Males should continue to use birth control for at least 3 months after the end of treatment. Females should continue to use birth control for at least 1 menstrual cycle after the end of treatment. If you become pregnant or think you may be pregnant, tell your doctor right away. Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the tablets.
Methotrexate passes into breast milk and may harm a nursing infant. Therefore, breast -feeding while using this drug is not recommended. Consult your doctor before breast-feeding. Please refer to the instructions for use at the end of the leaflet. The manner of handling and disposal must be consistent with that of other cytostatic preparations in accordance with local requirements.
Methotrexate should not come into contact with the surface of the skin or mucosa. In the event of contamination, the affected area must be rinsed immediately with plenty of water. Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them. The frequency as well as the degree of severity of the side effects depends on the dosage level and the frequency of administration. Methotrexate is also used to treat certain types of cancer including cancers that begin in the tissues that form around a fertilized egg in the uterus, breast cancer, lung cancer, certain cancers of the head and neck, certain types of lymphoma, and leukemia cancer that begins in the white blood cells.
Methotrexate is in a class of medications called antimetabolites. Methotrexate treats cancer by slowing the growth of cancer cells. Methotrexate treats psoriasis by slowing the growth of skin cells to stop scales from forming. Methotrexate may treat rheumatoid arthritis by decreasing the activity of the immune system.
How should this medicine be used: Lymphomas In Burkitt's Tumour, stages , methotrexate has prolonged remissions in some cases. Recommended dosage is mg per day orally for 4 to 8 days. In stage 3, methotrexate is commonly given concomitantly with other antitumour agents. Treatment in all stages usually consists of several courses of the drug interposed with 7 to 10 day rest periods, and in stage 3 they respond to combined drug therapy with methotrexate given in doses of 0.
Hodgkin's disease responds poorly to methotrexate and to most types of chemotherapy. Mycosis Fungoides Therapy with methotrexate appears to produce clinical remissions in one half of the cases treated. Recommended dosage is usually 2. Methotrexate has also been given intramuscularly in doses of 50 mg once weekly or 25 mg twice weekly. Psoriasis Chemotherapy Cases of severe uncontrolled psoriasis, unresponsive to conventional therapy, have responded to weekly single, oral, intramuscular or intravenous doses of mg per week, and adjusted according to the patient's response.
An initial test dose one week prior to initiation of therapy is recommended to detect any idiosyncrasy. A suggested dose range is mg. An alternative dosage schedule consists of 2. A daily oral dosage schedule of 2 to 5 mg administered orally for 5 days followed by a rest period of at least 2 days may also be used.
The daily dose should not exceed 6. The patient should be fully informed of the risks involved and the clinician should pay particular attention to the appearance of liver toxicity by carrying out liver function tests before starting methotrexate treatment, and repeating these at 2 to 4 month intervals during therapy. The aim of therapy should be to reduce the dose to the lowest possible level with the longest possible rest period.
The use of methotrexate may permit the return to conventional topical therapy which should be encouraged. Use in the elderly Methotrexate should be used with extreme caution in elderly patients. A reduction in dosage should be considered.
Patients with significantly impaired hepatic function Patients with pre-existing blood dyscrasias, such as significant marrow hypoplasia, leukopenia, thrombocytopenia or anaemia. Patients with active infections. Patients with overt or laboratory evidence of immunodeficiency syndrome s. Methotrexate is contraindicated in pregnancy. Because of the potential for serious adverse reactions from methotrexate in breast fed infants, breast feeding is contraindicated in women taking methotrexate.
Patients with a known allergic hypersensitivity to methotrexate or any of the other ingredients should not receive methotrexate. Because of the possibility of fatal or severe toxic reactions, the patient should be fully informed by the physician of the risks involved and be under his constant supervision.
Larger presentations are not suitable due to the risk of accidental overdose. Acute or chronic interstitial pneumonitis, often associated with blood eosinophilia, may occur and deaths have been reported. Symptoms typically include dyspnoea, cough especially a dry non-productive cough and fever for which patients should be monitored at each follow-up visit. Patients should be informed of the risk of pneumonitis and advised to contact their doctor immediately should they develop persistent cough or dyspnoea.
Methotrexate should be withdrawn from patients with pulmonary symptoms and a thorough investigation should be made to exclude infection. If methotrexate induced lung disease is suspected treatment with corticosteroids should be initiated and treatment with methotrexate should not be restarted.
When a patient presents with pulmonary symptoms, the possibility of Pneumocystis carinii pneumonia should be considered. Methotrexate has the potential for serious, sometimes fatal toxicity.
The toxic effects may be related in frequency and severity to the dose or frequency of administration but have been seen at all doses. Because the toxic reactions can occur at any time during therapy, the patients have to be observed closely and must be informed of early signs and symptoms of toxicity. Use caution when administering high-dose methotrexate to patients receiving proton pump inhibitor PPI therapy. In two of these cases, delayed methotrexate elimination was observed when high-dose methotrexate was co-administered with PPIs, but was not observed when methotrexate was co-administered with ranitidine.
However, no formal drug interaction studies of methotrexate with ranitidine have been conducted. Deaths have been reported with the use of methotrexate in the treatment of psoriasis. Full blood counts should be closely monitored before, during and after treatment. If a clinically significant drop in white-cell or platelet count develops, methotrexate should be withdrawn immediately. Patients should be advised to report all symptoms or signs suggestive of infection.
Methotrexate may be hepatotoxic, particularly at high dosage or with prolonged therapy. Liver atrophy, necrosis, cirrhosis, fatty changes, and periportal fibrosis have been reported. Since changes may occur without previous signs of gastrointestinal or haematological toxicity, it is imperative that hepatic function be determined prior to initiation of treatment and monitored regularly throughout therapy. If substantial hepatic function abnormalities develop, methotrexate dosing should be suspended for at least 2 weeks.
Special caution is indicated in the presence of pre-existing liver damage or impaired hepatic function. Concomitant use of other drugs with hepatotoxic potential including alcohol should be avoided.
Therefore it is not recommended in women of childbearing potential unless there is appropriate medical evidence that the benefits can be expected to outweigh the considered risks. Pregnant psoriatic patients should not receive methotrexate. Renal function should be closely monitored before, during and after treatment. Caution should be exercised if significant renal impairment is disclosed.
© Copyright 2017 Methotrexate koçak 50mg. Indications for Methotrexate injection: Breast cancer. Adult: See full labeling. Children: Not established. Contraindications: Pregnancy (Cat. X). Nursing mothers. Warnings/Precautions: Be fully familiar with this drug's toxicity before use. Discontinue if malignant lymphomas occur..