Methotrexate Usage, Side Effects and Dosage

Methotrexate is an antimetabolite and antifolate generic drug inhibits folic acid reductase, causing inhibition of DNA synthesis and of cellular replication. 

Usage of Methotrexate
Methotrexate is used to treat various clinical conditions ,including cancer and skin diseases.Cancers for which methotrexate is used include,
  • Choriocarcinoma (a type of uterine cancer)
  •  Acute lymphocytic leukemia
  •  Large cell lymphoma
  •  High grade lymphoma
  •  Head and neck cancers
  •  Breast cancers
  •  Bladder cancers
  •  Osteogenic Cancers
  • stomach cancers
And other conditions like,
  •  Inflammatory disease, 
  • rheumatoid arthritis, 
  • dermatological disorders(psoriasis), 
  • and to treat some gynecological conditions such as ectopic pregnancy, and for the induction of medical abortions.

Neotrexate-tablets-2.5mg from GlaxoSmithKline

Side Effects of Methotrexate
Common side effects are dizziness,hair loss, loss of appetite, nausea or vomiting, stomach upset.

Contact your doctor if your experiencing any of the following symptoms,
  • black, tarry stools and dark urine
  • blurred vision
  • chest pain
  • confusion , drowsiness and mood changes
  • cough or hoarseness
  • fever or chills
  • back pain
  • painful or difficult urination
  • pinpoint-sized red spots on skin
  • ringing in the ears
  • sensitivity to sunlight
  • shortness of breath
  • skin rash
  • sore eyes
  • stomach pain
  • unusual bleeding (e.g., vomiting blood, coughing up blood, blood in urine or stools) or bruising
  • yellow eyes or skin
Stop taking the medication and call your doctor immediately if any of the following  symptoms occur,
  • convulsions (seizures)
  • severe skin reaction (e.g., blistering or peeling skin)
  • symptoms of a severe allergic reaction (e.g., hives, difficulty breathing, swelling of the face, mouth, tongue, or throat)
Methotrexate can cause a decrease in the number of white blood cells, red blood cells, and platelets in  blood, especially when higher doses are used to treat cancer. This may increase  risk of bleeding or infections.

Dosage of methotrexate in different conditions


Cancer: The dose of methotrexate varies depending on the type of cancer and body weight or size. Methotexate available in injection and tablet forms.


Rheumatoid arthritis: The usual adult dose of methotrexate is 7.5 mg taken as one dose once weekly by mouth or 2.5 mg taken every 12 hours for 3 doses once weekly. Maximam dose should not exceed 20 mg weekly. The benefits of treatment usually appear about 3 to 6 weeks after starting the medication.

Psoriasis: The usual adult starting dose of methotrexate is 10 mg to 25 mg per week in one dose (tablet or injection) or 2.5 mg (tablet) taken every 12 hours for 3 doses once weekly. Maximum dose should be 30 mg weekly.

Children: Methotrexate has been used to treat cancer in children under the supervision of doctor.

FDA pregnancy of methotrexate
Methotrexate falls under the category of X.Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience.

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