What is methotrexate?
Methotrexate or MTX is a drug that suppresses the immune system and reduces inflammation. Methotrexate is in low dose (5 to 30 mg in a weekly dose) used in diseases such as psoriasis, rheumatoid arthritis, multiple sclerosis, Crohn's disease, lupus erythematosus, ulcerative colitis and asthma. In the high-dosage methotrexate inhibits the growth of some tumors with which it can be used in some types of cancer, for example in leukemia. The dosage is then often 1x per day. That is why the matter in the Netherlands on a list of drugs whose indication on the prescription should be mentioned.
Since 1954, methotrexate on the international market. A commonly used name is MTX. It is available by prescription. It is available as tablets and injections for in the home or as an infusion, usually for in the hospital.
Methotrexate is a drug that should be prescribed only if the prescriber has experience with methotrexate in the field of oncology (high dose) in the treatment of psoriasis or rheumatic diseases (low doses, 5 to 30 mg once a week).
Methotrexate mechanism of action
The agent is a folic acid antagonist. In tablet form, the drug itself is easy to take. Subcutaneous injections with a strength of 25 mg / ml do not have this advantage but cause less often complaints of stomach and intestine.
Typically, a certain amount of time is required before the drug effect in order to sort. This period may be up to two to three months. To bridge this period is often given temporary medication.
Previously it was advice Methotrexate not take with milk in, 1 August 2012 was canceled this opinion.
Cancer
Methotrexate inhibits in higher doses the growth of some tumors. The agent must be swallowed regular daily or administered through injections. Methotrexate inhibits the growth of the cancer cells in that it prevents the production of folic acid. Methotrexate may also be used to the recurrence of cancer, such as leukemia, to avoid. Because of the higher doses of methotrexate, folinic acid has to be used here instead of folic acid.
Rheumatism and psoriasis
Methotrexate - in small doses - suppresses the immune system; This plays an important role in the suppression of a number of rheumatic diseases and psoriasis. MTX primarily affects rapidly dividing cells. In psoriasis it therefore works in 2 ways: to address the inflammation and the rapidly dividing cells in the skin.
Methotrexate side effects
Because folic acid is necessary for cell division not only inhibits the growth of new cancer cells but also healthy cells. Side effects manifest themselves therefore mainly in areas with rapidly dividing cells, such as the stomach and intestines, skin, hair and blood. Usually, the doctor next methotrexate writes folic acid or folinic acid for. Because of these materials reduces the risk of side effects. The folic acid should not be taken on the day of the methotrexate use. Usually methotrexate 1 x weekly swallowed or injected and folic acid at a dose of 0.5 mg used daily except MTX day. Folic acid may also be used in a 10 higher dose (5 mg) of 1-2 x per week rather than daily. Even then, it may not be used on the same day as MTX.
Wrong dosage
In September 2009 it was announced by the Health Inspectorate that brought a pharmacist for the disciplinary board would be who had given a daily dose of methotrexate of 1 times per week. The relevant patient died as a result of this mistake 11 days after admission. The pharmacist got a warning. Over the period 2007 to September 2009 revealed that had occurred exactly the same mistake in the Netherlands 13 times, with 7 users methotrexate died.