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Methotrexate (MTX, amethopterin) is an antimetabolite and antifolate medication, used to treat cancers and some autoimmune diseases. Sometimes, this drug is used to induct medical abortion. The most common indication for methotrexate include: lymph, blood, bone, head, neck, and breast cancers. This medication is also the treatment for uterus and some other types of cancers.

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

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

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

Methotrexate injections should be used exactly as they were prescribed by your doctor. Be careful, because overdose of this drug may cause side 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 the active substance. Usual dosage for rheumatoid arthritis is one tablet every day and the maximal dose is about 7 to 10mg.

Adverse Effects

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

There is also a possibility that patients using methotrexate might experience hepatitis or pulmonary fibrosis. If you develop any of these symptoms, especially dry cough (which indicates lung problems) you should consult your doctor.


Metotrexate is labeled as pregnancy category X medication on the 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 rule applies to the women that want to get pregnant and the breastfeeding mothers.

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