Methotrexate teratogenicity

Methotrexate, an antimetabolite, is indicated for moderate to severe psoriasis. It is particularly beneficial for psoriatic arthritis. It is also indicated for patients refractory to topical or UV therapy. Methotrexate can be administered orally, subcutaneously, or intramuscularly. The starting dose is 7.5 to 15 mg per week, increased incrementally by 2.5 mg every 2 to 4 weeks until response maximal doses are approximately 25 mg/wk. Adverse effects include nausea, vomiting, mucosal ulceration, stomatitis, malaise, headache, macrocytic anemia, and hepatic and pulmonary toxicity. Nausea and macrocytic anemia can be ameliorated by giving oral folic acid 1 to 5 mg/day. Methotrexate should be avoided in patients with active infections and in those with liver disease. It is contraindicated in pregnancy because it is teratogenic. 

E. Treatment guidelines suggest the use of DMARDs early in the course of rheumatoid arthritis to slow the joint deterioration associated with the disease. Methotrexate is the DMARD of choice for people with moderate to severe forms of rheumatoid arthritis. Although NSAIDs can decrease methotrexate clearance, NSAIDs can be safely used with the low doses of methotrexate used in the therapy of rheumatoid arthritis. Methotrexate is highly teratogenic and should not be used by women who are or may become pregnant. 

Methotrexate (Rheumatrex Dose Pack, Trexall) [Antineoplastic, Antirheumatic (DMARDs), Immunosuppressant/ Antimetabolite] WARNING Administration only by experienced healthcare provider do not use in women of childbearing age unless absolutely necessary (teratogenic) impaired elimination w/ impaired renal Fxn, ascites, pleural effusion severe myelosuppression if used w/ NSATDs hepatotox can induce lung Dz ... 

Drugs known to be teratogenic include cytotoxics, warfarin, alcohol, lithium, methotrexate, phenytoin, valproate, ACE inhibitors and isotretinoin. Selective interference can produce characteristic anatomical abnormalities, and the phocomelia (flipper-Uke) limb defect was one factor that caused thalidomide to be so readily recognised. (For an account of thalidomide see p. 81.)... 

Malignant lymphomas have been reported in several patients treated with methotrexate. In some cases, lymphomas regressed when methotrexate was discontinued, strongly suggesting a causal relationship. Methotrexate is contraindicated in pregnant women because it is teratogenic. ... 

Methotrexate Anticancer Nausea, mucosal ulcers, hematotoxicity, teratogenicity... 

Exp. reprod. and teratogenic effects (large dose), human adverse systemic effects (large dose), exp. antineoplastic agent (and in co-administration with methotrexate, see Methotrexate). LD50 (mus, ipr) 2512 mg/kg. XP2071000 3 -Phosphate See Thymidine 3 -phos-phate, T-107... 

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