Methotrexate

It has a cell cycle specific action-kills cells in S phase; primarily inhibits DNA synthesis, but also affects RNA and protein synthesis. It blocks the conversion of a essential coenzymes required for one carbon transfer reaction in de novo purine synthesis and amino acid interconversion.

Indications: Lymphoblastic leukaemia. Choriocar­cinoma.

Dosage of Methotrexate

Lymphoblastic leukaemia: 20-40 mg/ sqm. body surface area twice weekly Lv or Lm. Maint dose: 15-30 mg/sqm 1-2 times weekly. Chorio carcinoma: 15-30 mg daily for 5 days.

Contra Indications of Methotrexate

• Severe leucopenia or throm­bocytopenia.
• Serious anaemia

Special Precautions of Methotrexate of drug

• Use of folinic acid rescue has permitted much higher doses of methotrexate.
• Hepatic and renal dysfunction.
• C.N.S. distur­bance.
• Bone marrow depression.

Paediatrics -- Use only in cancer treatment.

Pregnancy -- Contraindicated due to its teratogenic effects.

Lactation -- Should not be used.

Elderly -- Use with caution.

Side effects of Methotrexate

• Megaloblastic anaemia,
• pancytopenia,
• Desquamation and
• bleeding may occur in G.I.T.

Drug Interaction of Methotrexate

• Salicylates,
• sulphonamides phenytoin,
• phenylbutazone,
• tetracyclines,
• chloram: phenicol and para-aminobenzoic acid increase tox­ icity.
• Asparginase reduces toxicity.

Cancer Tip Remember, there are hundreds, possibly thousands of cancer fighting phytochemicals in plants. If you just stick to a familiar few types, you’ll miss out on all the other cancer fighting phytochemicals that are found in the foods you don’t eat on a regular basis.

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