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Examples

How It Works

Why It Is Used

How Well It Works

Side Effects

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References

Methotrexate Examples Methotrexate Abitrexate Folex PFS Mexate-AQ MTX Rheumatrex Trexall How It Works

Methotrexate is a folic acid derivative and a folic acid antagonist. Methotrexate counteracts and competes with folic acid in cells. This blocks DNA synthesis and stops the growth of rapidly dividing cells, causing cell death.

Methotrexate may be given as an injection intravenously (IV) or intramuscularly (IM), or as a pill (orally).Why It Is Used

Methotrexate can be used to treat several conditions and diseases, including:

Cancer. Methotrexate slows or stops the growth of cancer cells in the body. It is frequently used in combination with other chemotherapy medications. Autoimmune diseases.

Rheumatoid arthritis. Methotrexate is the most common disease-modifying antirheumatic drug (DMARD) used to treat rheumatoid arthritis. Methotrexate may be used to prevent disease progression in the early stages of rheumatoid arthritis or in combination with other medications such as other DMARDs, nonsteroidal anti-inflammatory drugs, or corticosteroids.

Juvenile rheumatoid arthritis (JRA). Methotrexate is safe and effective for children with JRA. It is generally reserved for children who do not respond to nonsteroidal anti-inflammatory drugs. It is also used to treat resistant chronic uveitis in children with JRA.

Psoriasis. Methotrexate slows the rapid growth of skin cells in psoriasis.

Sjögren's syndrome. Methotrexate is generally reserved for people who do not respond to other medication for Sjögren's syndrome.

Ectopic pregnancy. Methotrexate is used with leucovorin to end an ectopic pregnancy or to prevent the growth of any fetal cells that are left behind after surgery to end an ectopic pregnancy. How Well It Works

Methotrexate is effective in the treatment of many conditions and diseases.

Cancer. Methotrexate is effective in the treatment of many forms of cancer. However, the type and extent of a cancer will determine the effectiveness of this drug in slowing or stopping the growth of cancer cells in the body. It is commonly used in combination with other chemotherapy medications. Autoimmune diseases

Rheumatoid arthritis. Methotrexate safely and effectively relieves joint pain and prevents disease progression and disability by delaying joint destruction. It is commonly used in combination with other disease-modifying antirheumatic drugs (DMARDs). Juvenile rheumatoid arthritis (JRA). Methotrexate safely and effectively relieves joint pain, prevents disease progression, and limits disability in children with JRA. Psoriasis. Methotrexate greatly improves or completely clears psoriasis in most people. Symptoms may not return for up to a few weeks to a year or longer. Sjögren's syndrome. Methotrexate decreases joint pain, muscle aches, parotid gland enlargement, dry cough, and bruising (purpura). It decreases the sensation of dry eyes and dry mouth.1, 2

Ectopic pregnancy. Methotrexate effectively terminates ectopic pregnancy in early pregnancy. It is not used to treat ruptured ectopic pregnancy. Side Effects

Side effects from methotrexate occur more frequently with long-term use. Common temporary side effects include:

Nausea, vomiting, and loss of appetite. Fatigue and sleep disturbances. Reduced white blood cell count.

Less common side effects include:

Sun sensitivity, easy sunburn. Diarrhea or blood in the stool. Mouth sores. Easy bruising and bleeding. Skin rash or sores. Headaches. Chills and fever. Lightheadedness.

Long-term side effects may include:

Liver inflammation or damage. The risk of liver damage is increased in people with diabetes, people with a history of liver disease, and those with a history of alcohol abuse. Inflammation of the lungs (pneumonitis).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)What To Think About

Methotrexate should be administered only under the supervision of a medical oncologist or a rheumatologist.

Methotrexate can cause birth defects. Do not use this drug if you are pregnant or wish to become pregnant or father a child while you are taking it.

The antibiotic combination trimethoprim and sulfamethoxazole, such as Septra or Bactrim, should not be used in combination with methotrexate, as this may increase blood levels of methotrexate.

Frequent monitoring for blood cell counts and liver enzymes is needed during methotrexate therapy.

Do not drink alcoholic beverages, including beer and wine, while you are being treated with methotrexate.

See a list of questions to ask your doctor about medications. References

Citations

Jonsson R, et al. (2001). Sjögren's syndrome. In WJ Koopman, ed., Arthritis and Allied Conditions: A Textbook of Rheumatology, 14th ed., chap. 85, pp. 1736–1759. Philadelphia: Lippincott and Wilkins. Fox RI (2000). Sjögren's syndrome: Current therapies remain inadequate for a common disease. Expert Opinion on Investigational Drugs, 9(9): 2007–2016. Credits

Author

Sydney Youngerman-Cole, RN, BSN, RNC

Editor

Van Houten, RN, BSN, MBA

Associate Editor

Lila Havens

Associate Editor

Landauer

Primary Medical Reviewer

Joy Melnikow, MD, MPH- Family Practice

Specialist Medical Reviewer

Jay R. , M.D.- Radiation Oncology

Last Updated

4/29/2003

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Last updated: April 29, 2003

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