Gastrointestinal symptom methotrexate

METHOTREXATE ANTIMALARIALS -PYRIMETHAMINE t antifolate effect of methotrexate Pyrimethamine should not be used alone and is combined with sulfadoxine. Pyrimethamine and methotrexate synergistically induce folate deficiency Although the toxic effects of methotrexate are more frequent with high doses of methotrexate, it is necessary to do an FBC, liver and renal function tests before starting treatment even with low doses, repeating these tests weekly until therapy is stabilized and thereafter every 2-3 months. Patients should be advised to report symptoms such as sore throat and fever immediately, and also any gastrointestinal discomfort. A profound drop in white cell count or platelet count warrants immediate stoppage of methotrexate therapy and initiation of supportive therapy... 

Check FBC, U Es and LFTs before starting treatment, repeating weekly until stabilized and then every 2-3 months. Patients should be advised to report symptoms such as sore throat, fever or gastrointestinal discomfort immediately. Stop methotrexate and initiate supportive therapy if the white cell or platelet count drops. Do not administer aspirin within 10 days of high-dose methotrexate treatment... 

Gastrointestinal Pseudomembranous colitis occurred in a 13-year-old boy with rheumatoid arthritis taking methotrexate [74 ]. His symptoms improved after withdrawal of methotrexate and administration of metronidazole. 

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