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Methotrexate (MXT) is an anticancer antimetabolite and antifolate agent for treating conditions related to abnormally rapid cell growth, including psoriasis, arthritis, cancer and autoimmune disorders. It can be used to terminate early pregnancies, including ectopic ones. The drug is available in oral tablets, which should be taken once weekly.
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What is Methotrexate?
Methotrexate, often abbreviated MTX, is an antifolate and anticancer antimetabolite agent. It comes as tablets, each containing various strengths of Methotrexate sodium as active ingredient. The agent is known to block metabolism of cells thus slowing down the growth of malignant cells and suppressing the immune system. Due to this effect, the drug is helpful in treating certain conditions associated with abnormally rapid cell growth, such as cancer of head, neck, breast, lungs or bladder as well as psoriasis and rheumatoid arthritis. It is also used for treating autoimmune disorders.

When is Methotrexate indicated?
Methotrexate is indicated for chemotherapy of neoplastic diseases, including gestational carcinoma, chorioadenoma destruens, hydatidiform mole, lymphoma, osteosarcoma, leukemia, trophoblastic neoplasms. It can be used alone or with other anticancer agents to treat breast cancer and epidermoid cancers of head and neck, and cancer of lungs, particularly small cell and squamous cell types. It is also prescribed for the treatment of severe autoimmune disorders, including psoriasis, rheumatoid arthritis, juvenile arthritis, lupus, eczema, sarcoidosis and vasculitis. It is used to induce miscarriage, including in women with ectopic pregnancies.

How to take Methotrexate?
Methotrexate tablets are taken by mouth without regard to food. Since the drug is very strong, doses must be calculated by the doctor and should be taken once weekly to limit toxicity. Rheumatoid arthritis and adult psoriasis is treated with 7.5 mg q.w. as a single dose or 2.5 mg q12h, i.e. in 3 divided doses taken as a course q.w. The starting dose for juvenile arthritis is 10 mg q.w. For treating cancer the dose is patient-specific and depends on age, weight and type of cancer. It is also prescribed once weekly as a single dose or as a 5-day course with at least week-long intervals between therapies.

When is Methotrexate contraindicated?
Methotrexate is contraindicated to pregnant or nursing women and people with alcoholism, chronic liver disease and immunodeficiency syndromes.

What are Methotrexate side effects?
Methotrexate toxicity is dose-dependent. The drug may cause low white blood cell count, stomach upset, dizziness, fatigue, headache, mouth sores, hair loss, liver damage and kidney failure. Regular monitoring with blood tests is required.