Methotrexate is a Medicine belongs to Antineoplastic group whose information about Brand can be referenced from   Book : Martindale    Page : 829   Edition : 38  

  ►   Brandname : Biotrexate, Caditrex, Imutrex, Methocip, Neotrexate, Rheumatrex, Trexall
  ►  Strength : Tablet with 2.5 mg.  Tablet with 5 mg.  Tablet with 7.5 mg.  Tablet with 10 mg.  Tablet with 15 mg.  Injection with

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 656   Edition : 12   Martindale    Page : 829   Edition : 38  
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : Oral, IV, IM, SC, intrathecal
Reference :-   Book : Martindale    Page : 823   Edition : 38  

Dosing of Medicine differ in Adult & Pediatrics ↓

Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 Rheumatoid arthiritis Oral 7.5 mg Tablet Given as a single Oral, S.C, I.M or I.V dose, or as 2.5 mg orally every 12 hours for 3 doses, adjusted according to response to a usual maximum of 20 mg weekly.
2 Acute lymphoblastic leukaemia oral / i.m 15 mg/m2 tablet / injection Twice weekly.
3 Acute lymphoblastic leukaemia IM 20 30 mg/m2 Injection Twice weekly.
4 Acute lymphoblastic leukaemia Oral 20 30 mg/m2 Tablet Twice weekly.
5 Acute lymphoblastic leukaemia IV 2.5 mg/kg Injection Every 14 days.
6 Meningeal leukemia intrathecal 12 mg/m2 Injection QWK For 2 weeks; then once monthly.
7 Meningeal leukemia intrathecal 200 500 micrograms/kg Injection 2 to 5 days.
8 Meningeal leukemia intrathecal 12 mg Injection QWK
9 Burkitt’s lymphoma Oral 10 25 mg Tablet Daily for 4 to 8 days.
10 Burkitt’s lymphoma Oral 0.625 2.5 mg/kg Tablet Daily.
11 Lymphosarcoma IM or IV 0.625 2.5 mg/kg Injection Daily.
12 Choriocarcinoma Oral 15 30 mg Tablet Daily for 5 days, repeated after an interval of 1 week or longer, for 3 to 5 courses.
13 Osteosarcoma IV 8 12 gm/m2 Injection QWK
14 Breast cancer IV 40 mg/m2 Injection Days 1 and 8.
15 Breast cancer IV 10 60 mg/m2 Injection
16 Mycosis fungoides Oral 2.5 10 mg Tablet Daily for weeks or months.
17 Psoriasis IM or IV 10 25 mg Injection QWK
18 Psoriasis Oral 7.5 20 mg Tablet (Increased as needed to a maximum of 25 to 30 mg ) orally weekly, given as 3 divided doses over 24 hours, or as 3 divided dose at 12 hour intervals.or as 4 divided doses at 8- hour intervals; some suggest a test dose of 2.5 to 5 mg.
19 Psoriasis Oral 2 5 mg Tablet Daily for 5 days; followed by an interval of at least 2 days.
20 Rheumatoid arthiritis s.c, i.v, i.m 7.5 mg Injection Weekly.
21 Mycosis fungoides IM 50 mg Injection Weekly, as a single dose or in 2 divided doses.

Ref :-  Book : Martindale    Page : 823   Edition : 38   Martindale    Page : 822   Edition : 38  

Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1 juvenile rheumatoid arthritis Oral 10 mg/m2 Tablet QWK
2 Psoriasis 2 Year 18 Year Oral 200 micrograms/kg Tablet QWK
3 Non Hodgkin’s lymphoma IV Injection
4 Polyarticular juvenile idiopathic arthritis 3 Year 16 Year s.c/ i.m 10 15 mg/m2 Injection
5 Juvenile idiopathic arthritis, juvenile dermatomyositis, vasculitis, uveitis, SLE, localized scleroderma and sarcoidosis 1 Month 18 Year s.c/ i.m 10 15 mg/m2 Injection

Ref :- Book : Martindale    Page : 823   Edition : 38  
Precaution :- If a Patient is using 'Methotrexate' drug in  MEGALOBLASTIC ANEMIAS  disease, then Please Do not use .

Precaution :- If a Patient is using 'Methotrexate' drug in  rheumatoid arthritis  disease, then Please always be given with folic acid .

Precaution :- If a Patient is using 'Methotrexate' drug in  acute kidney injury   disease, then Please be used with caution .

Precaution :- If a Patient is using 'Methotrexate' drug in  OSTEOSARCOMA  disease, then Please Contraindication : Pregnancy. .

►  Side Effect : Bone-marrow depression can occur abruptly, and leucopenia, thrombocytopenia, and anaemia, Ulceration of the mouth and gastrointestinal disturbances are also early signs of toxicity: stomatitis and diarrhoea, Haemorrhagic enteritis, intestinal perforation, and death, Liver damage, both acute (notably after high doses) and, more seriously, chronic (generally after long-term use). Hepatic fibrosis and cirrhosis may develop without obvious signs of hepatotoxicity, and have led to eventual death., Renal failure and tubular necrosis after high doses, pulmonary reactions including life-threatening interstitial lung disease, skin reactions (sometimes severe), alopecia, and ocular irritation. Neurotoxicity, Leukoencephalopathy, paresis, demyelination, Cranial irradiation, Arachnoiditis, an acute syndrome of headache, nuchal rigidity, back pain, and fever., , Defective oogenesis and spermatogenesis, and fertility may be impaired, teratogenic, Lymphomas (generally reversible on withdrawal of treatment)
Ref :-   Book : Martindale    Page : 825   Edition : 38.  

►  Drug Interaction : Drug interaction of Methotrexate is with Non Sterodial Anti- Inflammatory Drugs , Salicylates, PENICILLINS , , , ,  Probenecid , Folic acid
Ref :-   Book : Martindale    Page : 827   Edition : 38.  

  ►    Mechanism of Drug Drug Interaction :  The effects of methotrexate may be enhanced by drugs that decrease its renal excretion, such as NSAIDs and salicylates, probenecid, and some penicillins. Fatal toxicity has occurred in patients given NSAIDs with methotrexate. Severe toxicity has occurred rarely when co-trimoxazole or trimethoprim was given with methotrexate. Use with other myelotoxic, hepatotoxic, or nephrotoxic agents may increase the risk of toxicity. Folic acid and its derivatives may decrease the effectiveness of methotrexate, although they are often used together to reduce methotrexate toxicity.
Ref :-   Book : Martindale    Page : 827   Edition : 38.  

►  Contraindication : Ulcerative disorders of the gastrointestinal tract, and in the elderly and the very young., Methotrexate-induced lung disease is suspected corticosteroid therapy may be started and further treatment with methotrexate should not be given, rheumatoid arthritis, Psoriasis in patients with alcoholism, liver disease or persistent abnormal liver function tests, or in those with significant renal impairment, immunodeficiency, or blood disorders., Pregnancy
Ref :-   Book : Martindale    Page : 827   Edition : 38.  
  ►  Mechanism of Action :   Methotrexate is an antineoplastic that acts as an antimetabolite of folic acid. It also has immunosuppressant properties. Within the cell, folic acid is reduced to dihydrofolic and then tetrahydrofolic acid. Methotrexate competitively inhibits the enzyme dihydrofolate reductase and prevents the formation of tetrahydrofolate which is necessary for purine and pyrimidine synthesis and consequently the formation of DNA and RNA. It is most active against cells in the S phase of the cell cycle
Ref :-   Book : Martindale    Page : 822   Edition : 38.  

Pathway of DIETARY Product

​   ► Act.Comp / Nutrient / Food / Herb as follows :- Vinca with Another pathwayAnother pathway.   Vinca with Another pathwayAnother pathway.   Angeer with Another pathway.  

  ►  Pathway with its reference as follows :-
  • 6-o-acyl-beta-d-glucosyl-beta-sitosterols.found in fig or anjeer have anticancer property. --- (Joseph, Baby. "Pharmacognostic And Phytochemical Properties Of Ficus Carica Linn –An Overview". International Journal of PharmTech Research 3.1 (2017): 08-12,. Print. )
  • Vincristine arrests multiplication of cancerous cells by breaking down the microtubules into smaller subunits, thus inhibiting the cell division. --- (Kokate, C. (2013). Pharmacognosy (4th ed.). Pune: Nirali Prakashan. )
  • Vincristine arrests multiplication of cancerous cells by breaking down the microtubules into smaller subunits, thus inhibiting the cell division. --- (Kokate, C. (2013). Pharmacognosy (4th ed.). Pune: Nirali Prakashan. )

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  • DIETARY Substance Interactions

    ​   ► This Medicine interact with :- NA

    ContraIndication DIETARY Substance

    ​   ► This Medicine contraindicate with :- NA

    ►   Route of Elimination :   Intestinal flora (metabolism), Faecal, Biliary, Renal
    Ref :-   Book : Martindale    Page : 828   Edition : 38.  

    ►    Plasma Half-life :   Min value :-   terminal elimination half-life of between 3 and 10 hours after doses less than 30 mg/m2 or 8 to 15 hours after high-dose parenteral therapy,    Max value :-   NA
    Ref :-   Book : Martindale    Page : 828   Edition : 38.  

    ►    Peak Plasma Concentration :   Min value :-   NA    Max value :-   NA