to induce remission. Rheumatoid arthritis 7.5 mg once wkly, adjust if needed. Up to 20 mg/wk. Crohn's disease 12.5-22.5 mg once wkly for up to 1 yr. PO/IV/IM Psoriasis 10-25 mg once wkly, adjust subsequent doses if needed. IV Osteosarcoma 12-15 g/m2 as infusion, followed by folinic acid. Breast cancer 10-60 mg/m2 often w/ cyclophosphamide and fluorouracil. Advanced lymphosarcoma Up to 30 mg/kg, followed by folinic acid rescue. Acute lymphoblastic leukaemia Maintenance: 2.5 mg/kg every 14 days.

How it should be taken : It comes as a tablet to take by mouth, and injection for IM, with or without food.

Special Instruction :
Caution should be exercised in patients with liver or kidney problems, blood disorders, diarrhea, and stomach problems. If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. It may cause liver or kidney impairment, bone marrow depression, ulcerative disorders of the GI tract. Avoid become pregnant while taking this medication. Monitor hematological, renal and hepatic function and GI toxicity regularly. Avoid drinking alcohol while you are taking this medication.

Side Effects :
CENTRAL NERVOUS SYSTEM
Dizziness, fatigue; headache; language disorder; weakness; paresis; convulsions; destruction of the myelin sheaths (IV after cranio spinal irradiation); inflammation of the arachnoid (a covering of the brain); transient paresis; nerve damage. SKIN
Redness of the skin, rashes, itching, loss of hair, hives, photosensitivity; pigmentary changes; skin discoloration; dilatation of blood vessels; acne; furunculosis; aggravation of psoriasis by ultraviolet light; severe allergic reactions.
EYE AND ENT
Blurred vision, inflammation of the gums, inflammation of pharynx.
GI
Nausea, vomiting; enteritis, mouth ulcer, diarrhea; abdominal distress (common); loss of appetite; blood in vomit, blood in stool, GI ulceration and bleeding.
GENITOURINARY
Renal failure; blood contains excess amount nitrogen, inflammation of the urinary bladder; blood in urine; severe kidney disease; reproductive disorders; infertility; abortion; fetal defects.
BLOOD
Deficiency of all three blood cell types, bone marrow depression, anemia, bleeding, presence of bacteria in the blood (septicemia).
LIVER
Elevated LFTs (liver function test); liver damage.
RESPIRATORb
Deaths from interstitial pneumonia; chronic interstitial obstructive lung disease.
MISCELLANEOUS
Malaise; chills, fever, lower resistance to infections, joint pain, muscle pain, diabetes, osteoporosis, allergic reactions, sudden death.

Other Precautions :
Do not take medicines containing aspirin, ibuprofen or folic acid while taking this medication.

Storage Conditions :
Store intact vials at room temperature (15-25°C). Keep this medication in airtight container.