antimetabolite drugs which exert their immunosuppressive effect by interfering with normal B and T lymphocytes activity
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Prototye Med
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Methotrexate (Rheumatrexate, Trexall)
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Other Meds
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Leflunomide (Arava)
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Decrease joint inflammation and subsequently joint damage
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Bone marriw suppression (Decrease platelets, red and white blood cells)
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Increased risk of infection
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Liver damage
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Gastrointestinal ulceration
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Pulmonary fibrosis
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Dizziness and headache
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Neausea and vomiting
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Monitor for decreased platelets, red and white blood cell counts
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Monitor for signs and symptoms of infection
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Monitor liver function tests and observe for jaundice
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Monitor for gastrointestinal bleeding (with methotrexate).
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Monitor for respiratory distress and decreased oxygenation
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Monitor for abdominal pain, diarrhea, nausea and vomiting
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Give methotrexate once a week via route prescribed (oral, subcutaneous, or intramuscular)
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Folic acid supplement may be prescribed to decrease risk of toxicity
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Report abnormal bleeding, bruising, or petechiae (pinpoint areas of blood under the skin). Report ulcerations of the mouth or tongue.
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Report signs and symptoms of infection immediately.
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Avoid ingesting alcohol.
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Report yellowing of the skin and eyes immediately.
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Report blood in vomitus or stools.
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Report difficulty breathing or shortness of breath.
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Drink adequate amounts (2L) of water daily to ensure excretion of drug.
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Follow advice of Healthcare provider regarding contraception for men and women of chold bearing age
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Avoid breastfeeding while on this drug.
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Teratogenic (methotrexate)
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Liver insufficiency or hepatitis
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Renal insufficiency
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Peptic ulcer or ulcerative colitis
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Active bacterial or viral infections
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Concurrent use of methotrexate and digoxin may reduce digoxin level
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Concurrent use of methotrexate and NSAIDs, salicylates, and sulfonamides may cause toxicity.
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Caffeine may reduce the effectiveness of methotrexate
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Concurrent use of warfarin may increase the risk for bleeding
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Alcohol use may increase risk of hepatotoxicity
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