Methotrexate (MTX)
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 promyelocytic leukemia
- Adult T-cell leukemia-lymphoma
- B-cell acute lymphoblastic leukemia
- Bladder cancer
- Breast cancer
- Burkitt lymphoma
- CNS leukemia
- CNS lymphoma
- Diffuse large B-cell lymphoma
- Extranodal NK/T-cell lymphoma, nasal type
- Head and neck cancer
- Hemophagocytic lymphohistiocytosis
- Histiocytoses
- HIV-associated lymphoma
- Large granular lymphocytic leukemia
- Mantle cell lymphoma
- NK/T-cell lymphoma
- Osteosarcoma
- Penile cancer
- Peripheral T-cell lymphoma
- Prostate cancer
- Small cell lung cancer
- T-cell acute lymphoblastic leukemia
- 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 medications
- Intrathecal medications
- Intravenous chemotherapy
- Oral chemotherapy
- Inflammitant chemotherapy
- Antimetabolites
- Antifolates
- Immunosuppresants
- Acute promyelocytic leukemia medications
- Adult T-cell leukemia-lymphoma medications
- B-cell acute lymphoblastic leukemia medications
- Bladder cancer medications
- Breast cancer medications
- Burkitt lymphoma medications
- Central nervous system (CNS) lymphoma medications
- CNS leukemia medications
- Diffuse large B-cell lymphoma medications
- Extranodal NK/T-cell lymphoma, nasal type medications
- Head and neck cancer medications
- Hemophagocytic lymphohistiocytosis medications
- Histiocytoses medications
- HIV-associated lymphoma medications
- Large granular lymphocytic leukemia medications
- Mantle cell lymphoma medications
- NK/T-cell lymphoma medications
- Osteosarcoma 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