Methotrexate

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Administration

  • Type: Immunosuppressant/antineoplastic
  • Dosage Forms:
  • Routes of Administration: IV/IM, oral
  • Common Trade Names:

Adult Dosing

  • Ectopic pregnancy: 50mg IM once
  • Doses for treatment of malignancy or autoimmune diseases vary widely

Pediatric Dosing

Special Populations

Renal Dosing

  • Adult:
  • Pediatric:

Hepatic Dosing

  • Adult:
  • Pediatric:

Contraindications

  • Allergy to class/drug
  • Breastfeeding, pregnant, or possibility of impregnating someone
  • Blood dyscrasias
  • Chronic liver disease

Adverse Reactions

Serious

  • Hepatotoxicity
  • Nephrotoxicity
  • Myelosuppression, aplastic anemia, pancytopenia
  • Infectious disease
  • Tumor lysis syndrome
  • GI bleed
  • Neurotoxicity, seizure
  • Pericardial effusion
  • TEN

Common

  • Nausea/vomiting, diarrhea
  • Stomatitis
  • Leukopenia, thrombocytopenia
  • Alopecia, photosensitivity, rash
  • Dizziness

Pharmacology

  • Half-life: 8-15hr
  • Metabolism: Extensive hepatic and intracellular
  • Excretion: Mostly renal. Dialyzable.

Mechanism of Action

  • Inhibits dihydrofolate reductase--> blocks DNA synthesis and thus, cellular replication/repair

Comments

See Also

References

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