Methotrexate

Question 1

What’s methotrexate used for?

Answer 1

Treatment of: Moderate to severe active rheumatoid arthritis, Crohn’s disease, malignant disease, psoriasis

Question 2

Methotrexate side effects

Answer 2

Blood dyscrasia
Liver toxicity/cirrhosis
Pulmonary toxicity

GI ulcers + bleeding
Hepatoxicity

Question 3

Methotrexate monitoring

Answer 3

FBC for blood dyscrasias - report any sore throat, signs of infection, bruising, mouth ulcers

LFTs for liver toxicity - before starting treatment - report liver tox - n+v, abdominal discomfort or dark urine

Report any pulmonary - shortness of breath, cough or fever

Question 4

Methotrexate interactions

Answer 4

NSAIDS/aspirin - leads to rise in methotrexate levels. monitor. care with otc.

Question 5

Oral dose of methotrexate? Max dose?

Answer 5

7.5mg once weekly

Max weekly dose 20mg

Question 6

Why need to give folic acid with methotrexate?

Answer 6

5mg - prevent mucositis/myelosuppression. Don’t give at same time.