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- What is methotrexate, and how does it work (mechanism of action)?
- What brand names are available for methotrexate?
- Is methotrexate available as a generic drug?
- Do I need a prescription for methotrexate?
- What are the side effects of methotrexate?
- What is the dosage for methotrexate?
- Is methotrexate safe to take if I'm pregnant or breastfeeding?
- What else should I know about methotrexate?
What is methotrexate, and how does it work (mechanism of action)?
Methotrexate is classified as an antimetabolite drug which means it is capable of blocking the metabolism of cells. (Metabolism consists of the production and destruction of important components of the cell as well as the production of energy for use by the cell.) As a result of this effect, it has been found helpful in treating certain diseases associated with abnormally rapid cell growth, such as cancer of the breast and psoriasis. Recently, methotrexate has been shown to be effective in inducing miscarriage, for example in patients with ectopic pregnancy. This effect of methotrexate is attributed to its action of killing rapidly growing cells such as those of the placenta. It also has been found very helpful in treating rheumatoid arthritis, although its mechanism of action in this illness is not known. It seems to work, in part, by altering immunity which may play a role in causing rheumatoid arthritis. The FDA approved methotrexate in December 1953.
What are the side effects of methotrexate?
Methotrexate can cause severe toxicity which usually is related to the dose taken. The most frequent reactions include:
- mouth sores,
- stomach upset;
- low white blood counts;
- severe toxicity of the liver, kidneys and bone marrow, which require regular monitoring with blood tests;
Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment
What is the dosage for methotrexate?
Methotrexate may be taken with or without food. For rheumatoid arthritis and psoriasis, the dose of methotrexate is given weekly, by injection or orally. The oral dose is 7.5 to 20 mg once weekly. For psoriasis, the starting oral dose is a single 7.5 mg dose weekly or 2.5 mg every 12 hours for three doses, once weekly. The final dose ranges between 10 and 25 mg weekly orally or by injection.
Is methotrexate safe to take if I'm pregnant or breastfeeding?
Methotrexate should not be used in pregnancy, as it can be toxic to the embryo and can cause fetal defects and spontaneous abortion (miscarriage). It should be discontinued prior to conception if used in either partner. Male patients should stop taking methotrexate at least 3 months prior to a planned conception in order to avoid the theoretical risk of methotrexate-induced abnormal sperm. Women should discontinue use for at least one ovulatory cycle before conception to reduce exposure of a developing ovarian follicle to methotrexate.
Methotrexate is excreted in breast milk and should not be used by nursing mothers.
What else should I know about methotrexate?
What preparations of methotrexate are available?
Injectable: 25 mg/ml. Powder for injection: 1 g. Tablet: 2.5, 5, 7.5, 10 and 15 mg
How should I keep methotrexate stored?
Methotrexate should be stored at room temperature 15 C to 30 C (59 F to 86 F), avoiding light.
Methotrexate (Rheumatrex, Trexall) is a drug prescribed to treat cancer, psoriasis, inflammatory diseases of the skin, arthritis (rheumatoid arthritis in adults and children), psoriatic arthritis, polymyositis, lupus, and to induce miscarriage in women with ectopic pregnancies. Side effects drug interactions, dosage, and pregnancy safety information should be reviewed prior to taking this drug.
Multimedia: Slideshows, Images & Quizzes
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Treatment & Diagnosis
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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Ankylosing SpondylitisAnkylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited. Treatment incorporates medications, physical therapy, and exercise.
Bullous PemphigoidBullous pemphigoid is a skin disease that causes blistering eruptions on the skin's surface and sometimes affects the inner lining of the mouth. Symptoms include severe itching and burning sensations. Treatment involves topical cortisone and sometimes high doses of cortisone. Severe cases may require immune-suppression drugs such as azathioprine.
Crohn's DiseaseCrohn's disease is a chronic inflammatory disease, primarily involving the small and large intestine, but which can affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are common symptoms.
Eosinophilic FasciitisEosinophilic fasciitis is a skin disease that causes thickening and inflammation of the skin and fascia. Symptoms include redness, warmth, and hardening of the skin, as well as occasional tissue and joint pain. Treatment for eosinophilic fasciitis aims to eliminate inflammation through the use of aspirin, NSAIDs, and cortisone. Aggressive forms of eosinophilic fasciitis may require the use of immune-suppression medications.
Juvenile ArthritisJuvenile idiopathic arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are six types of JIA. Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Myasthenia GravisMyasthenia gravis, a chronic autoimmune neuromuscular disease. Varying degrees of weakness of the voluntary muscles of the body are the main characteristics. A defect in the transmission of nerve impulses ot the muscles is the cause of myasthenia gravis. Symptoms include weakness of th eye muscles, facial expression, and difficulty swallowing. Treatment of myasthenia gravis are medical therapies to control the symptoms of the disease.
Polymyalgia RheumaticaPolymyalgia rheumatica (PMR) is a disorder of the muscles and joints that causes pain and stiffness in the arms, neck, shoulders, and buttocks. Treatment for polymyalgia rheumatica aims to reduce inflammation with aspirin, ibuprofen, and low doses of cortisone medications.
PolymyositisPolymyositis is a disease of the muscle featuring inflammation of the muscle fibers. It results in weakness of the muscles which can be severe and when associated with skin rash, is referred to as dermatomyositis. Although the cause of this disease is unknown, diagnosis includes physical examination of muscle strength, blood tests for muscle enzymes, electrical tests of muscle and nerves, and conformation by a muscle biopsy. Treatment of polymyositis and dermatomyositis includes high doses of cortisone-related medications, immune suppression, and physical therapy.
PsoriasisPsoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales. There are several types of psoriasis, including psoriasis vulgaris, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Symptoms vary depending on the type of psoriasis the patient has. Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy. There is no cure for psoriasis.
Severe Psoriasis PicturesLearn about the common skin condition psoriasis. Explore about the different types of psoriasis such as vulgaris (plaque psoriasis), guttate psoriasis, and scalp psoriasis. Discover different psoriasis treatment options.
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