🍽️ Amethopterin (R,S)

Cancer Treatment: Methotrexate is widely used in chemotherapy regimens for the treatment of various cancers, including leukemia, lymphoma, breast cancer, lung cancer, and others. It works by interfering with the synthesis of DNA and RNA, thereby inhibiting the growth and proliferation of cancer cells.

Rheumatoid Arthritis: Methotrexate is a first-line treatment for rheumatoid arthritis (RA) and other inflammatory joint diseases. It helps reduce joint pain, swelling, and inflammation by suppressing the immune system and modulating the inflammatory response. Methotrexate is often used as a disease-modifying antirheumatic drug (DMARD) to slow down the progression of RA and prevent joint damage.

Psoriasis and Other Skin Conditions: Methotrexate is effective in the treatment of severe psoriasis and other autoimmune skin conditions, such as psoriatic arthritis and dermatomyositis. It helps reduce skin inflammation, scaling, and plaque formation by inhibiting the rapid turnover of skin cells.

Inflammatory Bowel Disease: Methotrexate is sometimes used off-label in the treatment of inflammatory bowel diseases (IBD), such as Crohn's disease and ulcerative colitis. It can help reduce intestinal inflammation and control disease activity in patients who do not respond adequately to other medications.

Side Effects: Methotrexate can cause a range of side effects, which may vary depending on the dose, route of administration, and duration of treatment. Common side effects may include nausea, vomiting, diarrhea, mouth sores, fatigue, headache, hair loss, and skin rash. These side effects are usually mild and manageable but may require dose adjustments or supportive care.

Bone Marrow Suppression: Methotrexate can suppress bone marrow function, leading to a decrease in the production of blood cells, including white blood cells, red blood cells, and platelets. This may increase the risk of infections, anemia, and bleeding, particularly at higher doses or with prolonged use.

Hepatotoxicity: Methotrexate can cause liver toxicity, manifested by elevated liver enzymes and, rarely, liver failure. Patients taking methotrexate should undergo regular monitoring of liver function tests to detect and manage potential hepatotoxicity.

Pulmonary Toxicity: Rarely, methotrexate can cause pulmonary toxicity, including interstitial pneumonitis and pulmonary fibrosis. Patients experiencing respiratory symptoms such as cough, dyspnea, or chest pain should seek medical attention promptly.

Renal Toxicity: Long-term use of high-dose methotrexate may lead to renal toxicity, characterized by decreased kidney function and impaired urine concentration. Adequate hydration and urine alkalinization are often recommended to minimize the risk of renal toxicity during high-dose methotrexate therapy.

Teratogenicity: Methotrexate is highly teratogenic and can cause birth defects or fetal death if taken during pregnancy. It is contraindicated in pregnant women and women of childbearing potential unless there are no suitable alternatives, and strict contraception measures are in place.

Drug Interactions: Methotrexate may interact with other medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), certain antibiotics, and other immunosuppressive drugs. Close monitoring and dose adjustments may be necessary when methotrexate is used concomitantly with other medications.