Methotrexate is the generic form of medications such as Rheumatrex and Trexall. These medications target the cells in the body that reproduce rapidly like skin cells, cancer cells, and bone marrow cells. Methotrexate is commonly prescribed for patients who have been diagnosed with specific types of cancers, particularly lung, skin cancer of the head and neck, skin, or breast. Sometimes it is prescribed to help treat other diseases such as rheumatoid arthritis or very severe forms of psoriasis. Methotrexate is often prescribed when other medications have failed to provide the necessary relief or have not provided acceptable assistance in treatment.
Patients should always follow the exact dosing direction as prescribed by the physician. When patients take more medication than has been prescribed or take it longer than prescribed, they run a significant risk of methotrexate induced liver damage, kidney damage, immune system damage, or lung damage.
Methotrexate is not appropriate for every patient and it should never be prescribed without a thorough medical evaluation. Patients with a medical history of alcoholism, liver disease, cirrhosis of the liver, bone marrow disorders, blood cell disorders, or currently nursing an infant should not take methotrexate. Patients with a medical history which includes lung diseases, pneumonia, kidney disease, stomach ulcers, infections, or current radiation treatments may or may not be able to tolerate methotrexate. Careful monitoring for patients who can is required to be sure that the patient remains healthy.
Women who are pregnant, nursing, or who may become pregnant can not take methotrexate. The American Food and Drug Administration rated this medication as a pregnancy risk category X, which means that it is nearly guaranteed that this medication will cause birth defects or damage to a developing fetus or nursing baby. Men who are taking methotrexate can cause birth defects with a pregnant partner. Two forms of birth control are recommended regardless of which partner is taking the medications. Men should continue to use safe sex practices for at least 90 days after the conclusion of treatment with methotrexate.
In the event that a dose of methotrexate is missed, the patient should be advised to call the prescribing physician right away for personalized instructions on how to handle the missed dose.
Methotrexate should never be used in excess. Patients who overdose are likely to have fatal or near fatal reactions. If even a mild overdose is suspected, the patient requires immediate emergency medical care. An overdose may include symptoms such as mouth sores, vomiting, nausea, decrease or inability to urinate, unusual weakness, coughing up blood or vomiting coffee ground like material, black stool, bloody stool, come, seizures, and death.
Most patients will experience at least some side effects, although most will be common and fairly mild. All patients should report their symptoms to the prescribing physician. Mild side effects generally include things such as dizziness, fatigue, blurry vision, bleeding from the gums, nausea, vomiting, stomach discomfort, and headaches.
Some patients may experience severe side effects, which require immediate emergency medical attention. These side effects can be dangerous and indicate a more serious problem or be life threatening in themselves. Allergic reactions are likely to include swelling of the lips, mouth, tongue, or throat, hives, and difficulty breathing. Other serious side effects may include flu symptoms such as fever, chills, and body aches, bloody urine, bloody stools, inability to urinate or decreased urination, weakness with pale skin and easy bruising or bleeding, dry cough, shortness of breath, sore throat with a serious peeling and blistering red rash, diarrhea and vomiting often accompanied by white patches in the mouth, or nausea accompanied by low fever, loss of appetite, clay colored stools, dark urine, stomach discomfort, and jaundice.
Patients should never take any additional medications without first asking the prescribing physician, regardless of whether the medicine is over the counter or prescription. Vitamin supplements and herbal remedies can cause serious interactions as well. Medications with known interactions with methotrexate include NSAID pain relievers, penicillin based antibiotics, gold treatments, oral diabetes medication, injected insulin, steroids, sulfa drugs, theophylline, azathoiprine, chloramphenicol, hydroxychloroquine, retinol, tretinoin, phenytoin, probenecid, tetracycline, or salicylates.
Methotrexate has the following structural formula:
• Molecular formula of methotrexate is C20H22N8O5
• Chemical IUPAC Name is (2S)-2-[[4-[(2,4-diaminopteridin-6-yl)methyl-methyl-amino]benzoyl]amino]pentanedioicacid
• Molecular weight is 454.44 g/mol
• Methotrexate available : 10mg tablets
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