Methotrexate: An Essential Guide for Patients

Summary or Key Points

Methotrexate is a common medication prescribed for conditions such as Rheumatoid Arthritis, Psoriasis, and certain types of cancer. As with any drug, it’s vital to understand its uses, dosages, administration, and potential side effects. Always consult with your healthcare provider or a telemedicine professional before adjusting your dosage or if you have concerns about side effects.

Names of Medication

US Brand Name: Rheumatrex, Trexall (Methotrexate)

In simpler terms, a ‘generic name’ refers to the standard name of the drug, whereas the ‘brand name’ is the unique name given by the company that produces it. The generic name of this medication, Methotrexate, is listed in parentheses.

Pharmacologic Category

Methotrexate falls under the category of Antimetabolites, specifically Folic Acid Antagonists. Other medications in this category include Pemetrexed (Alimta) and Pralatrexate (Folotyn).

Dosing

Remember to consult your doctor or a telemedicine professional before starting or adjusting your dose. The typical dosing for Methotrexate varies according to the condition:

• Rheumatoid Arthritis: 7.5-20 mg per week, taken orally or by injection.
• Psoriasis: 10-25 mg per week, taken orally or by injection. Treatment usually continues as long as it is beneficial.
• Some Types of Cancer: Dosage and frequency vary depending on the type and stage of cancer. This is often given by injection.

Dosage Forms and Strengths

Methotrexate is available in the following forms and strengths:

• Tablets: 2.5 mg, 5 mg, 7.5 mg, 10 mg, and 15 mg.
• Injection solution: 7.5 mg/mL, 25 mg/mL, 50 mg/2 mL, and 1000 mg/10 mL.

Administration Instructions

Take Methotrexate exactly as directed by your healthcare provider. Do not adjust your dose without first consulting with your healthcare provider or a telemedicine professional.

Adverse Reactions and Side Effects

Methotrexate, like all medications, can have side effects. The frequency of these side effects varies. Some may be common while others are rare:

• Nausea and Vomiting: Common. You might feel sick or throw up. Taking the medication with food can help.
• Mouth Sores: Common. You might get painful spots in your mouth.
• Abdominal Pain: Common. You might experience discomfort in the stomach area.
• Hair Loss: Less common. You might notice your hair thinning.
• Liver Damage: Rare, but serious. Regular blood tests can help catch this early.

Contraindications

In medicine, a contraindication means a condition or factor that serves as a reason to withhold a certain medical treatment due to potential harm. Methotrexate should not be taken if:

• Pregnancy: Methotrexate can harm an unborn baby, causing birth defects or other complications.
• Breastfeeding: This medication can pass into breast milk and may harm the nursing infant.
• Liver Disease: Methotrexate can lead to liver damage, which may be exacerbated in those already suffering from liver disease.
• Alcoholism: Alcohol consumption increases the risk of liver damage associated with Methotrexate.

Drug to Drug Interactions

Certain medications may interact with Methotrexate, affecting its effectiveness and causing side effects. These include:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) such as Ibuprofen (Advil, Motrin).
• Antibiotics like Penicillin.
• Folic Acid Antagonists like Trimethoprim (Primsol).
• Proton Pump Inhibitors (PPIs) such as Omeprazole (Prilosec).

Methotrexate in Pregnancy

No, it is not safe to take Methotrexate when pregnant. This medication can harm an unborn baby, causing birth defects or other complications. Always consult your healthcare provider or a telemedicine professional if you are pregnant or planning to become pregnant.

Methotrexate while Breastfeeding

No, it is not safe to take Methotrexate while breastfeeding. This medication can pass into breast milk and may harm the nursing infant. Always consult with your healthcare provider or a telemedicine professional for safer alternatives.

Estimated Cost of Medication

The estimated cost of a 30-day supply of Methotrexate, without insurance but using a GoodRx coupon, is approximately $25-$75, depending on the dosage and pharmacy.

Possible Alternatives

Always consult your healthcare provider or a telemedicine professional before making any changes to your treatment plan. Potential alternative treatments for the following conditions include:

• Rheumatoid Arthritis: Physical therapy, NSAIDs, steroids, and alternative medications like Hydroxychloroquine (Plaquenil).
• Psoriasis: Topical treatments, light therapy, and newer medications like biologics.
• Some Types of Cancer: Other chemotherapy drugs, radiation therapy, and immunotherapy. Always consult with an oncologist for personalized treatment planning.

Recent Updates on Methotrexate Research

Recent research continues to explore the full potential of Methotrexate. Studies are ongoing to investigate its efficacy in treating other autoimmune diseases and its potential role in managing cardiovascular disease due to its anti-inflammatory properties. However, these findings are preliminary, and Methotrexate should only be used as directed by a healthcare provider or a telemedicine professional.

Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.