Methotrexate is a chemotherapy drug used to treat leukemia, lymphomas, and osteosarcoma. It is also used in the treatment of AIDS and rheumatoid arthritis, which is of interest because you can find information on this drug on the Web at sites relevant to these diseases as well as cancer sites.
Drug interactions
- Bactrim. Do not give methotrexate within 24 hours of a dose of this antibiotic (or probably any other; ask your doctor). Bactrim intensifies the effect of the methotrexate. (See the section on adverse reactions on the antibiotics page.)
- NSAIDs: nonsteroidal anti-inflammatory drugs. These over the counter anti-inflammatories prolong the levels of methotrexate in the blood. NSAIDs include aspirin, ibuprofen, acetaminophen, and naproxen.
- Cisplatin. Since this drug would be administered by your oncologist, they would be aware of methotrexate treatment at the same time.
- Vitamin C. Increases toxicity.
- Dilantin.
Side Effects Methotrexate
Common side effects.
- diarrhea
- skin and eye sensitivity to sunlight
- abnormal liver function tests
- hair loss
- immunosuppression
- skin rashes
- fatigue
- headache, backache, spinal cord irritation (when given IT)
Less common side effects:
- nausea, vomiting, loss of appetite, upset stomach, diarrhea
- mouth sores
- dizziness
- kidney damage
- headache, drowsiness, blurred vision
- liver damage (yellow skin and eyes)
- lung damage (dry cough)
- hair loss
- neurotoxicity which can cause learning disabilities
Possible signs of toxicity include:
- Severe vomiting, diarrhea, or mouth sores -- all of which may contribute to dehydration
- Signs of low white blood cells, such as frequent infections
- Signs of low blood platelets or anemia, such as easy bruising or bleeding
- Signs of liver fibrosis or cirrhosis (two types of liver damage), such as high liver enzymes or abnormal results from a liver biopsy
- A dry, nonproductive cough, which may be a sign of lung damage.
Methotrexate toxicity monitoring can be done by a regular blood test. These test can be performed in the oncology units. If the blood shows a high toxicity of methotrexate, then the treatment should be started immediately. Following are some of the treatment which may be performed by the doctor at the time of methotrexate toxicity.
- Active charcoal is given immediately if there is a case of overdose.
- Toxicity of methotrexate can be treated with urinary alkalinisation and adequate fluid, which should be given so as to prevent renal failure. The toxicity can be reduced to a large extent as it can be removed by urinating.
- Folic acid therapy are used in some cases which is said to be very effective.
- Folinic acid (leucovorin) can be given from the very first dose of the treatment as it removes the blockage present in the folic acid cycle. Hence, managing a proper functioning of immune system.
- Haemodialysis can also be performed in the case of renal or kidney failure. You can also scroll through methotrexate injection and methotrexate side effects for more info about them.
References: Biochemistry texts, Web sites (various).
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Unknown - Wednesday, 19 January 2011
