Methotrexate: Uses, Dosage, Price, Side Effects, Precautions & More

Methotrexate: Uses, Dosage, Price, Side Effects, Precautions & More

What is Methotrexate?

  • Methotrexate belongs to group of drugs called as “immunosuppressants” commonly used for the treatment of autoimmune diseases like rheumatoid arthritis and cancer (anti-neoplastic).
  • Apart from immunosuppressive property, Methotrexate also has anti-inflammatory properties. Due to these properties, it is drug of choice for rheumatoid arthritis (RA) and juvenile RA.
  • Methotrexate is most commonly used in the prevention and treatment of the following conditions:
  • Rheumatoid arthritis
  • Psoriasis
  • Neoplastic diseases (cancer)
  • Inflammatory bowel disease
  • Polymyositis (muscle inflammation)
  • Lupus (SLE)
  • Methotrexate may also be used for purpose not mentioned above.

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How does Methotrexate work?

  • Methotrexate acts by inhibiting the enzyme dihydrofolate reductase which blocks the conversion of dihydro folic acid to tetrahydrofolic acid (important step in cell cycle).
  • Thus as a neoplastic drug, it slows the growth of cancer cells and prevents their rapid proliferation in the body.
  • It treats rheumatoid arthritis by decreasing the activity of immune system (anti-inflammatory action).

Methotrexate Price in India

SpecificsMethotrexate Price
50 mg Vial of 1 InjectionRs 74
Also Read: Loperamide Price

How to Take Methotrexate?

  • Methotrexate is available in tablet (2.5mg) and injection form (50mg/2ml).
  • When taken in oral form, it is advised to take this medicine empty stomach for better absorption. However if patients experience gastric side effects, it can be taken after meals.
  • When taken in tablet form, swallow the tablet as a whole with plenty of fluids. Do not chew, break, or crush the tablet.
  • Injection form can be given in patients where oral form is not absorbed properly and there are repeated nausea and vomiting.

Uses of Methotrexate

  • Always use Methotrexate in a dose and frequency as advised. Never use more than the recommended dose or for longer periods as it can lead to severe side effects including death.
  • In case of non improvement of symptoms or symptoms getting worse, seek medical attention immediately.
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Common Dosage & when to take Methotrexate?

  • The dose and frequency of Methotrexate intake depends upon the condition of the patient and initial response to the treatment.
  • Methotrexate is usually taken once in a week usually on the same day every week when used for rheumatoid arthritis.
  • Initial dose is usually smaller (5-10mg a week) which is gradually increased depending upon the response up to 30mg per week.
  • It may take 3-6 weeks to see the desirable results after orally administering methotrexate in rheumatoid arthritis patients.
  • Continue to take methotrexate even if you feel better. The treatment should be stopped only after talking to your doctor.
  • When used as a neoplastic agent, 15-30mg daily either oral or in injection form for a 5 day course. Such courses are repeated multiple times with rest period of one or more weeks in between the course.
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When to avoid Methotrexate?

Methotrexate should not be used or should be used with caution when:

  • Allergic to any of its components
  • People with liver or kidney problem
  • Pregnant and breast feeding females
  • Patients with suppressed immune system
  • Heavy drinkers
  • Blood disorders

Side effects of Methotrexate?

  • Methotrexate may produce multiple side effects, although they may not be common in all the patients. Commonly observed side effects:
  • Drowsiness
  • Dizziness
  • Headache
  • Hair loss
  • Decrease appetite
  • Nausea
  • Vomiting
  • Stomatitis (mouth ulcers)
  • Dryness of skin
  • Drop in number of WBC
  • Drop in number of platelets

Effects on organs?

  • Patients with liver and kidney disease should administer Methotrexate with caution and under the observation of a doctor.

Reported Allergic Reactions?

Tell your doctor if you are allergic to any of its ingredients.

Allergy with Methotrexate may exhibit following symptoms:

Rash

Chest tightness

Itching

Shortness of breath

Swelling of face, lips, tongue, or throat.

Drug Interactions to Be Careful About

  • Drug interactions refer to effect of drugs on each other and on human body following ingestion. Large numbers of medicine have shown interaction with each other.
  • It is advised that the patient must always inform the physician about all the medicines/over the counter products/vitamin supplements used.
  • Consult your doctor before administering any other drugs concomitantly with Methotrexate. All the possible drug interactions might not be listed here. Few important ones include:
  • Alcohol
  • Cisplatin
  • Azathioprine
  • Probenecid
  • Procarbazine
  • Omeprazole
  • Folic acid
  • Aminoglycosides

Shows Effects / Results In:

  • Methotrexate doesn’t work immediately after oral administration. It may take 4-6 weeks to relieve symptoms of joint pain whereas it may take few months for complete recovery.
  • Even if symptoms disappear, it should be taken until advised to stop by the doctor.

FAQ

Is Methotrexate Addictive?

  • No such tendency has been reported.

Can I have Methotrexate with alcohol?

  • Interaction of Methotrexate with alcohol may increase the risk of alcohol damage in patients. Liver cirrhosis has also been reported in heavy drinkers taking Methotrexate.

Any particular food item to be avoided?

  • No alteration in its action seen with any food product.

Can I have Methotrexate when Pregnant?

  • Methotrexate should never be taken during pregnancy as it may lead to foetal deformity or miscarriage.
  • Always inform your doctor if you are pregnant or plan to become pregnant before taking methotrexate.

Can I have Methotrexate when feeding a baby?

  • Methotrexate should not be used in breastfeeding women as the drug may pass into breast milk and lead to adverse effects in foetus.

Can I drive after taking Methotrexate?

  • Few patients on methotrexate might exhibit drowsiness, dizziness or vision problems. Such patients should use Methotrexate with caution while driving or operating heavy machinery.

What happens if I overdose on Methotrexate?

  • It should not be administered in more than prescribed dose or frequency.
  • Taking more medication or with increased frequency can cause serious toxicity (abnormal liver function test, abnormal pulmonary function test, liver cirrhosis)

What happens if I eat expired Methotrexate?

  • The medicine may not work as well as the potency of the medicines decreases and also it may lead to some adverse effects.
  • To be on the safer side, always check and never use an expired drug.

What happens if I miss a dose of Methotrexate?

  • The medicine may not work well if you miss a dose because for effective working of the drug, a certain amount of drug must be present in your body at all times.
  • Always consume the missed dose as soon as you remember. But, if it is already time for the next dose – do not double the dose.

Storage of Methotrexate

Storage at room temperature away from direct heat and light.

Keep medicines away from children and pets.

Pro Tips When Taking Methotrexate:

  • As methotrexate is an immunosuppressant and decreases body’s immunity, there are increased chances of developing some infections like herpres zoster (chicken pox).
  • Methrotrexate can affect blood cells and liver so constant monitoring of blood tests especially in the first few weeks should be done.
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