Jonakayem Pharma Formulation (OPC) Pvt. Ltd.
METHOTREXATE

METHOTREXATE

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Sub Group Generic Formulary Brand Name Dosages Unit In treatment of Adverse Effects Contraiindication Special Precaution Interaction Servings

METHOTREXATE Rheumatrex,Trexall TM 1 gm/15 mg/50 mg/500 mg Vial Treatment of Burkitt's Lymphoma 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

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
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.
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 Phenaylbutazone, Tetracyclines, Chloaramphenicol, 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.
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