Methotrexate tabs 2.5mg #50

Methotrexate instruction

Reed more and buy Methotrexate online

Composition

The solution contains Methotrexate in the amount of 10 mg in 1 ml, in the concentrate for injections of 100 mg per 1 ml; additional components: sodium hydroxide, water for injection, sodium chloride.
Tablets contain Methotrexate in an amount of 2.5 mg; 5 and 10 mg; in the form of additional substances - cellulose, corn starch, silicon dioxide, magnesium stearate, lactose monohydrate.

Form of issue

Tablets in vials: 2.5; 5 and 10 mg.
In ampoules and vials of 1, 5 and 10 ml.
Concentrate in bottles of 5, 10 and 50 ml.

pharmachologic effect

A group of antimetabolites, in which the analogue is folic acid. It has an antitumor effect and additionally has an immunosuppressive effect.
The medicine slows DNA repair and its synthesis, inhibits the mitosis of cells. The influence of Methotrexate is most sensitive to tissues that are capable of high proliferation: tumor tissue, embryonic cells, bone marrow, epithelium of mucous membranes.
In the proliferation of malignant cells, which outstrips those in normal cells, Methotrexate leads to a disruption in the growth of malignant tumors without harming healthy tissues.
In the therapy of rheumatoid arthritis, the effect is presumably associated with the mechanism of immunosuppression. Methotrexate in rheumatoid arthritis can reduce inflammation and its symptoms - swelling, pain, stiffness.
In the treatment of psoriasis, Methotrexate acts on keratinocytes of plaques, in which the growth rate is increased in comparison with the normal proliferation of skin cells.

Pharmacodynamics and pharmacokinetics

The maximum concentration in the blood of Methotrexate occurs in 30-60 minutes. Patients with leukemia may have fluctuations of up to 3 hours.
In blood plasma binds to albumins. With simultaneous administration with salicylates, chloramphenicols, sulfonamides, tetracyclines, phenytoin, there may be a competitive substitution.
Methotrexate does not penetrate the blood-brain barrier, for this it must be administered intrathecally.
The half-life of Methotrexate is about 6-7 hours, in the case of high doses - increases to 17 hours.
It is excreted mainly (90%) by the kidneys during the day. About 10% is excreted with bile.
In the case of severe renal impairment, excretion is prolonged.
Methotrexate can accumulate in the liver, kidney and spleen as metabolic products.

Indications for use

    tumors of trophoblast;
    Neuroleukemia;
    non-Hodgkin's lymphoma, incl. lymphosarcoma;
    acute leukemia (myeloblast and lymphoblastic);
    osteogenic sarcoma and soft tissue;
    skin cancer, lung cancer, breast cancer, squamous cell carcinoma, cancer of genitals (male and female), bladder cancer, esophageal cancer, kidney cancer, medulloblastoma, retinoblastoma;
    severe stages of fungal mycosis, psoriasis;
    arthritis psoriatic and rheumatoid, systemic lupus erythematosus, dermatomyositis, ankylosing spondylitis.

Contraindications

    severe kidney and liver damage;
    alcoholism;
    severe infectious diseases (tuberculosis, HIV infection);
    the pathology of the hematopoietic system in the anamnesis;
    vaccination with live vaccines;
    ulcers of the gastrointestinal tract and oral cavity in the anamnesis;
    taking large doses of the drug with acetylsalicylic acid;
    the period of breastfeeding and pregnancy;
    individual intolerance.
Methotrexate is administered cautiously in patients with lesions of the kidneys and liver, obesity, suppression of medullary hemopoiesis, diabetes, use of before treatment hepatotoxic drugs, infectious diseases of bacterial, viral, fungal origin, when ascites, peritoneal and pleural effusions, dehydration, herpes zoster, previous contact with patients with herpes simplex, with measles, chicken pox, strongyloidosis, amebiasis; in the presence of urate gout or nefrourolitiaza, in infections and inflammatory processes of the oral mucosa, ulcerative colitis, ulcers, vomiting, diarrhea, gastrointestinal obstruction, aciduria, fatigue, chemotherapy or radiotherapy prior to treatment, elderly patients and children.

