How it is administered

Methotrexate can be given in several forms:

• Oral tablets or solution: Taken by mouth, usually once a week. Tablets are available in 2.5 mg strength, and oral solutions (such as Jylamvo) are also available.
• Injection: Can be administered by a healthcare professional as an intravenous (IV), intramuscular (IM), subcutaneous (under the skin), or intrathecal (into the spinal fluid) injection. Injectable forms come in vials with or without preservatives, depending on the route and patient needs.

Your doctor will choose the best form and dose for your specific situation.

How it works

Methotrexate is a type of chemotherapy medication known as an antimetabolite. It works by blocking an enzyme called dihydrofolate reductase. This enzyme is important for making DNA and other genetic material that cells need to grow and divide.

By blocking this enzyme, methotrexate interferes with the ability of cells to make new DNA. This is especially effective against rapidly dividing cells, like cancer cells in blood cancers such as leukemia and lymphoma. However, it can also affect normal cells that grow quickly, such as those in the bone marrow, mouth, and digestive tract, which is why side effects can occur.

Methotrexate is used in various blood cancers and other conditions because it helps stop the growth and spread of abnormal cells.

Who Should take it

Methotrexate is used for:

• Treatment of adults and children with acute lymphoblastic leukemia (ALL), as part of a combination chemotherapy regimen.
• Treatment of adults with mycosis fungoides (a type of cutaneous T-cell lymphoma).
• Treatment of adults with relapsed or refractory non-Hodgkin lymphoma as part of a combination regimen.

It is also used for other cancers and some autoimmune diseases, but in the context of blood cancers, it is a key part of therapy for certain leukemias and lymphomas. Your doctor will determine if methotrexate is appropriate based on your diagnosis, overall health, and other medications you may be taking.

Who should not take it

Methotrexate should NOT be taken by:

• Pregnant women being treated for non-cancerous diseases, due to the risk of harm or death to the unborn baby.
• Anyone with a history of severe allergic reactions (including anaphylaxis) to methotrexate.

Special caution is needed for those with liver or kidney disease, active infections, or bone marrow suppression. Your doctor will review your medical history and may monitor your blood tests closely if you have risk factors. Always inform your healthcare team of all your medical conditions and medications.

Commonly used with

Methotrexate is often used in combination with other chemotherapy drugs as part of a treatment regimen for blood cancers. For example, in acute lymphoblastic leukemia (ALL), it may be combined with medications such as vincristine, prednisone, and asparaginase, among others.

Folic acid or folinic acid (leucovorin) may also be given to help reduce some side effects, especially in non-cancer uses or high-dose regimens.

Commonly tested with

Methotrexate is commonly tested in combination with other chemotherapy agents in clinical trials for blood cancers. These may include drugs such as cytarabine, mercaptopurine, cyclophosphamide, and others, depending on the specific type of leukemia or lymphoma being treated.

Your doctor will determine the best combination based on the latest research and your individual needs.