Difference between revisions of "Methotrexate (MTX)"

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==General information==
 
==General information==
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Class/mechanism: Folate analog, antimetabolite, interferes with DNA synthesis.  Methotrexate inhibits dihydrofolic acid reductase, which catalyzes reactions that produce tetrahydrofolates, which are used in purine nucleotide and thymidylate synthesis.<ref name="insert">[http://www.rheumatrex.info/pdf/RheumatrexPackageInsert.pdf Methotrexate (MTX) package insert]</ref><ref>[http://hemonc.org/docs/packageinsert/methotrexate.pdf Methotrexate (MTX) package insert (locally hosted backup)]</ref>
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Class/mechanism: Folate analog, antimetabolite, interferes with DNA synthesis.  Methotrexate inhibits dihydrofolic acid reductase, which catalyzes reactions that produce tetrahydrofolates, which are used in purine nucleotide and thymidylate synthesis.<ref name="insert">[http://docs.boehringer-ingelheim.com/Prescribing%20Information/PIs/Roxane/Methotrexate/Methotrexate%20Tablets%20USP%202.5mg.pdf Methotrexate (MTX) tablet package insert]</ref><ref>[[Media:Methotrexatetablet.pdf|Methotrexate (MTX) tablet package insert (locally hosted backup)]]</ref><ref>[https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/011719s117lbl.pdf Methotrexate (MTX) injection package insert]</ref><ref>[[Media:Methotrexateinjection.pdf|Methotrexate (MTX) injection package insert (locally hosted backup)]]</ref><ref name="Otrexup">[http://www.otrexup.com/files/4014/8909/8025/Otrexup_PII-13-001_Rev_8.pdf Methotrexate (Otrexup) subcutaneous injection package insert]</ref><ref>[[Media:MethotrexateSQ.pdf|Methotrexate (Otrexup) subcutaneous injection package insert (locally hosted backup)]]</ref><ref>[http://www.otrexup.com Otrexup manufacturer's website]</ref>
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<br>Route: IV, PO, IM, IT, intraarterial
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<br>Route: IV, PO, IM, IT, SC, intraarterial
 
<br>Extravasation: [[inflammitant]]
 
<br>Extravasation: [[inflammitant]]
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*[[Glucarpidase (Voraxaze)]] can be used to treat toxic plasma methotrexate concentrations (greater than 1 micromole per liter) in patients with delayed methotrexate clearance due to impaired renal function
  
 
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer.  Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref>  
 
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer.  Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref>  
  
 
==Diseases for which it is used==
 
==Diseases for which it is used==
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<div style="column-count:3;-moz-column-count:3;-webkit-column-count:3">
 
*[[Acute lymphocytic leukemia]]
 
*[[Acute lymphocytic leukemia]]
 
*[[Acute promyelocytic leukemia]]
 
*[[Acute promyelocytic leukemia]]
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*[[Small cell lung cancer]]
 
*[[Small cell lung cancer]]
 
*[[Transplant conditioning regimens]]
 
*[[Transplant conditioning regimens]]
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</div>
  
 
==Patient drug information==
 
==Patient drug information==
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*[http://www.otrexup.com/files/4014/8909/8025/Otrexup_PII-13-001_Rev_8.pdf Methotrexate (Otrexup) subcutaneous injection package insert]<ref name="Otrexup"></ref>
 
*[http://chemocare.com/bio/methotrexate.asp Methotrexate (MTX) patient drug information (Chemocare)]<ref>[http://chemocare.com/bio/methotrexate.asp Methotrexate (MTX) patient drug information (Chemocare)]</ref>
 
*[http://chemocare.com/bio/methotrexate.asp Methotrexate (MTX) patient drug information (Chemocare)]<ref>[http://chemocare.com/bio/methotrexate.asp Methotrexate (MTX) patient drug information (Chemocare)]</ref>
 
*[http://www.uptodate.com/contents/methotrexate-patient-drug-information Methotrexate (MTX) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/methotrexate-patient-drug-information Methotrexate (MTX) patient drug information (UpToDate)]</ref>
 
