Methotrax
Generic Name
Methotrexate 10 mg Tablet
Manufacturer
Reputable Generic Pharmaceutical Company
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| methotrax 10 mg tablet | ৳ 15.00 | ৳ 150.00 |
Description
Overview of the medicine
Methotrexate is an antimetabolite and antifolate drug used in the treatment of various cancers, severe psoriasis, and severe rheumatoid arthritis. It works by interfering with the growth of certain cells in the body.
Uses & Indications
Dosage
Adults
Rheumatoid Arthritis/Psoriasis: Typically 7.5-20 mg orally once weekly. Cancer: Varies widely based on specific cancer type and treatment protocol, from low dose daily to high dose intravenous pulses.
Elderly
Use with caution due to potential decreased renal and hepatic function; lower doses may be required.
Renal_impairment
Significant dose reduction or discontinuation required due to impaired excretion and increased toxicity risk. Contraindicated in severe renal impairment.
How to Take
For rheumatoid arthritis and psoriasis, methotrexate is typically taken orally once weekly on a consistent day. For cancer, administration varies widely (oral, intravenous, intramuscular, intrathecal) based on protocol. Should be taken with caution and as directed by a physician.
Mechanism of Action
Methotrexate inhibits dihydrofolate reductase (DHFR), an enzyme that participates in the tetrahydrofolate synthesis. This prevents the formation of reduced folates, which are necessary for DNA synthesis, repair, and cellular replication. The cytotoxic effect is primarily due to inhibition of purine and pyrimidine synthesis, leading to cell death, particularly in rapidly dividing cells like cancer cells and immune cells.
Pharmacokinetics
Onset
For rheumatoid arthritis/psoriasis, clinical effects may take 3-6 weeks to manifest. For cancer, effects are often seen more rapidly.
Excretion
Primarily renal excretion (50-90% unchanged drug in urine). Some biliary excretion (up to 10%).
Half life
Low dose: 3-10 hours; High dose: 8-15 hours (prolonged in renal dysfunction).
Absorption
Oral absorption is dose-dependent, variable and saturable. Bioavailability ranges from 20-90%. Peak plasma concentrations are reached in 1-4 hours.
Metabolism
Limited hepatic metabolism to polyglutamates and 7-hydroxymethotrexate. Polyglutamates are retained in cells and contribute to efficacy and toxicity.
Side Effects
Contraindications
- Pregnancy and lactation
- Severe renal or hepatic impairment
- Pre-existing blood dyscrasias (e.g., severe anemia, leukopenia, thrombocytopenia)
- Active serious infection
- Immunodeficiency syndromes
- Alcoholism or chronic liver disease
Drug Interactions
Trimethoprim/Sulfamethoxazole
Increases risk of bone marrow suppression.
NSAIDs (e.g., Ibuprofen, Naproxen)
May reduce methotrexate clearance, leading to increased and prolonged methotrexate serum levels and increased toxicity.
Salicylates, Sulfonamides, Phenytoin
May displace methotrexate from plasma protein binding, increasing free methotrexate levels and toxicity.
Proton Pump Inhibitors (PPIs) (e.g., Omeprazole, Pantoprazole)
May reduce methotrexate clearance, especially at high methotrexate doses.
Storage
Store at room temperature (20-25°C), away from light and moisture. Keep out of reach of children.
Overdose
Overdose symptoms include severe bone marrow suppression (leukopenia, thrombocytopenia, anemia), mucositis, and gastrointestinal toxicity. The primary antidote for methotrexate overdose is Leucovorin (folinic acid) rescue, which should be administered as soon as possible.
Pregnancy & Lactation
Methotrexate is contraindicated in pregnancy due to severe teratogenic effects and risk of fetal death. Effective contraception must be used by both male and female patients during treatment and for a specified period after. It is also contraindicated during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date, check specific product packaging.
Availability
Available in pharmacies and hospitals worldwide
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Methotrexate is a very well-established drug with extensive clinical trial data supporting its efficacy and safety across various indications. Ongoing research continues to explore new uses, optimize dosing strategies, and investigate its role in combination therapies.
Lab Monitoring
- Complete Blood Count (CBC) with differential (before treatment, weekly/bi-weekly during initiation, then monthly)
- Liver Function Tests (LFTs) (before treatment, regularly)
- Renal Function Tests (RFTs) (before treatment, regularly)
- Serum Methotrexate levels (especially with high-dose therapy or impaired renal function)
- Chest X-ray (periodically or if pulmonary symptoms develop)
Doctor Notes
- Emphasize strict weekly dosing for inflammatory conditions; daily use for these indications is toxic.
- Ensure proper folic acid supplementation to mitigate side effects, but clarify timing relative to methotrexate dose.
- Monitor CBC, LFTs, and RFTs regularly as per guidelines. Be vigilant for signs of bone marrow, hepatic, or pulmonary toxicity.
- Counsel patients on avoiding alcohol and effective contraception. Address any potential drug interactions.
Patient Guidelines
- Take your methotrexate dose exactly as prescribed, typically once weekly on a specific day.
- Take folic acid/folinic acid as directed by your doctor; it helps reduce side effects.
- Avoid alcohol completely or limit it significantly, as it increases the risk of liver damage.
- Report any unusual symptoms like fever, persistent cough, severe mouth sores, or jaundice to your doctor immediately.
- Ensure you are using effective contraception if you are a woman of childbearing potential or a male patient whose partner could become pregnant.
Missed Dose Advice
If you miss a dose, take it as soon as you remember within 1-2 days of your usual dosing day. If it's much later than that, do not take the missed dose and consult your doctor for advice. Never double a dose to make up for a missed one, especially with weekly dosing.
Driving Precautions
Methotrexate may cause dizziness, fatigue, or blurred vision in some individuals. If you experience these effects, avoid driving or operating machinery until you know how the medication affects you.
Lifestyle Advice
- Protect yourself from excessive sun exposure, as methotrexate can increase photosensitivity. Use sunscreen and wear protective clothing.
- Maintain good oral hygiene to help prevent mouth sores. Use a soft toothbrush.
- Stay well-hydrated, especially if experiencing gastrointestinal side effects.
- Avoid close contact with people who have infections, as your immune system may be weakened.
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