Methotrexate is a cytotoxic drug that belongs to the group of folic acid antagonists. Even in small doses leads to an immunosuppressive effect. It was first obtained in 1940.Currently used as a remedy to suppress immunity.
Composition, Form and Conditions of Storage
Methotrexate is available in tablets or as an injection solution for intravenous or intramuscular administration.
Photo Methotrexate in ampoules
The medicine should be stored in places where children can not reach it. Mandatory compliance with the temperature regime from 15 to 20 degrees. It is released on the prescription.
Manufacturers of
Produced by various manufacturers. Differences are mainly related to fillers and stabilizers.
Doctors say that this does not affect the efficiency, but the side effects on the components can be different.
- In Austria, the release is arranged in Ebewe Pharma. Supplied in tablets, ampoules and concentrate in vials with different active ingredient values.
- In Germany, Medac GmbH produces a ready-made solution for injections, packed in disposable syringes.
- In Russia, is produced by several companies: "Valenta Pharmaceuticals", "Ozone".
Indications for use
Methotrexate is effective in the treatment of:
- acute lymphoblastic leukemia,
- trophoblastic tumors,
- mushroom mycosis,
- rheumatoid arthritis,
- psoriasis.
The effectiveness of cancer of the renal pelvis and ureter, of the lung, of the mammary gland, as well as of aplastic anemia, has been proven.
Contraindications
You can not take the drug during pregnancy, severe changes in the kidneys, liver, bone marrow hypoplasia.
Because the drug depresses immunity, it is not prescribed in the period of acute infectious diseases, as well as with immunodeficiency syndrome. With caution in ulcer diseases, gout and dehydration.
Special attention should also be given to people who have previously undergone radiation therapy or chemotherapy.
Mechanism of action
An antineoplastic drug stimulates the formation of dihydrofolate reductase, which plays a significant role in the reduction of dihydrofolic acid to tetrahydrofolate. This leads to processes of inhibition of synthesis and DNA repair.
Mechanism of action Methotrexate is associated with:
- Suppression of LTB formation.
- Reduced synthesis of IL-1.
- Suppression of the activity of proteolytic enzymes in the joints.
- Suppression of mononuclear cells and the synthesis of antibodies.
Instructions for use Metabrexate Ebeve and Teva: dosage
The drug is taken orally or injected intramuscularly. To reduce toxicity in the first case, the drug is applied weekly. The dose is calculated depending on the weight of the patient or body surface area.
Injection of
Methotrexate-Ebwee is administered: in / m, in / in, in / a.
- With trophoblastic tumors of 15-30 mg for five days. The interval is about one week. Another scheme can be prescribed, when the dose increases, and the interval is about a month.
- When leukemia is prescribed up to 5000 mg / square meter.m. It is administered by infusion once every 2-4 weeks.
- When treating children, age is taken into account. Up to 1 year 6 mg, 12 months - 8 mg, children over 3 years - 12 mg.
Before administration, it may be necessary to remove the cerebrospinal fluid to the extent that the medication is administered.
Tablets
The scheme of reception depends on individual indications.
- With leukemia as part of complex therapy of 33 mg / square.m in combination with prednisolone. After the onset of positive dynamics of 15 mg / square.m. once a week or 2.5 mg / kg every two weeks.
- For trophoblastic tumors 15-30 mg every day for five days. The course is repeated 3 to 5 times.
- In rheumatoid arthritis , 7.5 mg once a week is initially taken. The dose can be assigned at one time or divided into three with a difference of 12 hours. With juvenile chronic arthritis for children per week, the dose can reach up to 1 mg / kg.
- With psoriasis , the dose is gradually increased when the effect is achieved, it begins to decrease. With mushroom mycosis prescribed 25 mg twice a week. If you cancel, the patient's reaction and blood counts are taken into account.
Side effects of
The severity of side effects from taking Methotrexate in all people is different.
- On the part of the digestive system , it is possible to develop ulcerative stomatitis, anorexia, pharyngitis. In rare cases, diarrhea or pancreatitis develops. In exceptional situations, cirrhosis and liver necrosis are possible.
- Patients often note the appearance of a feeling of fatigue , sometimes there are headaches, drowsiness, convulsions.
- On the part of the reproductive system there is a violation of the menstrual cycle, a decrease in libido, the development of impotence.
- Other allergic and dermatological reactions may appear: chills, skin rash, furunculosis, pigmentation disorder.
Severity of complications depends on many circumstances, including the severity of the ailment.
Special instructions
The injection agent in the form of a powder can not be injected intrathecally due to the presence of a preservative.
Pregnancy should also be avoided during and after treatment.
Men should not do this within three months after the end of treatment, women - at least one ovulation cycle.after the treatment is recommended to use calcium folio to reduce the toxic manifestations.
Drug Interaction
Methotrexate action is enhanced, and its action is prolonged with simultaneous use of NSAIDs, barbiturates, corticosteroids, tetracycline and some other drugs.
Folic acid gives the opposite effect, reducing the effectiveness of the drug.
Many enteric antibiotics affect the enterohepatic circulation due to the suppression of bacterial metabolism.
Penicillin group drugs reduce renal clearance.
With concomitant therapy with medications that affect the bone marrow, the development of more severe hematologic disorders is often noted.
Reviews about the drug Methotrexate
Many people note that the remedy is 100% effective, many do without the development of side effects.
People note that despite the cumulative effect, pains quickly disappear, edema in the joints, but because of the suppression of immunity, the body does not resist the catarrhal and viral infections, leads to inflammatory diseases.
At long receptions at some citizens nausea, headaches, chills are noted. In children there is a violation in the growth of teeth.
How much does the drug cost?
The prices for Methotrexate are different, the most expensive will be a syringe for injections of German origin.
Analogues
If necessary, the doctor can replace Methotrexate with one of the following medicines:
- Zexate;
- Method;
- Emtexate;
- Treksan;
- Evetrex.
Answers to Frequently Asked Questions
- Methotrexate is a chemotherapy?
Yes, it was originally created as a method of chemotherapy. It is used alone or in combination with other agents. Effective in the treatment of cancer, autoimmune diseases, is an abortifacient.
- Methotrexate or Method, what is better?
Applied in different doses, but the method is considered a more expensive analog. The indications or side effects are the same, since the active ingredient is methotrexate in both drugs. However, Methodic in the form of tablets does not happen.
- Sulfasalazine or Methotrexate, which is better?
It is believed that Metrotresat treatment gives a more lasting result. However, sulfasalazine causes side effects less often than the analogue. Both drugs are designed for a long period of treatment, which would allow them to accumulate in the body. Is methotrexate hormonal or not?
No, this is not a hormonal drug, but some actions are similar to the action of glucocorticosteroids.
- Methotrexate: which manufacturer is better?
It is believed that imported drugs are better tolerated, but there is no official evidence for this.
- Methotrexate and alcohol.
Doctors do not recommend combining these two ingredients, because the load on the liver increases several times. The consequence is an increased risk of side effects. The consequences of such a violation are unpredictable, up to a lethal outcome.
- Pregnancy after Methotrexate.
It is not recommended for women to become pregnant during one menstrual period after the end of treatment. Men should abstain from conception for at least three months.
- Is it possible to prick methotrexate for a cold?
In viral and bacterial infections, doctors usually take a break during treatment with this drug. In some cases, treatment is not canceled.
Video about the brief information about Methotrexate Ebove: