ISSN 2398-2942      

Methotrexate

icanis

Introduction

Name

  • Methotrexate.

Class of drug

  • Antimetabolite antineoplastic agent.

Description

Storage requirements

  • Room temperature.
  • Reconstituted powder stable for 4 weeks at room temperature and for 3 months under refrigeration when diluted to 2-25 mg/ml.

Uses

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Indications

  • Lymphomas Lymphoma and some solid tumors.
  • This may be limited by its toxicity when used in a high dose regimen.
  • In human medicine it is also used to treat refractory rheumatoid arthritis.

Administration

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Pharmacokinetics

Precautions

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Interactions

with other drugs

Chloramphenicol Chloramphenicol, oral anticoagulants, phenylbutazone, phenytoin Phenytoin, salicylates, sulphonamides and tetracycline Tetracycline

  • Methotrexate is highly bound to serum albumin and thus may be displaced, resulting in increased blood levels and toxicity.

Folic acid supplements

  • May inhibit the response to methotrexate.

Pyrimethamine Pyrimethamine

  • A similar folic acid antagonist, may increase methotrexate toxicity.

Cytarabine Cytarabine

  • Increased cytotoxicity.

Hydrocortisone Hydrocortisone, hydroxyurea Hydroxycarbamide, methylprednisolone Methylprednisolone

  • Cellular uptake of methotrexate decreased.

Amphotericin B Amphotericin B, vincristine Vincristine

  • Cellular uptake of methotrexate increased.

NSAIDs

  • Increased risk of hematologic, renal and hepatic toxicity.

Adverse Reactions

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Further Reading

Publications

Refereed papers

Other sources of information

  • Fischer D S, Knobf M T et al (2003) The Cancer Chemotherapy Handbook. 6th edn. Philadelphia, PA, Mosby. pp 167-171.
  • Based onSmall Animal Formulary. Tennant, Bryn (1999) 3rd edn. Cheltenham: BSAVA.
  • Fraizier D L & Hahn K A (1995) Commonly Used Drugs. In: Hahn K A & Richardson R C (eds) Cancer Chemotherapy A Veterinary Handbook. Philadelphia, PA. Williams & Wilkins. pp 112-113.
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