Side effects of Methotrexate

The system of hematopoiesis: anemia, thrombocytopenia, leukopenia, pancytopenia; very rarely - a serious impairment of bone marrow function; megaloblastic anemia.
Central nervous system: fatigue, drowsiness, mood changes, headache, depression, insomnia, confusion; rarely - violations of cognitive functions, paresthesia and pain in the extremities, taste of metal in the mouth, paralysis and epileptic seizures, symptoms of meningism.
Organs of vision: irritation, conjunctivitis.
Respiratory system: pneumonitis (symptoms include cough dry, short breathing, fever), pleural effusion, alveolitis; rarely - bronchial asthma or pulmonary fibrosis, thickening of pleural sheets, pulmonary edema.
Digestive System: nausea, inflammation and ulceration of the oral mucosa, stomatitis, dyspepsia, vomiting, anorexia, increased transaminases, diarrhea, fibrosis and cirrhosis, steatosis.
Urinary system: ulceration and inflammation of the urinary bladder, impaired urination and renal function, oliguria and anuria, electrolyte imbalance.
Skin: itching, erythema, alopecia, photosensitivity, vasculitis, shingles, herpetiform eruptions; rarely - epidermal necrolysis. Under the influence of ultraviolet light, pigmentation of the nails, furunculosis, hydradenitis, acute paronychia are possible.
Musculoskeletal system: pain in muscles and joints, osteoporosis.
System of the heart and blood vessels: bleeding, vasculitis, effusion into the pericardial cavity; rarely - cardiac tamponade.
Immune system: pharyngitis, decreased immunity; rarely - sepsis, an increase in the number of rheumatoid nodules, anaphylactic reactions.
Reproductive system: inflammation and ulcers of the vagina; very rarely - impotence, disorders of the menstrual cycle, vaginal discharge, decreased desire.
Other side effects that may occur are: fever, malaise, chills, rarely - poor wound healing. In the case of intramuscular injection, there may be tissue damage at the site of administration (abscess, destruction), cysts and polyps, and lymphomas. An unknown frequency can cause metabolic disorders, diabetes.
In the case of intrathecal administration of Methotrexate, arachnoiditis (headache, rigidity of the neck muscles, fever) may sharply arise. In the future, there may be paresis and plethysm, a disorder of the cerebellar functions. Chronic reactions to intrathecal administration may be leukoencephalopathy, which is manifested by confusion, convulsions, dementia, coma, and rarely a fatal outcome.

Instructions for use Methotrexate (Method and dosage)

It is possible to administer Methotrexate - Ebwe intramuscularly, intraarterially, intravenously or intrathecally. Tablets are not chewed, before meals.
The instruction on Methotrexate warns that the choice of dose and treatment regimens for each specific pathology should be strictly in accordance with the special literature.
In the case of trophoblastic tumors, daily up to 30 mg of intramuscular injection is administered in 5 days. The courses are repeated after 1 week, until a dose of 400 mg is reached.
Lymphomas and leukemias suggest an intravenous injection of 200-500 mg per m2 once a month.
Neuroleukemia: injected intrathecally 1 - 2 times in 7 days at a dose of 12 mg per m2.
Children are prescribed the following doses:
    younger than 1 year of 6 mg;
    age 1 year - 8 mg;
    up to 2 years 10 mg are used;
    over 3 years, 12 mg are administered.
Methotrexate in rheumatoid arthritis is prescribed, starting at a dose of 7.5 mg, once a week. According to the indications, the dose is increased, but not more than 20 mg per week.
In psoriasis, a dose of up to 25 mg per week, intramuscularly or intravenously, is given.
With mushroom mycosis injected 50 mg per week once or in 2 divided doses, intramuscularly.

Overdose

The main symptoms of overdose are signs of oppression of the hematopoiesis system. Antidote is calcium folinate, which is administered no later than 60 minutes, with the dose should be equal to or higher than the dose of Methotrexate. In severe cases, urine alkalization and hydration are used.
In case of exceeding the dose with intrathecal administration, along with the administration of an antidote, rapid drainage of cerebrospinal fluid is provided.

