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Methotrexate

Mechanism of action:

It is a folate analog. It inhibits the enzyme dihydrofolate reductase inhibiting the production of tetrahydrofolate which in turn inhibits formation of thymidylate, leading to inhibition of DNA replication & RNA transcription. It acts both on T & B cells. Methotrexate has little action on resting cells. It is mainly active against rapidly dividing immune cells.

Indication:

Juvenile rheumatoid arthritis, children with pars planitis, sarcoidosis, and scleritis associated with connective tissue disorder. Methotrexate is the first choice immunosuppressant in paediatric uveitis

Dosage:

0.1 -0.5 mg/kg/week; low dose therapy is started at a dose of 7.5 mg/week and it can be increased up to 25mg/week.Generally given orally once a week.

Side effects:

Reversible hepatotoxicities, bone marrow suppression, dry cough and interstitial pneumonia

Monitoring:

If parameters of the liver function tests are elevated to twice the normal, dosage of the drug should be adjusted or stopped.

Statutory Warning

Materials / Informations provided here are for educational purpose only ; and not to be used for medical advice, diagnosis or treatment