How it is administered

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

• Oral tablets or oral solution: Taken by mouth, usually once weekly. Available as tablets (such as 2.5 mg) or as a liquid solution (such as 2 mg/mL in Jylamvo).
• Injection: Can be given by intravenous (IV), intramuscular (IM), subcutaneous (under the skin), or intrathecal (into the spinal fluid) injection. Some forms are preservative-free for specific uses like intrathecal administration.

The route and dose are determined by your healthcare provider based on your diagnosis and treatment plan.

How it works

Methotrexate works by blocking an enzyme called dihydrofolate reductase. This enzyme is needed for cells to make DNA and other important molecules. By blocking this enzyme, methotrexate stops cells from growing and dividing, especially cells that grow quickly, like cancer cells.

In blood cancers such as large B cell lymphoma and other non-Hodgkin lymphomas, methotrexate helps slow or stop the growth of cancerous cells. It is particularly effective against rapidly dividing cells, which makes it useful in the treatment of various cancers. Methotrexate may also affect normal cells that divide quickly, such as those in the bone marrow, mouth, and intestines, which can lead to side effects.

The medication is often used as part of a combination chemotherapy regimen, meaning it is given along with other cancer drugs to increase effectiveness.

Who Should take it

Methotrexate is indicated for adults with relapsed or refractory non-Hodgkin lymphoma, including large B cell lymphoma, as part of a metronomic combination chemotherapy regimen. It is also used in the treatment of other blood cancers, such as acute lymphoblastic leukemia (ALL), and in some cases for mycosis fungoides (a type of cutaneous T-cell lymphoma).

Your healthcare provider will determine if methotrexate is appropriate for you based on your specific diagnosis, overall health, and previous treatments. Methotrexate is also used for other conditions, such as rheumatoid arthritis and severe psoriasis, but in lower doses.

Who should not take it

Methotrexate should not be taken by:

• Pregnant women for non-cancer conditions, as it can cause serious harm to the unborn baby.
• Anyone with a history of severe hypersensitivity reactions (such as anaphylaxis) to methotrexate.
• People who cannot swallow tablets (for oral forms).

Methotrexate should be used with caution or avoided in patients with severe liver disease, significant kidney impairment, or active infections. Always inform your healthcare provider of your full medical history before starting methotrexate.

Commonly used with

Methotrexate is often used as part of a combination chemotherapy regimen for blood cancers. This means it is given along with other cancer drugs to improve treatment outcomes. The specific combination will depend on your type of lymphoma or leukemia and your overall treatment plan.

In some regimens, methotrexate may be paired with drugs like cytarabine, vincristine, cyclophosphamide, doxorubicin, and others. Your healthcare team will explain the combination and schedule that is right for you.

Commonly tested with

Methotrexate is commonly tested in combination with other chemotherapy agents in clinical trials for blood cancers, including large B cell lymphoma and other non-Hodgkin lymphomas. It may be tested with drugs such as cytarabine, vincristine, cyclophosphamide, doxorubicin, and others to determine the most effective regimens.

Clinical trials may also examine methotrexate with supportive medications like leucovorin (to reduce side effects) and in different dosing schedules or routes of administration.