Interaction

With alcohol abuse and the use of hepatotoxic drugs, the toxic effect of Methotrexate on the liver is increasing.
Simultaneous reception with leflunamide increases the incidence of pancytopenia and cases of hepatotoxicity.
Chloramphenicol, tetracycline for oral administration reduces the absorption of Methotrexate.
Ciprofloxacin, glycopeptides, penicillins, loop diuretics, phenylbutazone reduce the clearance of the drug in the kidneys, which increases its concentration in the blood and increases toxicity on the hematopoiesis.
Also the toxicity of Methotrexate is increased when used simultaneously with salicylates and non-steroidal anti-inflammatory drugs.
Chloramphenicol, sulfonamides, pyrimethamine have a negative effect on the bone marrow, so the combination with Methotrexate exacerbates hematologic disorders.
Trimethoprim and sulfamethoxazole, which cause folate deficiency, as well as hypolipidemic drugs and indirect anticoagulants, can increase the toxic effect of Methotrexate.
It is necessary to avoid during the treatment of increased consumption of coffee, tea and sugary drinks with caffeine, as the clearance of theophylline can decrease.
With simultaneous admission with cytostatics, the clearance of Methotrexate is reduced.
Combination with radiotherapy increases the likelihood of tissue necrosis.
Methotrexate inhibits the immune response to vaccination, and in the case of administration of live vaccines, severe antigenic reactions are likely.
The use of amiodarone contributes to the appearance of skin ulcers.
With the introduction of acyclovir and simultaneous use of Methotrexate, the risk of neurologic damage is intrathecal.

Terms of sale

You don't need a prescription to buy Methotrexate online.

Storage conditions

The drug is stored, observing the temperature regime from 15-25 ° C, in a place closed from light and away from children.
Shelf life - 3 years.

special instructions

The drug is prescribed only by an oncologist with experience of chemotherapy.
The patient should be informed of the risk of developing severe adverse reactions in the form of toxic lesions that can lead to death.
If the patient has a fluid in the cavities (abdominal or pleural), it is necessary to remove the liquid before starting treatment.
If there are symptoms of stomatitis, indicating a toxic lesion of the gastrointestinal tract, it is necessary to temporarily stop treatment with Methotrexate, as the risk of ulceration and perforation of the intestine increases.
Before the start of therapy, a thorough investigation of laboratory blood counts (extensive clinical and biochemical analysis), kidney function tests, chest X-ray.
When taking Methotrexate, the patient is constantly under the supervision of a doctor for the timely detection of complications.
In the process of treatment, the patient is monthly examined, including:
    examination of the oral cavity;
    an expanded blood test;
    functional tests of the liver;
    urinalysis and functional state of the kidneys;
    study of the respiratory system.
1 week before the surgery, therapy with Methotrexate should be canceled and reassigned after 2 weeks.
The drug increases the risk of developing malignant lymphomas, including when taken in low doses.
Before the start of treatment, pregnancy should be excluded.
Patients of reproductive age should be informed about the negative effect of Methotrexate on the reproductive system and recommend the use of contraception during the treatment period.
With the intrathecal administration of Methotrexate, life-threatening complications are possible, therefore, when the first signs of side effects appear, it is necessary to cancel the drug.
Do not mix with other substances in the same bottle.
In case of contact with skin or mucous membranes, rinse immediately with water.
During treatment with the drug, caution should be exercised in occupations that require increased attention and rapid reaction.

Children

Apply with caution.

With alcohol

Alcohol can aggravate the hepatotoxic effect of Methotrexate, so use during the period of treatment is contraindicated.

In pregnancy and lactation

Methotrexate has an embryotoxic effect (causes fetal malformations), it is contraindicated in pregnancy.
The drug penetrates into breast milk in dangerous concentrations. In this regard, during the period of treatment, breast-feeding is stopped.

Reviews about Methotrexate

There are multiple reviews of the drug. Almost all the reviews with ectopic pregnancy tell about side effects in the form of severe nausea, abdominal pain, liver aches. It is necessary to monitor the effectiveness of getting rid of ectopic pregnancy in human chorionic gonadotropin.
Reviews for psoriasis are mostly not very good, many prefer to dispense with Methotrexate. Patients report that, when exacerbated, the drug significantly alleviates the condition, however, when the cancellation occurs, deterioration occurs. There are mentions of cases of toxic hepatitis.
Reviews for rheumatoid arthritis about the effect is mostly positive. There are persistent remissions on the drug, but at the same time and frequent side reactions in the form of nausea. The advantage is that the condition does not deteriorate when canceled. It is important to observe a smooth increase in dosage at the beginning of therapy. There are also individual reviews of the low effectiveness of the drug.