*[http://www.uptodate.com/contents/methotrexate-patient-drug-information Methotrexate (MTX) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/methotrexate-patient-drug-information Methotrexate (MTX) patient drug information (UpToDate)]</ref>
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==History of changes in FDA indication==
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* 12/7/1953: Initial FDA approval
  
 
==Also known as==
 
==Also known as==
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==History of changes in FDA indication==
 
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* 12/7/1953: Initial FDA approval
 
  
 
==References==
 
==References==

Revision as of 04:44, 27 April 2017

General information

Class/mechanism: Folate analog, antimetabolite, interferes with DNA synthesis. Methotrexate inhibits dihydrofolic acid reductase, which catalyzes reactions that produce tetrahydrofolates, which are used in purine nucleotide and thymidylate synthesis.[1][2][3][4][5][6][7]
Route: IV, PO, IM, IT, SC, intraarterial
Extravasation: inflammitant

  • Glucarpidase (Voraxaze) can be used to treat toxic plasma methotrexate concentrations (greater than 1 micromole per liter) in patients with delayed methotrexate clearance due to impaired renal function

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]

Diseases for which it is used

Patient drug information

History of changes in FDA indication

  • 12/7/1953: Initial FDA approval

Also known as

Synonyms
Abitrexate Alltrex Amethopterin Antifolan APO-Methotrexate Artrait Biometrox Biotrexate
Caditrex Cytotrexate Ebetrexat Emthexat Emthexate Emthexate PF Emthexate S Ervemin
Farmitrexat Fauldmetro Folex PFS Folitrax Hextrate Ifamet Imutrex,Ledertrexate Ledertrexate Sodium
Ledertrexato Lumexon Matrex Maxtrex Medsatrexate Merex Metex Methobax
Methoblastin Methorex Methotrexaat Methotrexaat Sandoz Methotrexat Biosyn Methotrexat Ebewe Methotrexate Bigmar Methotrexate Bristol
Methotrexate DBL Methotrexate Disodium Methotrexate DUP Methotrexate Ebewe Methotrexate Farmos Methotrexate Knoll Methotrexate Lederle Methotrexate LPF
Methotrexate Mayne Methotrexate Merck Methotrexate Paranova Methotrexate R Methotrexate Remedica Methotrexate Singad Methotrexate Sodium Methotrexate Sodium Lederle
Methotrexate Teva Methotrexate Wyeth Methotrexat Lederle Methotrexat Medac Methotrexato Methotrexat Ridupharm Methotrexat Teva Methotrexatum
Meticil Metolate Metotressato Metotrexate Metotrexato Asofarma Metotrexato Chiesi Metotrexato Dosa Metotrexato Filaxis
Metotrexato Lederle Metotrexato Martian Metotrexato Microsules Metotrexol Metrex Metrexan Metrexato Metrotex
Mexate Miantrex CS MTX MTX Hexal Neometho Neotrexate Novatrex Oncotrex
Oncotrex-PF O Trexat P&U Methotrexate Pharmatrexate Ratio-Methotrexate Remtrex Reumatrex Rextop
Rheumatrex Tecnomet Texate Texate T Texorate Tratoben Trav Methotrexate Tremetex
Trexall Trexan Trexeron Trixilem Trixilem RU Unitrexate Vero Methotrexate Zexate

References

  1. ↑ 1.0 1.1 Methotrexate (MTX) tablet package insert
  2. ↑ Methotrexate (MTX) tablet package insert (locally hosted backup)
  3. ↑ Methotrexate (MTX) injection package insert
  4. ↑ Methotrexate (MTX) injection package insert (locally hosted backup)
  5. ↑ 5.0 5.1 Methotrexate (Otrexup) subcutaneous injection package insert
  6. ↑ Methotrexate (Otrexup) subcutaneous injection package insert (locally hosted backup)
  7. ↑ Otrexup manufacturer's website
  8. ↑ Methotrexate (MTX) patient drug information (Chemocare)
  9. ↑ Methotrexate (MTX) patient drug information (UpToDate)
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