METHOTREXATE

Product: 
METHOTREXATE
Formulary: 
Generic Formulary
Category: 
Neoplastics
Sub Group: 
ANTI NEOPLASTIC AGENTS
International Brand Name: 
Rheumatrex,Trexall TM
Dosages: 
1 gm/15 mg/50 mg/500 mg
Unit of Packing: 
Vial
In treatment of: 
Treatment of Burkitt's Lymphoma
Adverse Effects: 
1. Nausea 2. Vomiting 3. Difficulty in breathing 4. Closing of the throat 5. Bone marrow suppression 6. Bruising or unusual bleeding 7. Tarry stools 8. Fever 9. Chills 10. Congestive heart failure 11. Diarrhea 12. Loss of appetite 13. Facial flushing 14. Darkening of skin and nails 15. Alopecia 16. Red urine 17. Hepatotoxicity 18. Hyperurecemia 19. Pancreatitis 20. GI ulceration 21. Jaundice 22. Thrombocytopenia 23. Leucopenia 24. Arachnoiditis 25. Neurotoxicity 26. Necrotizing demyelinating leukoencephalopathy 27. Pharyngitis 28. Gingivitis
Contraiindication: 
1. Hypersensitivity to the drug 2. Haematological failure 3. Immunodeficiency 4. Treatment of rheumatoid arthritis or psoriasis 5. Blood dyscriasis 6. Liver disease 7. Abnormal liver function test 8. Renal failure
Special Precaution: 
1. Renal impairment 2. Hepatic impairment 3. Bone marrow depression 4. Ulcerative disorders of the GIT 5. CNS disturbances 6. Folate deficiency 7. Infection 8. Monitor patient`s haematological, hepatic and renal function regularly.
Interaction: 
Aminoglycosides: Decrease absorption and AUC of oral methotrexate. Charcoal: Decreases serum level of both oral and IV methotrexate. Etretinate: Hepatotoxicity. Folic acid or its derivatives: Decrease response to methotexate. NSAIDs: Increase plasma levels of methotrexate which may be fatal. Phenytoin: Serum concentation of phenytoin decreased. Probenecid, Salicylates & Sulfonamides (including Phenylbutazone, Tetracyclines, Chloramphenicol, PABA & TMP-SMZ): Increase in efficacy as well as toxic effects of methrotrexate. Procarbazine: Increases nephrotoxicity of methotrexate. Thiopurines: Increase AUC and plasma levels of thiopurines. Asparaginase: Reduces toxicity. Food: Reduction in plasma concentration of methotrexate.
Servings: 
Oral- Adult- For acute lymphoblastic leukemia: 15mg/metre square once or twice weekly For choriocarcinoma: 15 to 30 mg/day for 5 days at intervals of 1-2weeks, for 3-5 cycles For Burkitt`s lymphoma:10 to15 mg/day for 4-8 days, repeated after 7-10 days For mycosis fungoides:2.5 to 10mg/day For psoriasis: 10 to 25mg/day For rheumatoid arthritis:7.5mg weekly Intramuscular- For choriocarcinoma:15-30mg/metre square for 5 days at intervals of 1-2 weeks; 3-5 such cycle For Burkitt`s lymphoma:50mg as a single dose or in 2 divided doses weekly Intravenous- For adjunct treatment in osteocarcinoma:12mg/metre square for 4 hour For head and neck carcinoma: 40-60mg/metre square /week

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