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Methotrexate injection

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Generic Name for Methotrexate injection

Methotrexate 25mg/mL; soln for IV, IM, intra-arterial, or intrathecal administration after dilution; preservative-free.

Legal Classification:

Rx

Pharmacological Class for Methotrexate injection

Folic acid antagonist.

Manufacturer of Methotrexate injection

Bedford Laboratories

Indications for Methotrexate injection

Gestational choriocarcinoma. Chorioadenoma destruens. Hydatidiform mole.

Other Indications for Methotrexate injection

Adult dose for Methotrexate injection

See literature. Tablet form is often preferred when low doses are being administered. Choriocarcinoma and similar trophoblastic diseases: 15–30mg orally or by IM inj daily for 5 days; usually repeated 3–5 times as required with a rest period of ≥1 week between courses.

Children's dosing for Methotrexate injection

Not applicable.

Also:

Contraindications for Methotrexate injection

Pregnancy (Cat. X). Nursing mothers.

Warnings/Precautions for Methotrexate injection

Be fully familiar with this drug's toxicity before use. Discontinue if malignant lymphomas occur. Obtain baseline and monitor CBCs with differential, platelet counts, chest X-ray, and hepatic, renal and pulmonary function. During therapy monitor hematology monthly, renal and hepatic function every 1–2 months, more often if increasing dose or predisposed to toxicity (eg, dehydration). Discontinue immediately if blood counts drop significantly. Rule out pregnancy in women of childbearing potential; use effective contraception during therapy and for at least 1 ovulatory cycle afterwards for women and for at least 3 months afterwards for men. Interrupt therapy if vomiting, diarrhea, stomatitis, or pulmonary symptoms occur. Hepatic or renal impairment. Obesity. Diabetes. Peptic ulcer. Ulcerative colitis. Infection. Dehydration. Folate deficiency. Ascites, pleural effusions: evacuate fluid, monitor for toxicity and reduce dose or discontinue if needed. Elderly (use low doses and monitor closely). Debilitated.

Interactions for Methotrexate injection

Avoid live virus vaccines. Toxicity increased by NSAIDs, salicylates, phenytoin, sulfonylureas, sulfonamides, probenecid, folic acid antagonists. May be potentiated by penicillins (monitor), tetracyclines, chloramphenicol, non-absorbable broad spectrum antibiotics. May be antagonized by folic acid. May potentiate theophylline, mercaptopurine. Increased risk of soft tissue necrosis and osteonecrosis with radiotherapy. Caution with other hepatotoxic drugs (eg, azathioprine, retinoids, sulfasalazine) and nephrotoxic agents (eg, cisplatin).

Adverse Reactions for Methotrexate injection

Ulcerative stomatitis, leukopenia, nausea, GI upset, malaise, fatigue, chills, fever, dizziness, infection, myelosuppression, hepatotoxicity, renal toxicity, CNS toxicity, seizures (esp in children); interstitial pneumonitis, tumor lysis syndrome, skin reactions (may be fatal; eg, toxic epidermal necrolysis, Stevens-Johnson syndrome).

How is Methotrexate injection supplied?

Tabs—30
Soln (2mL, 4mL, 8mL, 10mL)—10 (single-use vials)
Pwd (1 gram)—1 (single-use vial)

Related Disease:

Cancer, breast
Cancer, head and neck
Cancer, lung
Chorioadenoma destruens
Choriocarcinoma, gestational
Hydatidiform mole
Mycosis fungoides
Non-Hodgkin's lymphoma

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