What is Methotrexate?

Methotrexate is an antitumor, cytostatic, and immunosuppressive medication. The medication has a pronounced immunosuppressive effect even in relatively low dosages that do not have hematological toxicity (blood toxicity). Due to this, Methotrexate is wider than other cytostatics with immunosuppressive activity is used as an immunosuppressant.
The formulation represses the synthesis and reparation of DNA of target cells, i.e. fast-dividing cancer cells, and stops the growth of tumors.

You can buy Methotrexate if your doctor prescribes it to you for:
- Uterine carcinoma;
- Leukemia;
- Tumors of the central nervous system;
- Cancer of breasts;
- Lung, bladder, bones, soft tissues, stomach, and other organs cancers;
- Hodgkin's lymphoma;
- Non-Hodgkin’s lymphoma;
- Refractory psoriasis;
- Rheumatoid arthritis.

The medication is available in different forms for intravenous and oral use. You need to clarify with your doctor what form of the medication is needed for your diseases as it is a decisive factor.

Prohibitions for Methotrexate use

- Allergy to the medication’s components;
- Alcoholism;
- Immunodeficiency;
- Anemia;
- Severe infections (for instance, tuberculosis);
- Blood disorders;
- Leukemia with an increased risk of bleeding;
- Renal or hepatic failure;
- Pregnancy and breastfeeding;
- Live vaccines use.

Limitations for use (risks and benefits must be assessed):

- Infectious diseases;
- Oral and digestive tract ulcers;
- Recent surgery;
- Gout or kidney stones in history;
- Elderly and childhood age.

Can the formulation be used when expecting a baby?

No, the medication is strictly prohibited for pregnant women as it can cause the death of the fetus or severe congenital malformations.

Adverse reactions the formulation can cause

When you buy generic Methotrexate, you should know that the most dangerous adverse reactions related to medication use are the dysfunctions of the blood system and digestive tract disorders. The negative effects are invertible when early diagnosed. In their occurrence, the dosage of the medication should be lowered or the therapy interrupted with the resuming of the therapy with the minimal dosages and caution.
- Inhibition of bone marrow function, blood disorders, anemia, or a set of these conditions; pancytopenia, megaloblastic anemia. The first signs of these disorders are fever, sore throat, and ulcers of the mouth, flu-like symptoms, severe fatigue, nosebleeds, and hemorrhages. The use of the medication must be immediately stopped in a significant decrease in the number of red blood cells.
- Sluggishness, headache, weakness, vision failure, pain, myasthenia gravis,  seizures.
- Blurred vision, eye irritation, conjunctivitis, vision loss, edema of the eyelids, blepharitis, epiphora, and photophobia, transient blindness.
- Dry, unproductive cough, wheezing, fever, acute pulmonary edema, asthma,
- Lack of appetite, pain in the abdomen, ulcers of the mouth and throat, dyspepsia, diarrhea was observed, ulcers of the digestive tract, enteritis, pancreas dysfunction, hepatitis, and others.
- Inflammation of the bladder, renal dysfunction, urinary disorders such as oliguria, anuria, electrolyte imbalance, azotemia, and proteinuria.
- Rash, skin itching, sensitivity to light, hair loss, shingles, urticaria, allergic swelling, and others.
- Muscle pain, osteoporosis, stress fractures.
- Lowered resistance to infections, pharyngitis,and fever.
- Vasculitis, bleeding of various localization, hypotension, thromboembolic phenomena.
- Ulcers and inflammations of the vagina, lowered sex drive, erectile dysfunction, reduced sperm count in semen, menstrual disorders, inability to conceive, and gynecomastia have been recorded.
- Depression, confusion, mood changes, sometimes insomnia, transient disturbance of perception.

Serious adverse reactions can develop even with low-dose treatment, so it is important to supervise the patient’s condition regularly at short intervals.

