Methotrexate

Metoject®, Methrexx®, weitere
Blood count, (if leukocytes < 3x103/μl: differential blood count), liver values, kidney values, hepatitis B/C, chest x-ray (for pathol. Rx: lung function recommended)
s.c. or p.o.
5 - 15 mg/week initial, 10 - 30 mg/week maintenance dose, 24 - 48h after application 5 mg folic acid p.o.
4 - 6 weeks
Renal insufficiency (dose adjustment), pulmonary diseases, live vaccines, polypharmacy, planned conception (male and female)
Excessive alcohol consumption, liver disease, bone marrow disease, kidney disease, immune deficiency, peptic ulcer, pregnancy and breastfeeding
Stomatitis, nausea, upper abdominal complaints, diarrhoea, hair loss -> dose reduction. Gl-hemorrhage, infections, transaminase increase -> interruption. Pneumonitis -> abortion. In case of overdose: Leukovorin
No more upper limits to stick to. Cumulative dose controversially discussed: 1.5 g according to literature the max. cumulative dose. Annual Fibroscan recommended at USZ
intralesional