How it is administered

Methotrexate can be given in several forms, depending on the specific condition and patient needs:

• Oral tablets: Swallowed whole with water, typically once weekly for cancer treatment. Brands include Jylamvo (oral solution), Trexall, and Xatmep (oral solution).
• Oral solution: Liquid form for those who have difficulty swallowing tablets (e.g., Jylamvo, Xatmep).
• Injection: Methotrexate can be given by intravenous (IV), intramuscular (IM), subcutaneous (under the skin), or intrathecal (into the spinal fluid) injection. This is usually done in a hospital or clinic setting.

The specific dose and schedule depend on the disease being treated, the patient's age and weight, and other medications being used.

How it works

Methotrexate works by blocking an enzyme called dihydrofolate reductase. This enzyme is necessary for cells to make DNA and other important molecules needed for cell growth and division. By blocking this enzyme, methotrexate interferes with the ability of rapidly dividing cells—like cancer cells—to grow and multiply.

Because blood cancers like Burkitt lymphoma involve rapidly growing cancer cells, methotrexate can help slow or stop their growth. However, methotrexate also affects other fast-growing cells in the body, such as those in the bone marrow, mouth, and digestive tract. This is why it can cause side effects in these areas.

Methotrexate is often used as part of a combination chemotherapy regimen, meaning it is given with other cancer-fighting medications to increase effectiveness.

Who Should take it

Methotrexate is used to treat various cancers, including certain types of blood cancers like non-Hodgkin lymphoma (which includes Burkitt lymphoma), acute lymphoblastic leukemia (ALL), and others. It is also used for other conditions such as rheumatoid arthritis and severe psoriasis, but for blood cancers, it is typically part of a combination chemotherapy regimen.

For Burkitt lymphoma, methotrexate may be used in both adults and children as part of a multi-drug chemotherapy protocol. The exact regimen and dosing will be determined by your healthcare team based on your specific diagnosis and health status.

Who should not take it

Methotrexate should not be taken by:

• Pregnant women being treated for non-cancerous conditions, as it can cause serious harm to an unborn baby (it may be used in pregnant women for cancer only if the benefits outweigh the risks).
• Anyone with a history of severe allergic reactions to methotrexate.
• People with severe liver disease, significant kidney problems, or certain blood disorders may not be able to take methotrexate or may need close monitoring.

Always tell your healthcare provider about your full medical history, including any allergies, current medications, and if you are pregnant or planning to become pregnant.

Commonly used with

Methotrexate is usually given as part of a combination chemotherapy regimen for blood cancers. This means it is used together with other cancer drugs such as vincristine, cyclophosphamide, doxorubicin, cytarabine, and others, depending on the specific protocol for Burkitt lymphoma or other blood cancers.

Leucovorin (a form of folinic acid) may be given after methotrexate to help reduce its side effects and protect healthy cells.

Commonly tested with

Methotrexate is commonly tested in combination with other chemotherapy agents in clinical trials for blood cancers. These combinations may include drugs like vincristine, cyclophosphamide, doxorubicin, cytarabine, and others. The goal is to find the most effective and safest combinations for treating diseases like Burkitt lymphoma.

Methotrexate levels in the blood may also be monitored during treatment, especially when high doses are used, to reduce the risk of toxicity.