Medication dosing

The treatment with the medication must be made under the supervision of an experienced oncologist, dermatologist, or rheumatologist depending on the condition treated. The medication is used once a week. The dosages provided here are general. You need to get individual instructions before you order Methotrexate and start using it.
The pills should be swallowed without chewing or crushing one hour before or 1.5-2 hours after a meal.
For cancer treatment, the formulation can be used orally in the dosage up to 30 mg/square meter. Higher dosages should be infused.

Dosage adjustments

- The medication should be cautiously used by individuals with kidney dysfunction. The dosages are adjusted based on creatinine clearance rate. For cc lower than 20 ml per minute, the medication is prohibited.
- Liver dysfunction also requires dosage adjustment based on the level of bilirubin.
- Since liver and kidney function deteriorates with age, and folate reserves decrease, it may be advisable to reduce doses for elderly patients.

Methotrexate overdose

The most usual symptoms of an overdose are induced by the depression of the blood system and include inflammation of the mucous membranes, stomatitis, ulceration in the mouth, nausea, ulceration, and bleeding in the digestive system. In some patients, overdose symptoms were absent.
The use of the medication every day instead of once a week can lead to death.
The treatment implies the use of an antidote, calcium folinate, which neutralizes the toxic adverse reactions of Methotrexate. The use of the formulation is made at a hospital.

Methotrexate interactions

When you order generic Methotrexate, you should know that it can interact with other medicines that you use or plan to use:
- The medication use is prohibited along with living vaccines use;
- The effect of the medication, as well as its toxic impact, is enhanced by the use of NSAIDs, barbiturates, sulfonamide medications, corticosteroids, tetracycline antibiotics, para-aminobenzoic and para-amino-hippuric acids, and other medications;
- Folic acid lowers the effect of the formulation;
- The risk of bleedings is increased when the medication is used along with indirect anticoagulants;
- The washing out of the medication is lowered by the use of penicillins;
- The effect of the medication can be eliminated when it is used with asparaginase;
- Neomycin taken orally can interfere with the absorption of Methotrexate taken orally;
- Medications that induce pathological changes of the blood enhance the negative effects on the blood of the formulation;
- The bone marrow suppression is enhanced in the combined use of the medication with any medications that also have this effect or radiotherapy;
- The synergic antitumor effect is possible in the use of the formulation with cytarabine.

Precautions and special recommendations

- The medication is used under strict supervision of a qualified healthcare provider. To identify the intoxication on time, it is needed to control blood composition every other day, then once in ten days, and once in two weeks in remission, renal and hepatic function, and do an x-ray of chest;
- If the number of lymphocytes, neutrophils, or platelet falls below the established norm, the use of the medication is stopped. The elevation of creatinine in the plasma by 50% compared to the initial requires repeated test and possible cessation of the therapy. The raise in bilirubin indicates the need of intensive detox therapy;
- During the use of the formulation, increased water intake is required;
- General condition worsening is possible in the therapy start after radiotherapy, chemotherapy, sulfonamides, amidopirin derivatives, chloramphenicol, and other formulations which suppress bone marrow. The risk is higher in senior individuals and kids;
- In the occurrence of diarrhea and inflammation of the mouth mucosa, the therapy must be interrupted for the prevention of hemorrhagic enteritis;
- In pulmonary toxicity (specifically dry cough), the therapy is advised to be ceased as there is a risk of permanent toxic damage of the lungs;
- During the therapy, it is advised to refrain from alcohol use and use of any medications that have a negative effect on the liver;
- In combined therapy, every medication must be taken in the set time;
- During the therapy, it is prohibited to get vaccinated and it is advised not to interact with people who are vaccinated or have any bacterial or viral infections;
- Any signs of bone marrow suppression such as bleedings or hemorrhages, bruising, dark stool or visible blood in it or urine require immediate consultation with a medical professional;
- It is advised to be careful with any sharp objects, beware of traumas and injuries as the medication makes the likelihood of bleeding very high. Be careful brushing teeth, flossing, doing manicure, and other regular chores;
- It is advised to finish or dental procedures before the therapy is started or after it when the blood indicators are back to normal.

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Our doctor prescribes online for free, and there is no doctor’s consultation fee.

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