Methotrexate (Methotrexate)
Overview of Methotrexate
Methotrexate is an analogue of folic acid and is a widely used antimetabolite anticancer drug, with a role in the treatment of both haematological malignancies perticularly leukaemias and solid tumours.Methotrexate is also used commonly as an immunosupressive agent in the treatment of a number of autoimmune and inflammartory disorders.
Indication of Methotrexate
Methotrexate is primarily indicated in conditions like Adjunct in epilepsy, Bone marrow transplantation, Breast cancer, Choriocarcinoma, Endometriosis, Gastric cancer, Graft rejection, Graft versus host disease, Granulomatous disease, Head and neck cancer, Juvenile rheumatoid arthritis, Leukaemia, Lymphocytic leukaemia, Lymphoma, Medulloblastoma, Mycoses, Non-hodgkin's lymphoma, Osteosarcoma, Ovarian cancer, Pityriasis, Premedication, Psoriasis, Rheumatoid arthritis, Status epilepticus; seizures in neurosurgery, Wegeners granulomatosis, and can also be given in adjunctive therapy as an alternative drug of choice in Crohn's disease, Dermatomyositis, Hydatidiform mole, Systemic lupus erythematosus.
Contraindication of Methotrexate
Methotrexate is contraindicated in conditions like Neutropenia,Ulcerative colitis,Thrombocytopenia,Renal failure,Bone marrow depression,Pulmonary disease.
Side Effects of Methotrexate
The severe or irreversible adverse effects of Methotrexate, which give rise to further complications include Hepatotoxicity, Coma, Seizures, Neurotoxicity, Hepatotoxicity, Eelvated hepatic enzymes, Chemical arachnoiditis, Motor paralysis of extremities, Cranial nerve palsy, Dementia, Dementia, Nuchal rigidity.,Methotrexate produces potentially life-threatening effects which include Myelosuppression, Nephrotoxicity, GI mucositis. which are responsible for the discontinuation of Methotrexate therapy.,The signs and symptoms that are produced after the acute overdosage of Methotrexate include Myelosuppression, Motor paralysis of extremities.,The symptomatic adverse reactions produced by Methotrexate are more or less tolerable and if they become severe, they can be treated symptomatically, these include Nausea, Vomiting, Fever, Erythema, Cough, Ocular irritation, Desquamation, Pneumonitis, Vasculitis, Pleuritis, Intestitial pulmonary infitterate.
Precautions of Methotrexate
Methotrexate should be used with caution in patients with history of kidney, liver, lungs or intestinal diseases, chickenpox (or recent exposure to it), alcohol use and of any allergy, especially drug allergies. As this may cause sensitivity to the effects of the sun, so avoid prolonged exposure to sunlight or sunlamps. Avoid touching eyes or inside nose without first washing hands to prevent eye infections. Do not have immunizations or vaccinations without consent of doctor and avoid contact with people who have recently received oral polio vaccine. Avoid alcohol use. Males should ensure that effective contraceptive measures are used during and for 3 months after methotrexate treatment. Methotrexate should not be used during pregnancy or lactation.