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Methotrexate (MTX,amethopterin) is anantimetabolite and antifolate medication, used to treat cancers and some autoimmunediseases. Sometimes, this drug is used to induct medical abortion. The mostcommon indication for methotrexate include: lymph, blood, bone, head, neck, andbreast cancers. This medication is also the treatment for uterus and some othertypes of cancers.

This drug works by inhibiting the metabolism of folic acid. Folicacid is necessary for the synthesis of thymidine, and thymidine is needed for DNAsynthesis. Methotrexate also inhibits the synthesis of purines and proteins. Cancercells can’t survive without these constituents and gets destroyed. Normal cellsin the body also get affected, causing some adverse effects.

Methotrexate is used to treat: Hodgkin’s lymphoma (lymphcancer), acute non-lymphocytic leukemia, cancer of the brain and meninges, softtissue, stomach, esophageal, pancreas, colon and rectum cancer. It is also usedin patients suffering from: bladder cancer, cancers of the ovaries or cervixand in men having penis cancer.

This drug is available only as the prescribed drug, as atablet, powder for solution, solution or injection.

Methotrexate injections should be used exactly as they wereprescribed by your doctor. Be careful, because overdose of this drug may causeside effects. Injections are usually administered once or two times every week.Methotrexate injections might be also used to treat rheumatoid arthritis or psoriasis,and in those cases doses can be lower than those used to treat cancerouschanges.

There are also methotrexate tablets, containing 2.5mg of theactive substance. Usual dosage for rheumatoid arthritis is one tablet every dayand the maximal dose is about 7 to 10mg.

Adverse Effects

Side effects include: nausea, vomiting, sometimes diarrheaor skin conditions (rash, acne, skin blisters, discoloration, photosensitivity)and blood problems, such as anemia or neutropenia. Some patients mightexperience blood vomiting when using methotrexate injections. Mouth and lips blisters,stomach ulcers, intestine blisters and stool changes are common in patients onmethotrexate therapy. Many people experience hair thinning and loss of hair. Prolongeduse of this antimetabolite may increase the risk of infections, especially pneumonia,nocardiosis and sepsis.

There is also a possibility that patients using methotrexatemight experience hepatitis or pulmonary fibrosis. If you develop any of thesesymptoms, especially dry cough (which indicates lung problems) you should consultyour doctor.


Metotrexate is labeled as pregnancy category X medication onthe FDA list. It means that pregnant women shouldn’t use this medication,since it is proven to be teratogenic for the unborn child. The same ruleapplies to the women that want to get pregnant and the breastfeeding mothers.

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