Methotrexate Drug Benefits and Cautions

Methotrexate, pronounced meth-oh-trex-ate, is a chemotherapy drug that can be taken alone or with other therapies to help patients control, achieve remission or even attain full recovery from serious disorders.

Methotrexate (MTX) has been prescribed since the 1950s to treat cancer of the breast, leukemia, lymphoma, lung cancer, head/neck cancers, and cancer cells forming around fertilized eggs in uterine by injection and is also offered in 2.5 mg pills. By 1988, it was approved for use in treating rheumatoid arthritis (RA). It is successful in treating inflammation for other serious autoimmune disorders like psoriatic arthritis (PA), crohn's disease, ankylosing arthritis (AS), idiopathic juvenile arthritis (IJA), irritable bowel syndrome (IBS) and others.

According to the American Society of Health System Pharmacists, it is sold as brand names Trexall® and Rheumatrex®. Amethopterin and methotrexate (MTX) are the generic names of the drug. It can be a short or long term use drug.

Benefits, Cost and Convenience

Approved by the U.S. Food and Drug Administration (FDA) in 1953, methotrexate is a long time favorite of many prescription insurance companies for treating acute arthritis disorders and some cancer diseases in adults and children. Patient price tag can be low to none, because its generic formula is included on the drug list covered by most insurance prescription benefits.

About half the size of an aspirin with thin outer coating, swallowing methotrexate tablets is effortless. The slightly sweet taste is a pleasant surprise. It is also available by injection for those who need that option.

Often prescribed to be taken once-a-week, it can be more convenient than the daily dose requirements of other medicines. For autoimmune disorders, methotrexate may be taken in dosages of four, six, or eight of the 2.5 mg tablets. Doses larger than eight tablets, or 20 mg per week, are usually prescribed for cancer illnesses.

Patient Responsibilities and Cautions

Whether prescription or over-the-counter, any medicine meant to treat illness can also cause health issues. Methotrexate carries possible serious side effects of liver trouble, hair loss, mouth sores and lowering infection immunity. These worries are less likely when doctor and patient work as a team to maintain regular monitoring of liver function, healthy lifestyle choices, and sometimes adding folic acid supplements. Common short term side effects are tiredness and general body aches.

Before methotrexate is prescribed, blood tests are done to assure initial liver and immune system health. The patient must follow doctor orders diligently to have the best chance of the drug working for his better health and does not harm him. He must agree to undergo repeated blood tests about every two to three months for as long as the drug is needed, to monitor continued liver function and immunity health.

Alcohol consumption while under methotrexate treatment is a very bad idea. This drug does its job by relying heavily on liver function and even a glass or wine or a weak beer is likely to take a toll. Liver issues can also be created by using any pain medication containing Tylenol® or acetaminophen, whether over-the-counter or a prescription combination.

Methotrexate does not mix well with penicillin-like antibiotics, so it is important the patient's pharmacist and all doctors are aware of methotrexate use. A serious adverse effect can result from taking both these drugs. If an antibiotic is needed for any infection, make sure it is not a penicillin.

The Bottom Line

When other therapies have been unsuccessful, methotrexate can help some autoimmune inflammatory diseases, and it is effective in treating some cancers. It can be taken alone or used in combination with other therapies. Several months of treatment may be necessary before improvement is evident, so patience and diligence are paramount.

Commitment beyond taking a few pills once-a-week is required for success with methotrexate treatment. Good communication and follow-up with physician, as well as patient compliance with regular blood tests, folic acid supplements and not consuming alcohol, Tylenol or acetaminophen-based products offer the best opportunity to full remission and recovery.

Sources

MedPageToday.com
ArthritisInsight.com
American Academy of Dermatology Association at aad.org
Author, Lynn Pritchett, personal medication experience