Difference between revisions of "Methotrexate (MTX)"
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==General information== | ==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.<ref name="insert">[http://www. | + | 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> |
− | <br>Route: IV, PO, IM, IT, intraarterial | + | <br>Route: IV, PO, IM, IT, SC, intraarterial |
<br>Extravasation: [[inflammitant]] | <br>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 [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== | ||
+ | <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]] | ||
Line 27: | Line 29: | ||
*[[Small cell lung cancer]] | *[[Small cell lung cancer]] | ||
*[[Transplant conditioning regimens]] | *[[Transplant conditioning regimens]] | ||
+ | </div> | ||
==Patient drug information== | ==Patient drug information== | ||
+ | *[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> | ||
+ | |||
+ | ==History of changes in FDA indication== | ||
+ | * 12/7/1953: Initial FDA approval | ||
==Also known as== | ==Also known as== | ||
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==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
- Acute lymphocytic leukemia
- Acute promyelocytic leukemia
- Bladder cancer
- Bone cancer
- Breast cancer
- Burkitt lymphoma
- CNS lymphoma
- Diffuse large B-cell lymphoma
- Extranodal NK/T-cell lymphoma, nasal type
- Head and neck cancer
- Hemophagocytic lymphohistiocytosis
- HIV-associated lymphoma
- Large granular lymphocytic leukemia
- Mantle cell lymphoma
- NK/T-cell lymphoma
- Penile cancer
- Peripheral T-cell lymphoma
- Prostate cancer
- Small cell lung cancer
- Transplant conditioning regimens
Patient drug information
- Methotrexate (Otrexup) subcutaneous injection package insert[5]
- Methotrexate (MTX) patient drug information (Chemocare)[8]
- Methotrexate (MTX) patient drug information (UpToDate)[9]
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
- ↑ 1.0 1.1 Methotrexate (MTX) tablet package insert
- ↑ Methotrexate (MTX) tablet package insert (locally hosted backup)
- ↑ Methotrexate (MTX) injection package insert
- ↑ Methotrexate (MTX) injection package insert (locally hosted backup)
- ↑ 5.0 5.1 Methotrexate (Otrexup) subcutaneous injection package insert
- ↑ Methotrexate (Otrexup) subcutaneous injection package insert (locally hosted backup)
- ↑ Otrexup manufacturer's website
- ↑ Methotrexate (MTX) patient drug information (Chemocare)
- ↑ Methotrexate (MTX) patient drug information (UpToDate)
- Drug index
- Chemotherapy
- Intramuscular chemotherapy
- Intrathecal chemotherapy
- Intravenous chemotherapy
- Oral chemotherapy
- Inflammitant chemotherapy
- Antimetabolites
- Antifolates
- Acute lymphocytic leukemia medications
- Acute promyelocytic leukemia medications
- Bladder cancer medications
- Bone cancer medications
- Breast cancer medications
- Burkitt lymphoma medications
- Central nervous system (CNS) lymphoma medications
- Diffuse large B-cell lymphoma medications
- Extranodal NK/T-cell lymphoma, nasal type medications
- Head and neck cancer medications
- Hemophagocytic lymphohistiocytosis medications
- HIV-associated lymphoma medications
- Large granular lymphocytic leukemia medications
- Mantle cell lymphoma medications
- NK/T-cell lymphoma medications
- Penile cancer medications
- Peripheral T-cell lymphoma medications
- Prostate cancer medications
- Small cell lung cancer medications
- Transplant medications
- Drugs FDA approved in 1953
- WHO Essential Cancer Medicine