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Methotrexate is a prescription dihydrofolate reductase inhibitor used for selected cancers and inflammatory disorders. Current oral tablets contain 2.5 mg. U.S. labeling includes certain leukemias and lymphomas, rheumatoid arthritis in adults, polyarticular juvenile idiopathic arthritis in children, and severe psoriasis in adults. Dosing schedules differ substantially by condition.
read more about methotrexate ...Methotrexate inhibits dihydrofolate reductase, an enzyme involved in producing folate compounds needed for DNA synthesis. This interferes with the growth and division of susceptible cells. At lower doses used for inflammatory disorders, methotrexate also changes immune activity and inflammatory signaling through several biological pathways.
Current tablet labeling includes adults with rheumatoid arthritis or severe psoriasis and children with polyarticular juvenile idiopathic arthritis. Cancer indications include acute lymphoblastic leukemia in adults and children, mycosis fungoides in adults, and selected relapsed or refractory non-Hodgkin lymphomas in adults. Pregnancy is a contraindication when methotrexate is used for noncancer conditions.
Rheumatoid arthritis treatment starts at 7.5 mg by mouth once weekly. Polyarticular juvenile idiopathic arthritis starts at 10 mg per square meter once weekly, while severe psoriasis uses 10 mg to 25 mg once weekly. Cancer regimens differ and can involve once-weekly or more frequent dosing under specialist supervision. Folic acid or folinic acid supplementation is recommended for inflammatory indications. Taking a prescribed weekly dose every day can be fatal.
Methotrexate carries boxed warnings for embryo-fetal toxicity, severe hypersensitivity, serious or fatal adverse reactions, and medication errors. Toxicity can involve bone marrow suppression, severe infections, mouth and intestinal injury, liver damage, lung inflammation, kidney injury, and serious skin reactions. Blood counts, kidney function, and liver function are monitored during treatment.
Methotrexate treats selected cancers, rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, and severe psoriasis.
No. Current oral labeling directs once-weekly dosing for rheumatoid arthritis. Accidental daily administration has caused deaths.
The recommended oral starting dose is 7.5 mg once weekly.
Yes. The boxed warnings address fetal toxicity, hypersensitivity, severe adverse reactions, and potentially fatal dosing errors.
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