Methotrexate is an antimetabolite used to treat certain types of cancer

Methotrexate: instruction, and the use of formula


Mode of action – antineoplastic, cytostatic, immunosuppressive.

It inhibits dihydrofolate reductase (DGF), which converts dihydrofolate tetrahydrofolic

The nosological classification

C00-C14 Malignant neoplasms of lip, oral cavity and pharynx

C15-C26 Malignant neoplasms of digestive organs

C16 Malignant neoplasm of stomach

C30 Malignant neoplasm of nasal cavity and middle ear

C30-C39 Malignant neoplasms of respiratory and chest

C31 Malignant neoplasm of accessory sinuses

C32 Malignant neoplasm of the larynx

Methotrexate is an antimetabolite used to treat certain types of cancer

Methotrexate is an antimetabolite used to treat certain types of cancer

C34 Malignant neoplasm of bronchus and lung

C40 Malignant neoplasm of bone and articular cartilage of limbs

C41 Malignant neoplasm of bone and articular cartilage of other and unspecified sites (osteosarcoma, osteogenic carcinoma)

C44 Other malignant neoplasms of skin

C45 Mesothelioma

C45-C49 Malignant neoplasms of mesothelial and soft tissue

C49 Malignant neoplasm of other types of connective and soft tissue

C50 Malignant neoplasm of breast

C53 Malignant neoplasm of the cervix

C54 Malignant neoplasm of corpus uteri

C56 Malignant neoplasm of ovary

C58 Malignant neoplasm of placenta

C62 Malignant neoplasm of testis

C67 Malignant neoplasm of bladder

C69.2 Malignant neoplasm of the retina

C71 Malignant neoplasm of brain

C76.0 Malignant neoplasm of head, face and neck

C81 Hodgkin’s disease [lymphoma]

C81-C96 Malignant neoplasms of lymphoid, haematopoietic and related tissue

C82 Follicular [nodular] non-Hodgkin’s lymphoma

C83 Diffuse non-Hodgkin’s lymphoma

Large-C83.3 (diffuse) non-Hodgkin lymphoma

C83.7 Burkitt’s tumor

C84.0 Mycosis fungoides

C84.1 SĂ©zary’s disease

C85 Other and unspecified types of non-Hodgkin’s lymphoma

C85.0 lymphosarcoma

C91.0 Acute lymphoblastic leukemia

L40 Psoriasis

M06.9 Rheumatoid arthritis, unspecified

Application of the Methotrexate

Horionkartsinoma uterus, acute lymphocytic leukemia, central nervous system tumors (leukemoid infiltration of the meninges), breast cancer, head and neck cancer, lung cancer, bladder, stomach; Hodgkin’s disease, non-Hodgkin’s lymphoma, retinoblastoma, osteosarcoma, Ewing’s sarcoma, soft tissue sarcoma; refractory psoriasis (only when the diagnosis in case of resistance to other forms of therapy), rheumatoid arthritis.


Hypersensitivity, immune deficiency, anemia (including hypo-and aplastic), leukopenia, thrombocytopenia, leukemia with hemorrhagic syndrome, liver or kidney failure.

Restrictions apply

Infectious diseases, ulcers of the mouth and digestive tract, recently transferred operations, gout or renal calculi in the history of (risk of hyperuricemia), the elderly and children’s age.

Side effects

From the nervous system and sensory organs: encephalopathy (especially with the introduction of multiple doses of intrathecal as well as in patients after brain irradiation), dizziness, headache, blurred vision, drowsiness, aphasia, back pain, muscle stiffness back of the neck, convulsions, paralysis, hemiparesis; in some cases – fatigue, weakness, confusion, ataxia, tremors, irritability, coma; conjunctivitis, excessive lacrimation, cataract, photophobia, cortical blindness (at high doses).

Cardio-vascular system (blood, hemostasis): anemia, leukopenia, thrombocytopenia, neutropenia, lymphopenia (particularly T-lymphocytes), hypogammaglobulinemia, hemorrhage, septicemia due to leukopenia; rarely – pericarditis, pericardial effusion, hypotension, thromboembolic changes (arterial thrombosis, cerebral thrombosis, deep vein thrombosis, renal vein thrombosis, thrombophlebitis, pulmonary embolism).

From the respiratory system: rarely – interstitial pneumonitis, pulmonary fibrosis, exacerbation of pulmonary infections.

From the digestive tract: gingivitis, pharyngitis, ulcerative stomatitis, anorexia, nausea, vomiting, diarrhea, difficulty swallowing, melena, ulceration of the gastrointestinal mucosa, gastrointestinal bleeding, enteritis, liver damage, fibrosis and cirrhosis of the liver (the probability is increased in patients receiving continuous or long-term therapy).

With the genitourinary system: cystitis, nephropathy, azotemia, hematuria, or severe hyperuricemia nephropathy, dysmenorrhea, unstable oligospermia, violation of oogenesis and spermatogenesis process, fetal defects.

For the skin: skin erythema, itching, hair loss (rarely), photosensitivity, ecchymosis, acne-like rash, abrasions, peeling, de- or hyperpigmentation of the skin, blisters, folliculitis, telangiectasia, toxic epidermal necrolysis, Stevens – Johnson.

Allergic reactions: fever, chills, rash, hives, anaphylaxis.

Other: immunosuppression, rarely – opportunistic infections (bacterial, viral, fungal, protozoal), osteoporosis, vasculitis.

Pregnancy and breast-feeding

Contraindicated during pregnancy (may cause fetal death or cause birth defects).

Category effects on the fetus by FDA – X.

At the time of treatment should stop breastfeeding.