Drug title

Methotrexate

Application

Methotrexate affects the growth of certain cells, particularly of those, which multiply quickly, such as cancer cells, bone marrow cells and skin cells.

Methotrexate is prescribed to treat certain types of breast, skin, head, neck or lung cancer. Methotrexate is also used to treat severe psoriasis and rheumatoid arthritis.

Application method

Methotrexate can be taken by mouth with or without food to avoid an upset stomach.

Take it for the entire duration of treatment preferably at the same time everyday. Increase your fluid intake while taking Methotrexate.

It may be weeks before you start seeing the effect of the drug. Do not stop without consulting your doctor.

The best way to use the drug is as recommended by your doctor.

Mechanism of action

Methotrexate is an antimetabolite drug. It treats cancer and psoriasis by blocking an enzyme that is needed for cell growth, helping to retard the growth of cancer cells and abnormal skin cells. The exact principle of the drug’s effect is unknown. It reduces the symptoms of inflammation (for example, pain, swelling, stiffness) caused by rheumatoid arthritis.

Missed dose

If you miss a dose of Methotrexate then you may take it as soon as you remember and adjust the remaining doses accordingly. However, if it is nearly time for the next dose then you may skip this dose and continue with the regular dosage. Do not take a double dose to make up for the missed dose.

Keeping

Keep Methotrexate at temperature of 77 degrees Fahrenheit (25 degrees C). Long-term keeping at 59-86 degrees F (15 °C and 30 °C) is not allowed. It should be kept away from heat, moisture and light. Do not keep it in the bathroom. Keep Methotrexate in a place inaccessible for children and away from pets.

Overdose

Some of the typical symptoms of a Methotrexate overdose include bloody stools, severe nausea or vomiting.

Precautionary measures

Discuss with your doctor about any prior medical condition that you may have including allergies to medicines, food or other substances, if you are allergic to any ingredient in Methotrexate, if you have a history of lung problems, immune system problems, nervous system problems (eg, seizures), liver problems (eg, hepatitis), or blood problems (eg, anemia, low white blood cells, low blood platelets), have an active infection, severe vomiting or diarrhea, or dehydration, if you have mouth sores, excess fluid in your stomach or around your lungs, stomach or intestinal ulcers, bowel inflammation (eg, ulcerative colitis), or a blockage of your stomach or bowel, if you have a folic acid deficiency, are in very poor health, if you are receiving chemotherapy or radiation.

You must not take if you are allergic to any ingredient in it or you are treating psoriasis or rheumatoid arthritis, abuse alcohol or have liver or kidney problems, have an immunodeficiency syndrome (eg, AIDS), bone marrow problems, or blood problems (eg, anaemia, low white blood cell count, low platelet count) or you are taking aspirin.

If you are pregnant or suspect that you are, then stop using Methorexate and contact your doctor immediately. It is known to cause harm to the fetus.

Do not become pregnant while using Methotrexate. Use an alternate form of contraceptive if you are unsure about this.

Methotrexate is secreted in breast milk. Avoid breast feeding while using the drug.

Certain drugs can interact with and hence, mention clearly to your doctor or pharmacist all medicines, dietary supplements and herbal prescriptions that you are taking.

Nausea, vomiting, and loss of appetite are common with Methotrexate. Ask your doctor or pharmacist for ways to decrease these effects if they occur. If vomiting or diarrhea occurs, you will need to take care not to become dehydrated.

Methotrexate should not be used in children younger than 2 years of age as the safety and effectiveness of the drug have not been confirmed yet.

Ensure that you inform your doctor and your dentist about before receiving any form of medical treatment or dental treatment or emergency surgery.

Methotrexate may make you more sensitive to the sun so please avoid the sun, sunlamps or a tanning booth until you know how your body reacts to the drug. If you cannot avoid going out in the sun for a long while, then wear protective clothing or use a proper sunscreen.

Methotrexate reduces the number of blood clotting cells in your body so avoid getting injured or bruised. Tell your doctor if you have dark, tarry, or bloody stools. This might be a sign of internal bleeding.

Methotrexate also weakens your immune system. So avoid contact with people who have infections like cough, cold and sore throat.

Avoid taking live vaccines like measles, mumps.

Periodic lab tests may be recommended to monitor your health while taking the drug. Ensure that you do not miss any lab tests.

It has been noted that elderly patients are more sensitive to the side effects of the drug. They might need a dosage adjustment or special monitoring throughout the treatment.

Side effects

Consult your doctor if any of these most extensive side effects remain or become frequent:

• dizziness, headache, appetite loss, alopecia, nausea, stomachache or stomach upset, tiredness, vomiting.

Consult your doctor immediately if any of these serious side effects occur:

• Allergic reactions (rash, hives, heavy breathing, mouth, face, lips or tongue swelling), black, tar-like stool, urine blood, leg pain or or swelling, change of urine amount, chest pain, coma, mental confusion, emptysis, dark urine, diarrhea, difficult or painful urination, dry cough, fever, chills, sore throat, menstrual changes, mood changes, mouth sores, weakness, red or blistered skin, fits, severe or persistent nausea or vomiting, dyspnea, speech changes, unusual bleeding or bruising, unusual pain and skin discoloration, unusual tiredness, vision change or loss, skin or eyes yellowing.

Additional information

Methotrexate should be used only on prescription.