Methotrexate
Uses of Methotrexate
Methotrexate is commonly used to treat Blood Cancer, Breast Cancer, Head And Neck Cancer, Lung Cancer, Non Hodgkin Lymphoma Nhl, Psoriasis, Rheumatoid Arthritis, Choriocarcinoma, Mycosis Fungoides, Crohn's Disease, Osteosarcoma
How Methotrexate Works
Methotrexate which is a folic acid antagonist works by inhibiting the enzymes responsible for the building blocks of DNA hence blocking the DNA synthesis.
Side Effects of Methotrexate
Mouth ulcer, Skin rash, Balding of the head, Joint pain, Anaemia, Nausea, Vomiting, Fatigue, Dizziness
Warnings
Kidney High Risk
Dosage adjustment is needed for patients with mild to moderate renal impairment and is contraindicated for patients with severe renal impairment.
Alcohol Not Advisable
Consumption of alcohol with Methotrexate may potentiates the hepatotoxicity of the latter.
Pregnancy Not Safe - High Risk
Methotrexate is strictly contraindicated for a pregnant woman. Effective contraception is advisable in child-bearing age woman if the treatment is started.
Driving Not advisable
It is not advisable to drive when under Methotrexate treatment due to its potential side effects such as fatigue and dizziness which can affect the ability to concentrate and drive.
Liver Use With Care
Dosage adjustment is needed for patients with hepatic impairment based on their bilirubin value. It is contraindicated to be used if the bilirubin value is more than 5mg/dL.
Lactation Not Advisable
Methotrexate is present in human breastmilk and because of the potential toxicity towards the nursing infants, it is contraindicated to be used during breastfeeding.
Written by Dr Sri Viknarajan, MD (Universiti Hasanuddin, Indonesia)
Reviewed by Dr Nur Syuhada binti Zulkifli, MD, Universiti Kebangsaan Malaysia (UKM).
