All Medications
Common brand names
- Jylamvo
- Trexall
- Various
- Xatmep
How it is administered
Methotrexate can be administered in several ways, depending on the specific condition being treated:
- Oral tablets or oral solution: Taken by mouth, usually once weekly. Available as tablets (2.5 mg) or oral solution (2 mg/mL).
- Injection: Given by a healthcare provider 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.
Your doctor will decide the best form and schedule for you based on your diagnosis and treatment plan.
How it works
Methotrexate works by blocking an enzyme called dihydrofolate reductase. This enzyme is necessary for cells to make DNA and replicate. By inhibiting this enzyme, methotrexate interferes with the ability of rapidly dividing cells, such as cancer cells, to grow and multiply.
Because blood cancers like lymphoma involve rapidly dividing abnormal cells, methotrexate can slow or stop their growth. It also affects other rapidly dividing cells in the body, which is why it can cause side effects. Methotrexate is considered a type of chemotherapy and is used alone or in combination with other medications to treat various cancers, including certain types of lymphomas and leukemias.
Common side effects
- Ulcerative stomatitis (mouth sores)
- Leukopenia (low white blood cell count)
- Nausea
- Abdominal distress
- Fatigue
- Fever
- Dizziness
- Elevated liver tests
- Vomiting
- Rash or itching
- Diarrhea
- Hair loss (alopecia)
Serious side effects can also occur, including infections, liver or kidney problems, lung issues, and severe skin reactions. Always report any new or severe symptoms to your healthcare provider.
Who should take it
Methotrexate is used to treat adults with certain types of blood cancers, including:
- Acute lymphoblastic leukemia (ALL) in adults and children as part of combination chemotherapy
- Mycosis fungoides (a type of cutaneous T-cell lymphoma)
- Relapsed or refractory non-Hodgkin lymphoma as part of a metronomic combination regimen
It may also be used for other cancers and some autoimmune diseases, but for blood cancers, your doctor will decide if methotrexate is right for you based on your specific diagnosis and health needs. It is sometimes used in combination with other chemotherapy drugs.
Who should not take it
Methotrexate should not be used in:
- Pregnant women being treated for non-cancerous conditions, due to the risk of harm to the unborn baby
- Anyone with a history of severe allergic reactions (anaphylaxis) to methotrexate
It should be used with extreme caution in people with liver or kidney disease, active infections, or significant fluid collections in the body (like pleural effusions or ascites). Your doctor will review your medical history and may order tests before starting methotrexate to ensure it is safe for you.
Commonly used with
Methotrexate is often used in combination with other chemotherapy drugs, depending on the type of cancer being treated. For blood cancers, it may be part of a multi-drug regimen with medications such as:
- Vincristine
- Prednisone
- Doxorubicin
- Cyclophosphamide
- Cytarabine
- Leucovorin (used as a 'rescue' medication to reduce toxicity)
Your treatment plan will be tailored to your specific diagnosis.
Commonly tested with
Methotrexate is commonly tested with other chemotherapy agents in clinical trials for blood cancers. These may include drugs like vincristine, doxorubicin, cyclophosphamide, cytarabine, and others. It is also tested with supportive medications like leucovorin to manage side effects and improve safety.