PEBC: What You Need to Know: Methotrexate

Indications: Rheumatoid arthritis, psoriasis, certain cancers


Dose: most of the time weekly or cyclical basis

-tablets: with food to reduce nausea

-may be given subcutaneously, intramuscularly and intravenously depending on indication

-large doses require adequate hydration (for kidney protection)


Contraindications:

-pregnancy (off-label it is used to induce abortion)


Adverse Effects:

-mouth ulcers, gastric ulcers and nausea - due to folate depletion - supplement with folic acid at least 24 hours after methotrexate dose

-fatigue

-alopecia

-renal failure: adequate hydration is key

-pneumonitis