METHOTREXATE

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INTRODUCTION

• It is a folic acid antagonist

• MTX / amethopterin
• Uses- it is used to treat severe
psoriasis, rheumatoid arthritis
and also an anti-cancer drug
• Other uses – Crohn’s disease,
multiple sclerosis, other
autoimmune diseases.
PHARMACOLOGY

Structure

Absorption & Distribution

Mechanism of action
INDICATIONS

• PSORIASIS
Erythrodermic psoriasis
Psoriatic arthritis
Pustular psoriasis
Extensive plaque psoriasis
Palmoplantar psoriasis
Recalcitrant psoriasis
Other
Indications
• Bullous pemphigoid
• Rheumatoid arthritis
• Pemphigus vulgaris
• Systemic sclerosis
• Dermatomyositis
• Cicatricial pemphigoid
Dermatologic Indications
• PSORIASIS
• Major clinical use of MTX is therapy of Psoriasis.
• Uncontrolled by conventional methods, or not responding to
conservative therapies.
• Only absolute contraindication to the use of MTX are pregnancy and
lactation.
• Response to MTX therapy typically demonstrates within 1-4 weeks.
 REGIMEN GIVEN IN PSORIASIS
• Test dose (often skipped) of 2.5-5 mg.
• Then 7.5-25 mg/week (adult dose) orally can be given as a single dose
or three divided doses at 12 hourly intervals.
ADVERSE DRUG REACTIONS
• Bone marrow suppression
• Hepatotoxicity
• Ulcerative stomatitis
• Pulmonary toxicity – Causes acute pneumonitis
• Pancytopenia
Immunobullous Dermatosis
• Bullous pemphigoid
• Pemphigus
• Cicatricial pemphigoid